ANN ARBOR, Mich. -- The smartphones that nearly all Americans carry could transform how people manage their health, especially for the tens of millions who have chronic conditions or complex health needs.

But a new study suggests that app makers are falling short on many counts when it comes to actually serving those who could get the most benefit from mobile health, or mHealth, apps.

The findings come from a team led by a University of Michigan Medical School mobile health researcher, and his colleagues at Brigham and Women's Hospital, who publish their findings in the new issue of Health Affairs.

It's based on a comprehensive review of 137 of the most highly rated or often recommended mHealth apps aimed at people with chronic conditions. They selected only the cream of the crop from the Apple and Google app stores that are aimed at people with high health needs. Such people have high health costs and may have care needs that are complicated by lower income or level of health knowledge.

But even these "best" apps for these patients fell short, say the researchers, led by first author Karandeep Singh, M.D., MMSc., an assistant professor of learning health sciences at U-M. Their key findings:

People with some conditions - such as diabetes and depression - can find a wide range of highly rated apps that offer to help them. But people with other conditions - such as arthritis or pain - find few options when they search for high-quality apps.
App store ratings, supplied by other users, aren't always a reliable guide even with highly rated apps. The researchers found that physicians and non-physicians on their evaluation team often rated apps much higher, or lower, than the app store ratings, based on how usable or useful they found the apps to be for actual patients.
Nearly all the apps (121) let people enter information into their phone about their health that day, such as a daily blood sugar or blood pressure level or whether they were feeling suicidal. But only 28 of these apps reacted appropriately when the reviewers entered a dangerous value - a blood pressure that was sky-high, a super-low blood sugar level, or a suicidal mood, for instance.
The results were somewhat better for apps aimed at certain populations: half of the apps aimed at people with asthma or stroke, and half of the few aimed targeted specifically at elderly people, responded appropriately to dangerous values entered by users.
Many apps offered tracking functions, education, reminders and alerts that could be useful to a high need, high cost population. But few provided tailored guidance based on what the user actually entered into the tracking interface, or offered ongoing engagement that rewarded "good" results.

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