The Patient Equation

12Disease Management Platforms

There's an app for everything, or so it seems these days. For every OneDrop, which has a carefully defined mission and proven clinical effectiveness, there are dozens of others with spurious value, whether calorie counters or fitness trackers or mood detectors or, recently found on a list of “best” health apps, Waterlogged, which reminds you throughout the day to drink more water.¹ Not to say that drinking more water isn't likely a smart call for many of us, or that an app can't engage us and help make sure we do, but when these apps are marketed to literally billions of people with smartphones, even a subscription price tag of a few U.S. dollars creates an attractive enough incentive to envision a new digital snake oil economy.

Atul Gawande has criticized wearables for not being “integrated into the practice of medicine in a really critical way…demonstrating major improvements in people's outcomes,” and the same criticism can apply to most apps.² They are standalone patches that purport to diagnose a problem or help to treat one, but they're not necessarily clinically validated, or part of a larger platform, or integrated into patients' lives such that they actually get used consistently, produce actionable information, and ultimately make a difference. Is all of this digital infrastructure, from apps to the proliferation of sensors around, attached to, and even inside us destined to be an ineffective fad? Clearly I don't think so, but acknowledging ...