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Mobile Health App Makers Still Shaky On Privacy Policies

Posted on September 16, 2016 I Written By

Anne Zieger is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

A new study has concluded that while mobile health app developers are developing better privacy practices, these developers vary widely in how they share those policies with consumers. The research, part of a program launched in 2011 by the Future of Privacy Forum, concludes that while mHealth app makers have improved their practices, too many are still not as clear as they could be with users as to how they handle private health information.

This year’s FPF Mobile App Study notes that mHealth players are working to make privacy policies available to users before purchase or download, by posting links on the app listing page. It probably has helped that the two major mobile health app distribution sites require apps that collect personal info to have a privacy policy in place, but consumer and government pressure has played a role as well, the report said. According to FPF researchers, mHealth app makers are beginning to explain how personal data is collected, used and shared, a step privacy advocates see as the bare minimum standard.

Researchers found that this year, 76% of top overall apps on the iOS App Store and Google Play had a privacy policy, up from 68% noted in the previous iteration of the study. In contrast, only 61% of health and fitness apps surveyed this year included a link to their privacy policies in their app store listing, 10% less than among top apps cutting across all categories.  “Given that some health and fitness apps can access sensitive, physiological data collected by sensors on a mobile phone, wearable, or other device, their below-average performance is both unexpected and troubling,” the report noted.

This disquieting lack of thorough privacy protections extended even to apps collecting some of the most intimate data, the FPF report pointed out. In particular, a subset of mHealth developers aren’t doing anything much to make their policies accessible.

For example, researchers found that while 80% of apps helping women track periods and fertility across Google Play and the iOS App Store had privacy policies, just 63% of the apps had posted links to these policies. In another niche, sleep tracking apps, only 66% of even had a privacy policy in place, and just 54% of these apps linked back to the policy on their store page. (FPF terms this level of performance “dismal,” and it’s hard to disagree.)

Underlying this analysis is the unfortunate truth that there’s still no gold standard for mHealth privacy policies. This may be due more to the complexity of the still-maturing mobile health ecosystem than resistance to creating robust policies, certainly. But either way, this issue won’t go away on its own, so mHealth app developers will need to give their privacy strategy more thought.

Steps In Integrating Patient-Generated Health Data

Posted on May 24, 2016 I Written By

Anne Zieger is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

As the number of connected health devices in use has expanded, healthcare leaders have grappled with how to best leverage the data they generate. However, aside from a few largely experimental attempts, few providers are making active use of such data.

Part of the reason is that the connected health market is still maturing. With health tracking wearables, remote monitoring set-ups, mobile apps and more joining the chorus, it might be too soon to try and normalize all this data, much less harvest it for clinical use. Also, few healthcare organizations seem to have a mature strategy in place for digital health.

But technical issues may be the least of our problems. It’s important to note that providers have serious concerns around patient-generated health data (PGHD), ranging from questions about its validity to fears that such data will overwhelm them.

However, it’s possible to calm these fears, argues Christina Caraballo, senior healthcare strategist at Get Real Health.  Here’s her list of the top five concerns she’s heard from providers, with responses that may help put providers at ease:

  • Fear they’ll miss something in the flood of data. Add disclaimers, consent forms, video clips or easy-to-digest graphics clarifying what consumers can and can’t expect, explicitly limiting provider liability.
  • Worries over data privacy and security: Give consumers back some of the risk, by emphasizing that no medium is perfectly secure, including paper health records, and that they must determine whether the benefits of using digital health devices outweigh the risks.
  • Questions about data integrity and standardization: Emphasize that while the industry has made great process and standardization, interoperability, authentication, data provenance, reliability, validity, clinical value and even workflow, the bottom line is that the data still comes from patients, who don’t always report everything regardless of how you collect the data.
  • Concerns about impact on workflow: Underscore that if the data is presented in the right framework, it will be digestible in much the same way as other electronic medical data.
  • Resistance to pressure from consumers: Don’t demand that providers leverage PGHD out of the gate; instead, move incrementally into the PGHD management by letting patients collect data electronically, and then incorporate data into clinical systems once all stakeholders are on board.

Now, I’m not totally uncritical of Ms. Caraballo’s article. In particular, I take issue with her assertion that providers who balk at using PGHD are “naysayers” who “simply don’t want to change.” While there are always a few folks fitting this description in any profession, the concerns she outlines aren’t trivial, and brushing them off with vague reassurances won’t work.

Truthfully, if I were a provider I doubt I would be comfortable relying on PGHD, especially biometric data. As Ingrid Oakley-Girvan of Medable notes, wearables giant Fitbit was hit with a lawsuit earlier this year alleging that its heart rate monitoring technology is inaccurate, and I wouldn’t be surprised other such suits arise. Digital health trackers and apps have transitioned from novelty to quasi-official medical device very quickly — some might say too quickly – and being cautious about their output just makes sense.

Nonetheless, PGHD will play a role in patient care and management at some point in the future, and it makes sense to keep providers in the loop as these technologies progress. But rushing them into using such data would not be wise. Let’s make sure such technologies are vetted before they assume a routine role in care.

EMR Permissions, EMR and mHealth, and EMR Adoption

Posted on December 15, 2013 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.


I think these are the types of issues that annoy EMR users the most. It’s something that could no doubt be easily solved, but finding the right person to solve it is often hard.


I think the answer to this is that it will make EMR more effective. I’ve already seen it start to happen with a number of EHR.


This isn’t surprising. Clinics with more doctors are able to share the cost of EMR.

Some Perspective on Mobile Health

Posted on November 28, 2013 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

This holiday weekend with family has been really interesting. It’s been fascinating to hear what my relatives and friends have to say about the mobile revolution that’s happening in healthcare and in every part of our lives. The most interesting observation is how little many of my relatives know about what’s really happening in mobile and definitely in mobile health.

Offhand I’ve mentioned a few of these topics to my relatives to see how they respond. As is often the case, it’s met with a general silence based on their lack of understanding of the subject. They certainly listen intently, but they know so little about the subject that they have very little to add to the conversation.

Of course, I’m dealing with a relatively small sample, but I think there’s a lesson there for those of us who live, eat, and breathe this stuff every day. A huge shift is happening, but most of the people out there know nothing about it.

I’m not sure this is a bad thing. While they know very little of the high level stuff, my wife, her sisters and mother did go wait in line for the $199 iPad mini deal today. So, there’s definitely interest in the devices. Although, I think few of them have any idea of how important all of these devices will be to their lives in a few years. They did however introduce me to a pointless, but addictive game called Space Team. At least they know about the most important things.

What Healthcare Can Learn from Casinos

Posted on November 21, 2013 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

My background comes from managing large IT projects at a number of the top Casinos in Las Vegas and around the world. As I’ve switched over to healthcare there are a number of things that healthcare could learn from what Casinos do.

Customer Focused Big Data
First, casinos are very good at knowing their customers very well. All of this sits on the back of big data and we’re just getting started on this in healthcare. In the casino industry they’ve been working on it for years. The amount of data they crunch to be able to provide a better customer experience goes beyond anything people in healthcare are even thinking about doing.

The focus of data in casinos is about getting the right customers to come to your establishment and then making sure that once they’re there they get the best user experience possible. Think about this in healthcare terms. How many organizations are using big data to make sure that the right patients are visiting their hospitals? Not that many. How much data is being used to drive a patient visit in healthcare today?

In our current sick care (not “health” care) environment, it’s pretty rare that big data drives a visit. That’s not to say that some data isn’t involved in the sick care we provide today, but we rarely look to outside sources of data to really improve the patient experience. I believe this will change as more and more mobile health devices start gathering our health data in a really portable manner. The future of health will likely be similar to a casino where the experience will be customized for every patient. Mobile health apps will likely be the conduit for much of this data.

Security and Privacy
Another big lesson healthcare can learn from casinos revolves around security and privacy. You can imagine the number of threats casinos have on their IT infrastructure. Everyone would love to find a way to hack into a casino and access their hundreds of millions of dollars that’s flowing every day. Security and privacy are a core part of every thing that’s ever done in a casino.

Imagine a healthcare system that has security and privacy built into everything they do. In some respects this is the case in healthcare. Many of the organizations I talk to pay a lot of attention to the security and privacy of their health IT systems. However, the same can’t be said for many of the mobile health applications hitting the market today. There are exceptions, but many mHealth apps focus on functionality over privacy and security. This could be a real problem going forward. We need to shift the mobile health market so privacy and security are a core feature of everything we do.

Does mHealth Increase or Decrease Doctors Power Over Patients?

Posted on October 23, 2013 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.


Does this tweet rub you the wrong way?

The idea of my doctor controlling me rubs me really wrong. There is nothing in this world that I abhor more than the idea of someone controlling me. There’s probably a reason that I work for myself as a blogger, but I digress.

Maybe control is the wrong word here. Doctors have a tremendous amount of influence over patients. I know that I trust my doctor to do what’s right for me. I go into the patient experience basically trusting my physician. I don’t think that mHealth changes that trust. I guess in many ways you could describe my view as a trust but verify positioning. mHealth helps me to verify much quicker. I think that’s a great thing.

What mHealth does do is hold doctors more accountable for the service they provide. This happens in many ways in mHealth. As I mentioned, it helps patients verify what they’ve been told by their doctor. mHealth also makes accessing and doing physician reviews much easier. Whether you like them or not, they’re here to stay and people are going to look at them. Doctors are going to have to be accountable for what’s said on those. Those are just a couple of examples.

I don’t think doctors should fear a loss of control thanks to mHealth. However, they should consider how mHealth will hold them more accountable for the work they do. That will be a dramatic shift for many doctors.

Healthcare Pricing, Wiki Style EMR Editing, and Quantified Self Data – @nickdawson Edition

Posted on August 4, 2013 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

It’s time again for my roundup of interesting EMR, EHR, and Healthcare IT tweets. Today’s tweets all come from Nick Dawson. I don’t know Nick really well, but see him online quite a bit. Plus, I did a Google Plus hangout with him after TEDMED. He’s a very interesting guy and these tweets illustrate some of his thinking.


I’ve been hearing more and more of these cases and many of them are not even international. I’m not sure if the shift is because of the growth in high deductible plans, but there’s definitely a shift happening as far as awareness of what healthcare really costs. I hope we see a sea change in this regard.

Also, don’t underestimate the medical tourism part of this. I think there are going to be regions of this country and around the world that are going to battle for medical procedures. Eventually we’ll know that certain regions of the country are known for certain medical specialties just the same way we know Texas has oil and Nebraska has corn.


Just the thought of this will make many doctors stomach’s churn, but I like the concept. It would definitely need to be refined so there was a well defined chain of who edited what and when. Not to mention some sort of method for knowing when something was modified and by who. A novel concept, but not one I think we’ll find anytime soon.


I love to read stuff like this. I wonder if Nick pays for the action that happens. This is what really has doctors scared. Nick saved a visit, but the doctor missed out on the revenue that visit would have generated. It’s also why we need to start reimbursing doctors for online visits.

Study Shows Mobile Devices Increase Patient Engagement

Posted on July 15, 2013 I Written By

Katie Clark is originally from Colorado and currently lives in Utah with her husband and son. She writes primarily for Smart Phone Health Care, but contributes to several Health Care Scene blogs, including EMR Thoughts, EMR and EHR, and EMR and HIPAA. She enjoys learning about Health IT and mHealth, and finding ways to improve her own health along the way.

I’ve heard many people ask the question of whether or not mobile health care helps or hurts patient engagement. The latest study says it definitely improves it.

A study conducted by the Center for Connected Health, published in 2013, found that when a patient used a wireless device to track data, they were found to track their blood pressure more often than those who else a telephone modem device.  In this study, the median age was 61.7 years old. Here are some of the other findings:

  • Those using wireless devices recorded and engaged more frequently 
  • The number of uploads per day were higher with those using a wireless device.

Personally, this doesn’t come as much of a surprise. If I had the option of tracking health data on a mobile device, or on a regular telephone, I would definitely choose the mobile device. It’s so much more convenient, and easier to remember. I don’t know if this was an option in the study, but I know with many mobile devices, you can set up push alerts. If a person gets an alert, reminding them to record certain information, I feel like it would help as well.

What I thought was most interesting was the median age — 61.7. I don’t think it would come as any surprise that someone quite a bit younger (myself) would think that mobile healthcare would help with patient engagement, especially with the younger generation. However, the fact that the participants in this study are older, I think that is what makes this study a little more monumental.  At least with the people I know that are around that age, mobile devices can be intimidating. But if they are set up with their device, shown how it works, and understand it, I think that people of all ages will start to benefit from mobile devices.

High Costs of Health IT, ePrescribing, and HIE — #HITsm Chat Highlights

Posted on June 29, 2013 I Written By

Katie Clark is originally from Colorado and currently lives in Utah with her husband and son. She writes primarily for Smart Phone Health Care, but contributes to several Health Care Scene blogs, including EMR Thoughts, EMR and EHR, and EMR and HIPAA. She enjoys learning about Health IT and mHealth, and finding ways to improve her own health along the way.

The following is our regularly scheduled roundup of tweets from yesterday’s #HITsm chat. You can also check out John’s blog post on yesterdays #HITsm topics.

Topic One: Costs vs benefits. Will high costs always be the #1 barrier cited to #healthIT adoption?

 

Topic Two: Why does ePrescribing have such widespread acceptance while #telehealth adoption is so low?

 

Topic Three: #HIE as a noun or a verb? Does negative press for HIE organization$ hinder health data exchange as a whole?

#HITsm T4: Is #CommonWell just a bully in a fairy godmother costume?

 

Topic Five: Open forum: What #HealthIT topic had your attention this week?

Pain Squad App Helps Adolescent Cancer Patients

Posted on June 26, 2013 I Written By

Katie Clark is originally from Colorado and currently lives in Utah with her husband and son. She writes primarily for Smart Phone Health Care, but contributes to several Health Care Scene blogs, including EMR Thoughts, EMR and EHR, and EMR and HIPAA. She enjoys learning about Health IT and mHealth, and finding ways to improve her own health along the way.

I can’t even imagine what a scary experience it would be to have cancer, let along as a child. One of the ways to treat the symptoms of cancer is to understand the pain level, and what the patient is feeling. However, that can be difficult to get a full grasp on, especially in children. If they aren’t tracking it daily, then information collected can be flawed.

Last year, an app was released in beta testing at a Canadian hospital in Toronto to help doctors understand more fully what their younger patients were feeling as they underwent cancer treatment. The app, called Pain Squad, was developed using the feedback from children and teenagers who had cancer. It involves pain surveys that have to be filled out twice daily, but involves the child and engages them.

The app features videos of celebrities from popular law enforcement shows, Rookie Blue and Flashpoint, giving motivation to kids as they do a certain amount of journals in a row, and they can be promoted to different ranks. This video does a great job of explaining the app, and shows some of the videos. They are so motivating!

I really liked this quote, from the parents of a little girl named Olivia, who was a study participant:

Filling out a paper pain journal was like homework. The Pain Squad app is interactive and the more Olivia used it, the more rewards she got. It only takes a few minutes to complete but it gave Olivia a better understanding of and more control over her pain.”

Last year, this was in some of the final stages of testing, and because of it’s success, it was set to be released in other areas in Canada, as well as outside of Canada. I’m not sure if it’s officially been released since then, but I love the idea of this. There’s only so much you can determine from asking someone to point at a smiley face on a poster board to describe their pain level (I personally never really know what to say when I’m confronted with that sign!)

This app is designed for the iPhone.