Commercial apps in a medical context

TRIX MULDER: We showed you all Anna’s data flows. Now let’s find out why she wants to seek medical attention abroad.

DOCTOR: So, Anna, welcome back, and what can I do for you?

ANNA: Well, I’m getting used to the idea of being pregnant with twins, but I do have some concerns due to my elevated heart rate. And I saw a German specialist who is specialised in multiples so I would like to get a referral.

DOCTOR: OK, so why would you like a referral to this specialist, because you’re already at our specialised department for twin pregnancies?

ANNA: Ever since I found out I was pregnant I still have an elevated heart rate. You can see it on the health app I use. Let me show you.

DOCTOR: OK. Well, an elevated heart rate during pregnancy is normal because you have a lot more volume to pump around and the heart cannot get bigger so it needs to pump faster. So it’s normal in pregnancy. And the use of wearables and the use of those apps is not recommended, and I’m not a great fan of the use in my practice. It is because the material you use is not calibrated or tested and the equipment that we have is tested. Furthermore, I’m bound to medical secrecy and the data are safe here.

And I have no idea what happens to the data that is recorded on your app because probably you needed to fill in details, and they know you’re pregnant, and they follow it, and I don’t know what happens to it. So I’m not a great fan and I think in normal life, for sport it’s good to use. But regarding this I don’t know what I can advise you.

ANNA: OK, I understand, but I still would like to see a specialist in Germany for a second opinion if it’s possible.

DOCTOR: OK, I can understand and it’s always good to have a second opinion. We happen to have a collaborative relationship with this particular gynaecologist, so what I’ll do is I’ll send the details to his office and you can call his office to make an appointment.

ANNA: OK, thank you so much.

TRIX MULDER: As you just saw before, Anna’s doctor, like many others, is not a big fan of using commercial apps and wearables in the medical practice. This has several reasons. The first reason is that, as Anna’s doctor pointed out, it is not clear who has access to the data generated by commercial apps and wearables. Remember these texts from a privacy policy, which we showed you in Week 1? As you can see, it does not become clear from this privacy policy who the third party and corporate affiliates are. In a professional context, this is better controlled due to confidentiality and technical and organisational measures, as we will see when we hear from an information security officer later this week.

The second reason for not using commercial apps and wearables in a medical context is that most of the time it is not clear where the data is stored. In practice this can become problematic if the data is stored on location outside of the EU. We will discuss cross-border health data in the next activity. The third reason is that sensors in these apps and wearables are not always accurate, calibrated, and tested. Medical devices which are used in a professional setting, on the other hand, are accurate, calibrated, and tested. This is of the utmost importance, considering that medical decisions are taken based on this data. The data, therefore, needs to be accurate. However, these are not the only risks.

More will be discussed in the next step.