News Feature | November 30, 2016

AMA Adopts New Policies To Integrate mHealth Apps Into Clinical Practice

Christine Kern

By Christine Kern, contributing writer

mHealth Cover Feature

AMA says mHealth principles provide important guidance for insurance coverage and payments.

The AMA has announced it is adopting a wide-ranging set of policies to help integrate the use of mHealth apps and associated devices, trackers, and sensors into clinical practice. Such principles are an integral part of the insurance coverage and payment decisions in today’s healthcare industry.

According to a September 2015 report from the IMS Institute for Healthcare Informatics, more than 165,000 mHealth apps are currently available to patients, yet there is no consistent standard or quality for mHealth apps. This causes a conundrum in terms of knowing which apps to use and which apps should be supported by insurance.

While some mobile apps and devices are subject to FDA regulation, others are not, and do not undergo rigorous evaluation before deployment for general use, which raises quality and patient safety concerns according to a recent AMA Council on Medical Service (CMS) report.

“Without ensuring there is strong and sufficient evidence that provides clinical validation to mHealth apps and associated devices, trackers, and sensors,” the CMS report adds, “physicians will not fully integrate mHealth apps into their practices. More investment is needed in expanding the evidence base necessary to show the accuracy, effectiveness, safety, and security of mHealth apps.”

According to the AMA, mHealth technologies should do the following:

  • Support the establishment or continuation of the patient-physician relationship;
  • Have a high-quality clinical evidence base to demonstrate their viability as a safe and effective mHealth app;
  • Follow evidence-based practice guidelines, particularly those developed by national medical specialty societies and based on systematic reviews, ensuring patient safety, quality of care and positive health outcomes;
  • Support patient-centered care delivery, promote care coordination, and facilitate team-based communication;
  • Support data portability and interoperability that promotes care coordination through accountable care models;
  • Abide by all state licensure and medical practice laws and requirements in the state in which the patient is receiving app-related services;
  • Require licensing of health professionals delivering services in the state where those services are being provided;
  • Ensure that the delivery of any health services via the app follow state practice laws;
  • Follow information privacy and security laws to protect patients’ medical information.

“The new AMA principles aim to foster the integration of digital health innovations into clinical practice by promoting coverage and payment policies that are contingent upon whether mHealth apps and related devices are evidence-based, validated, interoperable, and actionable,” AMA Immediate Past President Steven J. Stack, MD, said in a statement. ”It is essential for mHealth apps support care delivery that is patient-centered, promotes care coordination and facilitates team-based communication.”

“Physicians celebrate progress in digital health that produces great tools,” AMA Executive Vice President and CEO James L. Madara, MD, said in a speech during the 2016 Interim Meeting’s opening session. “At the same time, we don’t hesitate to call out those products that are unhelpful and may even do harm — for example a blood pressure app, which actually failed at high rates in detecting abnormally high blood pressure. Yet, for two years, this was one of the most highly downloaded health apps.”