The gadgetization of medicine

 I love my gadgets. I like that my car knows when I'm close, I like talking to my phone and having it answer. I even like the ancient, but, oh so convenient remote control, for my TV. And there is evidence that I'm not alone. Five years ago, the mobile app market was essentially nonexistent. Today there are more than 500,000 apps in the Apple App Store and more than 200,000 apps in the Android Marketplace. I've downloaded my share (and, like most people, don't use the vast majority more than a couple of times). And, most recently, the medical app market growth looks to be growing faster than any other market. According to a recent article by Kaiser Health News "the market has been something of an unregulated Wild West; for doctors and patients alike, it is difficult to know which apps actually live up to their health claims or provide accurate information." and reports on the FDA's efforts at regulation adding that, as important as it is, it's a Herculean task. It's also likely to fail both because of the sheer volume of app development and an evolving trend to avoid medical claims and to focus on user reviews. There are also a number of entities like Happtique that are trying to provide some degree of oversight to the space. Much of this may be beside the point  -  I think we should be focused upon applications that actually do some good and are actually needed. According to Accenture consumers' expectations are much more modest. But in most cases we seem to be looking more for the excitement than value. That might not be the American way: We tend to move right to statins rather than diet and exercise to treat high cholesterol we treat mHealth no differently. I have a small exercise that might help in thinking about and investing in mHealth applications.

For mHealth applications that have current standard analogs, I'd like to recommend an analysis based upon two axes: how well it works when compared to the current standard and how much it costs compared to the current standard. You can then place the application in question in one of four quadrants.

It's clear to me that an app that is both works better and is cheaper than the current standard (Quadrant I) merits investment and something that both more expensive and less effective than current standards (Quadrant III) does not (although I've seen examples where this wasn't true). The other two are much more interesting. Much of today's healthcare technology, like MRI and other fixed imaging technology have been very successful examples of Quadrant IV. Mobile technologies, like GE's compact ultrasound seem to fit well in Quadrant II.