Friday, April 28, 2017

Better Oversight, Research Needed to Realize Potential of Digital Technologies


Trust and transparency—they are what is missing from the burgeoning market for digital mental health applications, psychiatrists John Torous, M.D., and Laura Roberts, M.D., wrote in a recent editorial in JAMA Psychiatry

More than 10,000 mental health–related smart phone applications are available to download, and that number increases daily, the authors noted, but what’s needed is better market oversight and research to help the public to better understand which apps are actually effective (while protecting patient privacy) and which are not. They highlighted the APA App Evaluation Model as an example of what’s necessary to lend trust and transparency to the digital mental health marketplace.

That marketplace is a “wild, wild west,” Torous (pictured above), who is co-chair of the APA App Evaluation Work Group, told Psychiatric News in an interview. “There is tremendous potential for mobile and digital technology to improve psychiatric care and services, but it’s no longer a technology problem,” he said. “The biggest issue we face in the field is trust and transparency. In our editorial, Laura and I are saying that we need to focus less on new, shiny technologies and more on understanding what is useful and what’s not. For that we need to do real research.”

In the absence of oversight and regulation by the Food and Drug Administration (FDA)—which has taken a hands-off approach to regulating digital apps—Torous and Roberts noted that organizations like APA have a role to play. The App Evaluation Model helps clinicians determine “safety, evidence, usability, and interoperability of an application to make a more informed decision about use,” Torous and Roberts wrote.

“Finding the right balance in evaluating and regulating the mobile health space entails a judicious review of evidence and collaboration across diverse stakeholder groups, each bringing their own expertise and experience to bear on a contemporary and socially important issue,” Torous and Roberts added. “Members of the public, patients, clinicians, researchers, policymakers, payers, regulatory bodies like the FDA, and technology companies all have an important voice. These efforts should accelerate innovation and support a healthy, transparent, and trustworthy applications marketplace and progress toward realizing the true potential of these digital technologies.”

For more information, see the Psychiatric News article “APA to Provide Framework to Evaluate Mobile Health Apps” and the Psychiatric Services article “Three Problems With Current Digital Mental Health Research ... and Three Things We Can Do About Them.”