Laura Ferris, assistant professor of dermatology at the University of Pittsburgh, has been bombarded by people asking which mobile applications they could use to identify whether their moles were malignant or benign. Curious as to the reliability of these apps, Ferris and her colleagues tested three inexpensive ones that provided immediate feedback. The doctors were upset with their results.

“In our study, we found that the three automated apps missed 30-93 percent of melanomas, the most deadly form of skin cancer,” Ferris said. “If the patient decided to use that app, they could’ve been dissuaded from seeing a doctor for a disease that’s fatal if not caught.”

The potential harmfulness of mobile health care apps was one of the chief concerns raised at the Energy and Commerce Committee’s Disrupter Series Hearing on Health Care Apps. Ferris stated that, because dermatology relies heavily on visual observation, she and her colleagues were among the first in the medical world to encounter the possibilities of mobile health technology.

Ferris warned in her testimony that direct-to-consumer apps, such as the ones she tested, can harm patients by providing them with incomplete or inaccurate results. She stated that a better solution would be a system of teledermatology in which doctors used an app to analyze photos of skin lesions. Ferris and her colleagues have created a system of analysis that involves photos taken with a special instrument called a dermatoscope, which are more accurate than images taken with a smartphone.

“With this new system, we’ve identified 97 percent of melanomas,” Ferris said.

Witnesses also raised privacy concerns. Because medical data encompasses personal information and records, the security of such data is important to physicians and patients alike. Nicolas Terry, professor of law and executive director of law and health at the Indiana University Robert H. McKinney School of Law, was especially concerned with securing the data to which health care apps had access.

Terry stated that many patient-facing apps, which are used by patients rather than doctors, are not regulated by the Health Insurance Portability and Accountability Act (HIPAA). He said this unregulated data could lead to security breaches that would jeopardize the professional commitment to health privacy.

“Every day, doctors rightfully reassure their patients as to the legally enforced confidentiality of the information they share while their offices distribute required privacy notices,” Terry said. “However, the same or similar data collected on mobile devices lack these protections. Most mobile health apps are not subject to the HIPAA privacy and security rules, leaving patient wellness and health data woefully unprotected.”

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