The First Prescription-Only App

TWToxicity writes "Most prescriptions would say something like 'take two pills nightly with meal' on the bottle. Now, we may be adding a new method. Baltimore-based company WellDoc is making a national push in 2014 for doctors to prescribe their app, BlueStar, after a regional launch last Fall. BlueStar helps patients with Type II Diabetes by suggesting in real-time when to test and how to regulate their blood-sugar levels by, for example, altering their medication or food intake. Prescription apps may revolutionize mobile medicine and allow for more effective treatments because the patients get real time feedback and the data collected by the app is sent to their physicians. WellDoc is currently working on apps to monitor and coach patients with other diseases. The success of this product will rely on how many doctors prescribe it."

Comments

I can't imagine how they will acheive that...

[bob_super]

"The success of this product will rely on how many doctors prescribe it"

I'm too cynical to read stuff like this.

Security?

[root_brewski]

This looks great, and I could see products like them being used in the future to great benefit, but they'd better be sure the security is bulletproof inside and out. The line "data collected by the app is sent to their physicians" instantly sets off the "this could end badly" red flags in my head.

Re:Security?

[sunderland56]

Never mind security - who is going to be the first patient who died, because their cellphone battery died?

Re:Security?

[ColdWetDog]

I just love this meme on Slashdot. Instant Worse Case Scenario. In fact, instant OMG! Meteor-Strike-Worst-Case-Ever scenario. First off, it's not a ventilator - nobody dies instantly if the app doesn't work. Second, I'm rather sure that security was built in to the system (how effective it is remains to be seen). Third, it's been reviewed at the FDA level - some considerable thought has gone into the product.

The numbers they are describing - a nearly 2 point drop in Hemoglobin A1c (which measures a running 90 day average of blood sugar levels and is sort of well correlated with long term risks of complications from diabetes) are impressive. That level is typically better than a lot of drugs (manufacturers would be tickled pink to get a whole 1 point drop on a consistent basis). Experience tells us that efficacy in the field is typically less than in controlled trials, but even a 1 point consistent decrease in HbA1c for something as benign as a iPhone app is significant.

The real test is going to be how well these folks do 3, 4, 5 and 10 years down the line. That's the problem with chronic diseases like diabetes - you have to study interventions for long periods of time to determine if they really are helpful and to gauge any harms. Who knows what an iPhone will be like in 10 years - it may well be directly wired into your brain (and VISA card).

No thanks

[dreamchaser]

I guess I could see this being useful for some, but I am a diabetic and I have no need for this app. Most people who would need it just don't practice tight control with enough discipline. I know when to test, can tell by how I feel when things are off, and know how to adjust my diet and insulin as needed. I also don't think I like the potential for abuse with an app like this. Yes, I know there is HIPPA to protect privacy. For some reason that still doesn't make me feel warm and fuzzy about tracking my health or disorder with an app.

Re:No thanks

[wcrowe]

I am also diabetic, and I agree with you. Adjusting your diet and dosages is not that difficult to achieve good control. After a while it almost becomes second nature. Anyone who is too lazy to do it on their own is going to be too lazy to input data into an app which tells them what to do. And, as you say, the tracking component is highly undesireable. I don't need some faceless company nagging me about what I should or shouldn't be doing. Life's hard enough when you have to be your own pancreas.

I could see a future where insurance companies will require this sort of app, though. I hope they find a cure, or that I'm dead, by then.

Re:No thanks

[techno-vampire]

Me too neither. However, on the other side, I'm part of a clinical study of a new fast-acting insulin, and I have to keep a diary including when I take my basal insulin (Glargine/Lantus) in 24-hour time. As I'm ex-Navy, that's easy for me, but from what the clerks at the clinic tell me, most people find it very hard to keep straight. I'd guess that for people who can't manage 24-hour time, an app like this might be worth while, assuming that they actually use it properly.

Re:No thanks

[snoig]

I have also recently been diagnosed as a type II diabetic. While I'm sure that eventually I will easily be able to manage my diet by how I feel without an app like this, there is a learning curve and something like this could be very helpful to me at this stage. I've found some online resources that are very helpful when it comes to meal planning that could be even more useful if they could be integrated with my blood glucose meter and a smartphone. Imagine the day when there will be an implantable blood glucose meter that also monitors blood pressure and heart rate then communicates via wireless with your smartphone. Snap a picture of your meal, a barcode or menu item and it will be able to tell you how much time will need to spend on the treadmill to remain healthy.

The FDA could (will!) have something to say... NO!

[nani popoki]

I work in the medical products field as a software developer. You would not believe the amount of red tape involved in making a piece of software that is used to advise treatment. Such software is classified by the FDA as equivalent risk to an implanted defibrillator!

liability when something goes wrong?

[peter303]

Could the App be considered in a small sense an A.I. practicing medicine if it makes decisions and gives advice? Who gets the blame if something suddenly goes wrong or there is a gradual worsening? Plenty of other computer programs give advice, but are not as consequencial as a medical decision. Does the programmer or medical expert adviser share some of the blame? Where do you draw the line between looking up something in a manual versus actually having a decision made for you?

Re:My data

[techno-vampire]

Now, if it's making medication change suggestions the doctor should at least know about it.

Some diabetics need to adjust their dosage on a day-to-day basis, depending on their blood sugar reading. If so, they need to understand the process well enough to calculate how much insulin to take based on their reading. Not all of them are comfortable with math, and find it either frightening or confusing, if not both. An app like this would simply do the calculation for them, so that they would know how much they need.

'round here, we call it 'Rent Seeking'

[Penguinisto]

They do prescribe some electronic devices and programming (e.g. CPAP machines) to individuals, but in all honesty, this is one step too effing far.

Mind you, my missus is diabetic, but she can control her blood sugar levels just fine w/o being forced to buy/use a smartphone app to do it. Instead she uses a combination of common sense and a meter. So far, it's stayed happily between 98-130, and that's in spite of juggling two different types of insulin to keep it under control (Novolog and Lantus).

Last bloody thing I need is for some doc getting a kickback to push an app onto her phone that the insurance company gets billed $12,000 for :(