There is no shortage of apps in the health and wellness space; the good news is apps that demonstrably improve health outcomes are on the rise. The challenge of embedding these apps into existing clinical workflows and Electronic Medical Records (EMR) is worthy of deeper consideration.
A new paper by William Gordon and colleagues from Brigham and Women’s Hospital, Boston, published in Nature Digital Medicine, provides a framework of critical considerations for deploying apps in health care. The authors offer elements using smoking cessation apps as an example of a clinical area that is dealt with regularly in clinical care.
The table below lists key workflow components that include:
- Making the app easy to find within the EMR
- Building triggers and prompts associated with key diagnostic categories
- Developing an App recommendation engine based on critical indicators, e.g., smoking cessation
- Designing for optimal defaults for most commonly recommended apps for frequently occurring clinical scenarios
- Providing clear documentation of app prescription in EMR
- Developing prudent data integration that supports clinical care pathways
- Securing methods to de-prescribe an app if clinical targets are achieved, or app is no longer appropriate
Adding apps to standard care will require governance and monitoring systems to be developed in existing health systems models of care to ensure apps are of high quality and that they are improving outcomes. Currently, app aggregators and digital formularies are being rolled out by companies like AppScript (IQUVIA) and CVS- these moves will, in theory, make it more accessible for health systems to enter this market as the aggregator can shoulder the burden of quality assurance. Aggregators can also be responsible for adding new apps within a disease class. The digital health marketplace is evolving rapidly, and I suspect we will see tremendous progress this year. This framework offers options for consideration for organizations that want to add digital health to their system of care.
Thanks for reading – Trina
(Opinions are my own)
Gordon, W.J., Landman, A., Zhang, H. et al. Beyond validation: getting health apps into clinical practice. npj Digit. Med. 3, 14 (2020). https://doi.org/10.1038/s41746-019-0212-z