It?s long been a joke that when you are sick, you should never go online to look up your symptoms ? or else risk thinking that your common cold is actually a harbinger of something far more serious. ?Don?t ask Dr. Google!? your friends ? and your doctor ? will warn you, saying that the anxiety you develop from thinking that you have only days to live is bound to be far worse than any actual symptoms you have.

Yet despite the warnings, and the knowledge that we most likely don?t have an incurable disease, most of us do it anyway. The problem is only exacerbated by the hundreds of thousands of health apps that allow us to monitor our health, check our symptoms, and even ?see? a doctor without leaving home. And if you do have a chronic condition, physical or mental, there are apps designed to help you manage it. The question is, though, how much do all of these apps actually help, and is it possible to do more harm than good with a ?helpful? health app?

According to some industry advocates, the answer is yes. In the last few years alone, several studies have looked at the safety of medical and health care apps, and found some troubling information. For example:

• In 2012, the New England Center for Investigative Reporting evaluated more than 1,500 medical apps, and found that more than 20 percent of them claimed to treat or cure specific conditions, but only a handful had actual clinical approval.
• In Sydney, Australia, the Black Dog Institute found that only about 8 percent of the medical apps reviewed had actually been tested for effectiveness. 123 of those apps were marketed as ?suicide prevention? apps, but none had medically recommended levels of support, and some even provided information that could be harmful.
• Anecdotal evidence indicates that apps can cause unnecessary anxiety, or a false sense of security. In one case, for instance, an app purporting to detect skin cancer gave a user a false positive, which led to an emergency appointment to get the all clear.
• The FDA reports that an app associated with a blood glucose tracker miscalculated readings for nearly 60 patients, leading them to take too much insulin and have to be rushed to the hospital.

Still, the medical application market continues to grow, as does the number of stories of patients who have benefitted from apps. Data from fitness trackers, for instance, is now being used for cardiac patients to help determine treatment plans ? and to identify patterns that could lead to serious adverse events. These benefits beg the question: How can medical apps be made safer and avoid harming the very people they are designed to help?

Safety in Medical Apps

The responsibility for the safety of medical apps falls to app developers. With that in mind, healthcare app design needs to focus on a few key points.

QA and Testing. Patients relying on medical apps for the management of chronic conditions require accuracy. Even a seemingly minor glitch can result in significant health issues, so it is vital to test your app ? and then test it again, in every possible iteration. The app needs to be developed with physician input, and vetted by qualified professionals, to ensure that it is as perfect as possible.

Accessible UI. Who will be using your app? Is it accessible to users with varying degrees of health, technical skills, and mobility? Does it account for patient size, age, sensory limitations, etc.? While the user experience and interface is important for any app, when developing health care apps, it?s even more critical.

A user?s health can strongly influence how he or she uses the app, so you need to consider potential accommodations and build them into the app design.

Provider access. There is a growing skepticism of apps that rely entirely on one?s mobile device to provide a diagnosis or medical advice. While an app can provide general information, it should always come with a disclaimer to see a health care provider for diagnosis and treatment. Even popular apps like WebMD note that the information is not a replacement for seeing a doctor, and that the information provided is for informational purposes only.

A growing number of apps are instantly connecting users with licensed medical providers, who may be able to provide a preliminary diagnosis or advice via phone, and as the rules relating to telehealth change, that may become more commonplace. For now, though, it?s important that developers create apps, and market them in such a way that patients are clear about the limitations of the app.

Appropriate marketing. Finally, the FDA and industry groups are beginning to pay more attention to how healthcare apps are marketed, and the claims that are made. Again, apps should be designed to enhance, not replace, the care of a doctor, and should be marketed as such.

There are additional issues related to the safety of healthcare apps, including protecting data and maintaining compliance with HIPAA regulations. If apps are to remain useful, though, and the market robust, then developers need to focus on keep patients safe and not causing harm.

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