Amandeep: So a health app is a piece of software that is accessible on a tablet, smart phone or online on a desktop or laptop, that we use for perceived health benefits to patients or consumers. The whole health app area can be quite overwhelming. There are about 300,000 health apps alone in app stores. If you think about what patients and consumers are seeing, their getting exposed to these health apps and often then coming to the GP and saying “I'm using this, can I share the information with you?” or “what one do you recommend?” or “these are ones that other people have told me to use, what's your opinion?” and it can be very hard as GPs with all the other things that we need to do, to also be on top of what health apps to be referring our patients to.
Most apps in those 300,000 that I mentioned are focused on health and lifestyle. So they’re ones that are [based] around exercise, nutrition, telling people how to modify their activity levels or [are] more information based. Then there are other ones that get into the realms of diagnostic or therapeutic. If those are truly diagnostic and therapeutic apps, than we need to be mindful that they probably come under the TGA [Therapeutic Goods Administration] and need to be actually registered as medical devices on the ARTG [Australian Register of Therapeutic Goods] and then they need to go through that process. So I would be very careful about suggesting an app to a patient that was considered a medical device if I didn't see it on the ARTG. So that's another resource that you can go and check, and if that app isn't on the register then I wouldn't be prescribing it to a patient.
There are other health apps out there for medical records. So for example, for the My Health Record there are a few apps that give you a mobile version of the My Health Record. There are apps that support remote patient monitoring as well. And there's a few other categories, but those are the broad categories I think that as GPs we need to be aware of.
I'd say in the consultation “I’m happy for you to pull out the app and show me what information you have on there and I'll see how we might be able to add it to the information we're collecting generally about your history, and from your physical examination.” But I think that it does have value but I think you also need to be careful around the actual validity of the app - is it one that's trusted, is evidence-based - or if it's telling a patient that they're constantly hypertensive because they’ve been measuring their blood pressure, what is it measuring it against? How has it been calibrated? What is it defining as hypertension? I think we need to be very careful in taking any of that information and actually acting upon it unless we've got really good confidence in where that app has come from and the content in that app.
We have a fact sheet available in our resource section and that goes through some of the things that you might want to look at in an app to assess whether it's something you want to recommend to your patient or not. And this is in regards to the patient's literacy and using digital health products, the usability of the app, how engaging it is, or whether it has behavioural construct changes built into it. So there's lots of different things that you might want to assess in recommending an app, and also looking at other user reviews either on the app store or from other areas where users have commented. And there are various universities and other bodies that have done some research around apps that they would recommend so I think certainly it is worth looking at some of those resources and getting some of your top hit-list of “these are my top 5 mental health apps”. I already have this - I have my top mindfulness apps, I have my top behavioural change apps for things like smoking cessation or alcohol, so you can create your own little list of things that you have confidence in prescribing to your patients.