MIT offshoot set to launch health app reviews

A nonprofit institute, spun off from the healthcare entrepreneurship program at Massachusetts Institute of Technology, will soon start producing consumer reviews of mobile apps and other digital health tools that have been vetted by Harvard University clinicians, the nonprofit's co-founder said.

Set to launch in early December, these will consist of a consumer-focused list of the best apps, connected medical devices and technology-enabled services that are reviewed by Harvard physicians as well as by technical experts from MIT's Hacking Medicine Institute.

“None of the clinical institutes are willing to take that institutional risk to say, ‘These are the best' and to say, actually, [that] ‘these are unsafe at any speed.' But the Hacking Medicine Institute is a group of hackers, and we can take that risk,” said Zen Chu, a co-founder of the organization, which launched this past June.

The initial list will include a preliminary batch of what the institute considers the best apps, connected medical devices, telemedicine and websites for preventing and managing disease as well as for finding care. Regular updates to the list are planned throughout the year.

Health apps, reportedly numbering in the tens of thousands, vary widely in content and quality. The institute wants to “cut through the noise and the hype,” said Chu, who is also a senior lecturer in healthcare innovation at MIT's Sloan School of Management and an entrepreneur-in-residence at the university.

Chu (pictured) made the remarks during his keynote address at the “Who's Hacking Healthcare” event held in Boston on November 10, part of the MM&M SkillSets Live series of half-day conferences.

The Cambridge, Mass.–based university isn't the first to try to bring order to the tangle of health apps proliferating today in Apple and Android stores.

One entity, Happtique, a subsidiary of the Greater New York Hospital Association's for-profit arm, GNYHA Ventures, certified its first round of health apps in 2013, a year-and-a-half after announcing it wanted to begin its pay-for-certification program.

Under the program, Happtique evaluated apps' technical functionality and medical content. But the effort was suspended that same year after a health IT expert found security flaws in some of the 16 apps that initially passed muster.

The effort underscores the difficulty of paid certification for health apps. “The way Happtique went about it, trying to charge these little companies to go in and do a certification, is the wrong model,” commented Chu after the MM&M event. “It's got be done from the perspective of an unbiased nonprofit-driven organization for it to be credible and trusted both by physicians who want to prescribe [apps] as well as from patients and consumers.”

This requires new thinking. In the past, efficacy has been measured according to the efficacy of the molecule. With so-called digiceuticals—social media, apps, connected medical devices and new telemedicine services—“efficacy is influenced by the patient's behavior and their environment [which includes social media and their social connections/networks],” Chu explained.

The team of clinicians marshaled by the institute to work on the reviews includes “white-hat” hackers—those who apply their skills to developing creative solutions using technology—and clinician researchers working at Harvard Medical School–affiliated teaching hospitals, such as Massachusetts General Hospital, Brigham and Women's Hospital and Massachusetts Eye and Ear. Reviews will also reflect the voice of engaged patients and a consortium of big self-insured employers, payers and hospital systems working to develop population health data—the evidence to show whether a digital tool's benefits scale beyond an individual patient, he said.

Creating reviews, Chu added during his keynote, will be “very important for adoption because when you look at [the majority of digital health] apps … these have no reviews and very few downloads, and … it's because they didn't use patient-centered design process.”

“Patient-facing is really where the traction is,” said Chu, “and that's because you don't have to rely on clinician or hospital adoption, which is ingrained behavior—they're so slow—and that's why the best entrepreneurs and investigators in Silicon Valley—tech investors, not traditional healthcare investors—believe, along with me, that the digiceuticals world now feels like the Internet was in 1995. Because for the first time you can have a small start-up get funded—pre-capital—efficiently and compete head-to-head against the giants in healthcare.”

He gave examples of this, naming start-ups like PillPack—the mail-order pharmacy offering robot-filled custom-packaging of drugs—and Figure 1, the crowd-sourced diagnostics tool nicknamed “Instagram for Doctors.” (Chu was an early investor in both firms through his own fund, Accelmed.)

These start-ups have gone their own way, at least at first. Once they show they can scale, that would be an appropriate time to partner with traditional entities like pharma, hospitals, health systems or pharmacy chains, he said.

At the same time, it remains an open question in digital circles as to whether the majority of consumer use of health apps will come from clinicians prescribing them—which is what some firms are trying to facilitate, like IMS Health with its AppScript platform—or more organically through consumer media channels.

As to the timing of the institute's first curated list, planned to arrive just prior to the Christmas and New Year's season, “Holiday gatherings often cause families to discuss health issues and look for solutions,” Chu explained. “The best consumer technology can help patients take control of their health, including a lot of these new apps and connected consumer devices.”