In the jungle of health apps
Dr. Andrea Bannert has been with since 2013. The doctor of biology and medicine editor initially carried out research in microbiology and is the team's expert on the tiny things: bacteria, viruses, molecules and genes. She also works as a freelancer for Bayerischer Rundfunk and various science magazines and writes fantasy novels and children's stories.
More about the experts All content is checked by medical journalists.They motivate people to exercise, give tips on nutrition or store blood sugar levels - and they are becoming increasingly popular: health apps. But so far there are no uniform standards and quality criteria. Are there dangers in the brave new world of medical helpers?
In the morning the watch purrs on your wrist. The vibration alarm nudges Sebastian Müller from his sleep every morning. But his intelligent watch can do a lot more: "I slept easily for five hours and eleven minutes, and was deeply asleep for four hours," reports the 29-year-old product manager enthusiastically. The intelligent wristwatch monitored his sleep overnight and transmitted the pulse and body movement data to an app on the smartphone.
When he then walks into the bathroom to brush his teeth, she is already counting the first steps for the new day - he has planned a total of 7,000. He can even measure his heart rate with the program by placing his finger on the smartphone's viewfinder. The young man with the dark curly hair wants to consciously deal with his health. A little play instinct is of course also included.
Like Müller, every third German now uses smartphone apps on the subject of health - this was the result of a representative survey by the consumer protection ministry and the IT industry association Bitkom. The so-called health apps are not only used as a motivational aid and source of information; chronically ill people in particular appreciate functions such as the automatic data transfer from measuring devices via Bluetooth to the mobile phone and apps with a diary function. For example, they store blood sugar or blood pressure values, display their progress in the form of curves and give health tips, for example on diet and exercise.
Wild growth without standard
The market is booming - there are now more than 100,000 health apps in German, shows a study by the Hannover Medical School. It is not easy to find the right program for you. Apparently helpful apps are only used a few times and then remain as app corpses on the smartphone. So far there are no standardized quality and security checks for medical apps. Everyone is allowed to publish such a program, there are no controls - the purest wild growth. "This can be really dangerous in certain cases," warns the medical app expert Dr. Ursula Kramer in conversation with "For example when the app analyzes the blood sugar level recorded with a measuring device and gives the wrong recommendation for the insulin dose."
Dr. Egbert Schulz from the German High Pressure League e.V. sees risks: Even an automatic assessment of blood pressure values in the form of a traffic light system in green-yellow-red is problematic. "This allows the patient to change the dosage of the medication himself," warns the doctor. The setting of the blood pressure is a delicate matter that should only be done in consultation with the doctor. "Most doctors are rather skeptical about the benefits of health apps," confirms Kramer.
Apps on prescription?
The programs could significantly improve the therapy. Schulz also sees opportunities there: "If vital data are transmitted technically, it is far superior to paper documentation by the patient." For example, only 30 to 70 percent of the values are correctly recorded in the blood pressure diaries used so far.
If medical apps intervene in the diagnosis or therapy of a disease, they must be classified as "medical devices" and require approval. There are only a few apps in Germany, around 200 worldwide. If the effectiveness of an app can be proven by studies, it could even be prescribed by doctors and paid for by health insurance companies. The first pilot projects are running, for example with apps for the therapy of tinnitus and children’s squint.
Separating wheat from chaff
But that is still a long way off. To help consumers in the largely unregulated market to find trustworthy health apps, Kramer launched the HealtOn internet platform as a guide through the jungle of health apps. There are now over 450 independent app reviews on the portal that are supposed to separate the wheat from the chaff.
If you want to judge for yourself whether a health app is useful, you should pay attention to certain criteria, recommends the expert: “It is important that the app has sound medical knowledge.” Users should make sure that the app author is professionally qualified and the data sources are indicated. A reputable app always gives a contact through which you can ask questions about the program.
Inadequate data protection
Another indication of the seriousness of the products is the handling of user data. "However, only 23 percent of the apps we examined have a data protection declaration," complains Kramer. In fact, some providers of free health apps collect data from their users and then sell it. Users should be aware of this and the associated risks. But very few are.
Under constant observation
"For me it is above all important that the app is easy to use and that it appeals to me visually," says app user Müller. He does not feel uneasy about the meticulous documentation of his intimate data. On the contrary: he would like to put his body under the watch of smartphone programs even more. "I would find it exciting if I could just take a photo of my food and the app would then automatically recognize: This is spaghetti Bolognese." Annoying calorie entry would then be omitted, fat, carbohydrate, protein and vitamin content would be calculated automatically. The program could then derive recommendations for further meals or, if the calorie intake is too high, recommend exercise to compensate.
A utopia? App expert Kramer at least thinks it's realistic that something like this could happen in the near future. “The resolution of smartphone cameras is getting better and better,” she says. Such an application could also help diabetics, for example, to keep their blood sugar levels under control.
In any case, Müller is convinced of the usefulness of the apps: "The more I deal with my health at a young age, the better I deal with it."
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