by Robin Diamond, MSN, JD, RN, Senior Vice President, Patient Safety and Risk Management, The Doctors Company
With over 100,000 mobile health apps now available -- in addition to many new tools that allow physicians to remotely monitor their patients' conditions -- physicians now have to handle an increasing amount of constant data and patient information that they did not have in the past.
Mobile apps offer many potential benefits to doctors and patients:
- Mobile apps can help patients self-monitor their conditions and can alert them and their physicians to problems before they become serious medical issues.
- Mobile apps help patients remember important information about their healthcare.
- Mobile apps can engage patients in their healthcare.
But not all of the apps currently on the market are approved or regulated by the FDA, and the use of mobile apps does not come without liability risks.
Physicians could face allegations of failing to educate the patient/family about the risks and limitations of the app or failing to act appropriately if the app goes offline or malfunctions. Injuries could occur if:
- The physician receives information from a mobile app and does not act on this information. Physicians have a legal duty to review real-time data direct from the patient and respond. Mobile apps raise patient's expectations of how a physician will act -- the patient/family expect that the patient is monitored 24/7 and the physician will respond "within a moment's notice."
- The readings received from a mobile device are wrong and treatment is prescribed based on the wrong data.
Consider limiting your patients to one mobile app that you agree to monitor. This will make it easier to control the incoming data and help make the best use of the app. Other important considerations include:
- Consider whether the two-way communication between you and your patient is secure and, therefore, HIPAA/HITECH compliant. Ask the vendor for assurance that the app is HIPAA-compliant and that data is encrypted for security.
- Know the app:
- Vendor information, such as updates, downtime, and critical value alerts.
- How will it interface with your EHR?
- Is the device regulated by the FDA as a medical device?
- Will you get alerts by e-mail or a phone call from the vendor when the app isn't working?
- Clearly communicate and educate the patient/family about the purpose of the app and how and when the data is transmitted to the clinician.
- Avoid assuring the patient that the app will "take care of everything." Educate the patient/family about the limitations of app, with specific examples of instructions for the patient to follow.
- Identify a contact person within your organization to troubleshoot and be available to address technical problems.
- Have the patient/family sign a consent form that describes the risks, benefits, and purpose of the app.
- Do not do this alone! Avoid utilizing medical apps without support from your organization.
Contributed by The Doctors Company. For more patient safety articles and practice tips, visit www.thedoctors.com/patientsafety.