Last month iMedicalApps' Dr. Iltifat Husain penned a great piece of reporting on a paid iPhone app that purported to a sense user's blood pressure using just the phone's camera. Apart from the troubling claim, the developer said it was using a method developed by Johns Hopkins (which has denied any ties to the group). What's more, the $3.99 app, called Instant Blood Pressure, was one of the top 10 "paid" and "most grossing" medical apps in the AppStore in mid-July. At the end of the app's description, however, it added a fairly prevalent disclaimer: that the app is just for "recreational" purposes.
This week MobiHealthNews sought out apps in Apple's AppStore that appeared to pitch themselves as useful medical or health-focused apps, but also included some iteration of that common legal disclaimer: "For entertainment purposes only". While none of the apps we found appear to be trying to take advantage of their users with a fantastical claim, like some have suggested the Instant Blood Pressure app does, the inclusion of the "entertainment" disclaimer is still a bit puzzling and even humorous for some of these apps.
After all, how entertaining is a medical calculator app that helps you figure out the stages of a patient's acute tubular necrosis? I'm not a doctor. I've never attempted such a calculation myself. But I'm guessing it's not particularly fun.
Perhaps most surprising to me after reviewing the health and medical apps with promises of entertainment value are the handful of big healthcare companies that are including this disclaimer. Sure, larger companies are more risk-averse and more apt to adopt disclaimers, but for a lot of apps, this practice borders on the ridiculous.
Without further ado, and in no particular order, here's a roundup of otherwise serious-seeming health and medical apps that hedge with "entertainment only" in the fine print:
Walgreen's RxmindMe This free app in the medical category helps users remember to take their medication, vitamins, and supplements. Users can enter in their dosage information, set up reminders, and track whether they take a dose or not. It includes Rx refill features and Rx transfer options as well as the ability to export all of the prescription history a user has tracked via the app. It even has a search feature for the entire FDA Drug Database to find all the medications the user is taking. All those features are listed and then the app description reads: "Warning: RxmindMe is for entertainment purposes only. You should not rely on this app alone to remember to take medications." Link
Ezvid's Do I Have Anxiety? This $0.99 app in the Health & Fitness category might be one of the more forgivable apps on this list for some readers. Taking surveys online to learn about ourselves is an increasingly common, albeit lamentable, form of entertainment these days. The name of this app, however, seems to promise a diagnosis, but the app description begins with the disclaimer: "This app is provided for entertainment purposes only and does not provide a medical diagnosis." It then explains that users must complete the "carefully tuned psychological questionnaire and analysis system" once per week for "six contiguous weeks" in conjunction with "proper note-taking" to "shed light on self-diagnosed feelings..." It then adds that the test is not comprehensive and not a medical device nor is it a replacement or substitute for therapy. Link
Amanda Gates' Medical Calculators As referenced above, this $0.99 in the Medical category might be the least entertaining medical app that promises its users entertainment. To be fair, the description specifically says that while the all-in-one app offers dozens of medical calculators -- like acute lung injury, acidosis compensation, and bicarbonate deficit -- for doctors, nurses, technicians, and students, its two calculators for blood alcohol level are just for fun. "Disclaimer (for Blood Alcohol calculator, and Blood Alcohol Level calculators): This app is for entertainment purposes only and the calculation should not be used to determine whether [a] person is able to drive." Unclear if those two calculations make the whole app "for entertainment purposes only" or if it's only fun when using those specific functions. Link
ViTrox Technologies' What's My Heart Rate This app is free but offers in-app upgrades and is found in the Health & Fitness category. Its description reads: "What's My Heart Rate helps you to measure your heart rate and breath rate through your iPhone's or iPad's camera." And upgrades allow users to measure breath rate, too. "Your heartbeat causes micro color changes on your face. Our software uses camera and advanced software algorithm to detect these micro changes, with beat-to-beat accuracy. The algorithm is built based on reliable non-contact photoplethysmography concept," the description reads. "You may even help your lovely sleeping baby, or your grandparents to measure their heart rate by switching to back camera." Finally, it explains: "This app does not intend to replace medical monitoring devices. It is intended for informational and entertainment purposes only." Link
Philips' Vital Signs Camera Here's a very similar app to the one above, but this is one of the older contactless heart rate sensing apps in the store. This $0.99 one from Philips is in the Health & Fitness section. "Measure your heart rate and breathing rate from a distance, simply by using the camera of your iPad or iPhone! The first Health & Fitness app to measure heart rate and breathing rate from a distance that reached #1 in 75 countries!" It also links to a number of media reports that call the app, among other things, "pure genius", "surprisingly accurate", and an "amazing innovation". Then at the end comes the disclaimer: "The Vital Signs Camera app is not intended for diagnosis or for clinical measurements, monitoring or decision making. Measurements and statistics are provided for entertainment purposes only." Link
William T Jones' Sodium Tracker This free app in the Health & Fitness section promises users a "minimalist, clean, and easy to use" app for tracking daily sodium intake. And, like the other apps on this list -- it promises entertainment. "The National Institutes of Heath recommends you eat less than a teaspoon (2300 mg) of salt per day. Using nutrition labels, you can track your sodium intake throughout the day to make sure you're meeting your goal." The app keeps lists of favorite foods to make tracking quicker and it also helps users set daily goals based on recommendations. Then it explains: "Sodium Tracker is for entertainment purposes only, and should not be considered a medical device. Always consult a health care professional before beginning any significant diet change." Link
GP Imports' Spirometer Pro This $0.99 app in the Medical category describes itself as an app that "works very similar to real spirometers", but isn't one. "The spirometer records the amount of air and the rate of air that is breathed in and out over a specified period of time," the description reads. It also instructs users to "Just blow as hard as you can in the microphone of the device." It also has a forceful disclaimer (emphasis theirs): "Please do not use as a MEDICAL spirometer, this application is for entertainment purposes only. We are not liable for any misuse." Link
Axiom Therapeutics This free medication adherence app in the Medical category was developed by pharma company Axiom. "Axiom Therapeutics’ Adherence App is a medication reminder app for your prescriptions, as well as, over the counter medications," the description reads. "This app allows you to enter your medications, schedule reminders, as well as, keep track of your overall adherence for any particular medication." The app lists out a number of features before including an even longer disclaimer section: "The Axiom Therapeutics’ Adherence App is for entertainment purposes only and should not be interpreted as medical or treatment advice. This app does not collect any personal information. No personal identifiable classifications or characteristics will be stored, received, or shared. This app does collect anonymous overall adherence percentages, which are utilized to provide insight to your Physician or Clinic. Prior to using this app, you must obtain a unique 4-digit office code from your Physician or Clinic to login. This app will not operate without this unique office code. You should not rely on this app alone to remember to take medications." This is just an educated guess, but I think this might be the only entertainment app that requires users to get unique codes from their physicians before they can use it. Link
There are a number of other health apps available today masquerading as "entertainment-only" apps -- this was just a representative list. It is troubling for digital health that these companies feel the need to reduce their tools -- some of which could clearly help people better manage their own health -- to entertainment apps. Clearly, these companies don't actually believe that their apps have any real entertainment value.
For some, maybe that impulse to includes the disclaimer should be enough not to offer the app to the public in the first place.
For others, these addendums are the work of (perhaps overcautious) corporate lawyers worried about liability, but those concerns should drive quality, not encourage digital health companies to cut their tools down at the knees, attack their own integrity, and hide behind a disclaimer.