AMA approves list of guiding principles for digital health tools

By Heather Mack
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In a far cry from the previous comparison of digital health tools to “snake oil,” the American Medical Association is now openly embracing them, albeit with a healthy dose of discretion and some ground rules. 

During the AMA’s Interim Meeting last week in Orlando, the group approved a list of principles to guide coverage and payment policies that support the use of mobile health apps and devices. However, given the significant variance quality of digital health tools, the AMA cautioned for patients and physicians to hedge their enthusiasm by acknowledging that not all apps and devices are created equal.

“The American Medical Association (AMA) believes mobile health applications (mHealth apps) and devices that promote safe and effective patient care have the potential to be integrated into everyday practice,” the agency wrote on their website. “While physicians are optimistic about digital health innovation and its potential medical benefits, mHealth apps and device that are not safe can pose threats to the health and safety of patients. AMA policy acknowledges the need to expand the evidence base necessary to show the accuracy, effectiveness, safety and security of mHealth apps.”

The AMA’s guiding principles outline that apps, devices, trackers and sensors to be used by patients and doctors adhere to standards including the following: have a clinical evidence base to support their use; follow evidence-based practice guidelines to ensure patient safety and quality of outcomes; support establishment or continuation of valid doctor-patient relationships; support care delivery that is patient-centered and promotes care coordination; support data portability and interoperability; abide by state licensure and medical practice laws; and require health practitioners who are using the app to be licensed in the state where the patient is receiving care.

“The new AMA principles aim to foster the integration of digital heath innovations into clinical practice by promoting coverage and payment policies that are contingent upon whether mHealth apps and related devices are evidence-based, validated, interoperable and actionable,” AMA Immediate Past President Dr. Steven J. Stack said in a statement.

While there are no current, definitive regulations on apps, Apple has taken some matters into their own hands by updating their App Store guidelines that place extra scrutiny on health, and the FDA recently entered a draft guidance looking at ways to regulate software used as medical devices.

With that still-relative lack of oversight, the AMA is advising doctors to alert patients of potential privacy and security risks for any apps they recommend (or prescribe, if they are using something like Mount Sinai’s newly launched RxUniverse).

To keep the conversation on digital health tools evolving, the AMA is partnering with several health technology companies including Health 2047 and Omada Health and healthcare technology incubators like Chicago’s Matter and IDEA Labs to look at ways of advancing patient-centered, evidence-based digital health innovation.