Managing Risk and Modifying Lifestyle: The Role of Mobile Applications (Can an App a Day Keep the Doctor Away?)

Applications for mobile devices are commonplace.  These small but often sophisticated programs are quite varied and allow for anything from vehicle GPS navigation (Google Maps), taxicab or car pickups in New York City (Uber)  or rating wines and restaurants (Zagat).  As with most new gadgets and technologies, medicine and healthcare provide many opportunities for expansion and use. When we examine the available applications found at the Apple App Store, it is evident that medical mobile applications continue to be developed at a remarkable pace.  In response, the FDA is actively involved in developing strategies for evaluation and approval of new medical related applications as the market continues to rapidly grow and evolve. (And that in itself is a whole separate issue blog about!)

As the medical application industry grows, more disease specific programs have been created.  There are already several advanced apps that allow for tracking medications, daily weights, blood pressure and blood sugars–However, some of the more popular applications focus on more basic strategies for improving overall health status.  Many of these newly developed general health and fitness applications focus on self help, diet and exercise.  As we all know, diet and exercise are key components to making wholesale lifestyle changes and these changes can significantly reduce risk for chronic disease.  It stands to reason that many of the new medically relevant applications have focused on tracking dietary habits–calorie counts, food dairies, etc.  In particular, dietary applications can make a huge difference in our behaviors.  For instance, an application that tracks everything you eat can be quite eye opening.  In general, we have no idea as to the calories we take in on a daily basis–combine this with an app that can also track calorie expenditure and you have real time data that can be the impetus for change.  Data empowers us all–both doctor and patient.

This week in the New York Times, personal tech author Kit Eaton explores several new applications for iOS and Android that are specifically devoted to diet.  These applications provide the user the ability to create a food log and to actually scan labels to obtain exact nutrition information and calorie counts.  These applications then can track your exercise habits and estimate your calorie expenditures–some are even able to make suggestions for healthy food choices based on your pattern of intake and output.  Most start with the input of basic data such as height, weight and age.  Particularly in our current era of cost containment and as we stand in the shadow of the albatross that is Affordable Care Act, we must spend more time on prevention.  Preventative care is the single most important thing physicians can do for their patients during this time of reform.  We have long known that chronic conditions such as heart disease, type 2 diabetes and hypertension are directly related to obesity.  Obesity and obesity related illnesses account for nearly 150$ billion dollars of healthcare costs each year in the US alone.  Applications that provide assistance in lifestyle modification and risk factor reduction can have an enormous impact on our ability to successfully change negative habits. As we move forward as physicians, it will be important for us to engage patients and assist them in taking individual responsibility for their own health.  Applications are an important way for us to directly involve patients and promote change.

Based in California, an application known as Lift is working to make an impact now.  The motto on the Lift home page says it all:  “Unlock your potential..change your life”.  Working with researchers at UC Berkeley, Lift’s designers are now studying the effectiveness of individual diet plans on overall health and wellness.  Previous studies have compared the effectiveness of one or two diets against each other or a control–however, no one has ever evaluated several diets at one time via a mobile application.  The quantified diet project as it is known is likely to provide us with important information about the effectiveness of mobile technology and mobile “coaching” and its role in patient compliance and success.  Moreover, it will provide the opportunity to directly compare several popular diet plans all in one large study group.

Mobile applications have the potential to revolutionize preventative care.  As we continue to work to engage our patients and motivate them take individual responsibility for their health status, we must take advantage of emerging technologies.  Simple applications may result in significant changes.  Embrace change.  Embrace technology.  Advocate for your patients and prescribe an app today! (An APP a day make keep the doctor away!)

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