Independent research firm Mobiquity recently published a recent study entitled "Get Mobile, Get Healthy: The Appification of Health & Fitness" that reveals the untapped opportunity for healthcare professionals to leverage mobile technology to support patients' health behavior change and outcomes.

In fact, 34% of mobile health and fitness app users say they would increase their use of mHealth apps if their doctors actively recommended it. However, not enough healthcare providers are engaging patients about how monitoring lifestyle behaviors can have a direct impact on health and well-being. The Mobiquity, Inc study also found that while 70% of people use mHealth apps on a daily basis to track calorie intake and monitor physical activities, only 40% share data with their doctors.

"Our study shows there's a huge opportunity for medical professionals [and other] health organizations to use mobile to drive positive behavior change and, as a result, better patient outcomes," said Scott Snyder, president and chief strategy officer at Mobiquity.

The hard part for most people, doctors included, is identifying the better quality health apps in a sea of digital junk.

Essential Features of mHealth/Fitness Apps to use with Patients

Doctors can take a few simple steps to include mHealth technology in patient consults. There are a few key features to look for across apps designed to help track eating and exercise behaviors. In general health behavior apps should:

• Have a user-friendly, intuitive platform or else patient won't use it.
• Incorporate goal setting and provide visual or other feedback so users can see their progress and feel a sense of achievement.
• Provide positive reinforcement/accountability (e.g., social/ family support, other rewards);
• Accurately count/ measure data (calories, steps, miles, etc.).

Nutrition apps that monitor dietary intake of macro and micronutrients (e.g., calories, protein, fat, sodium, sugar, etc.) should have a few specific features of their own.

"With the diet apps, it is important to choose one with a comprehensive food database," says Dr. James O. Hill, Ph.D., Professor of Pediatrics and Medicine at University of Colorado School of Medicine - Center for Human Nutrition. "It's also important to make sure the foods a person typically eats are found in the database."

Concern should be raised with apps that suggest very specific diets. "In the case of eating well, what I would look for is reliable guidance for eating more nutritious, less processed foods overall," says David L. Katz, M.D., Director of the Yale University Prevention Research Center.

Depending on the person's goals, physical activity apps might be best if specific to the activity the user enjoys and will stick with over time. Or, for absolute beginners, Dr. Katz suggests looking for an app that provides "guidance for fitting more total motion and exertion into every day [rather than] an app narrowly focused on just one activity."

There are a wide variety of activity trackers on the market ranging from pedometers to arm/wrist bands to devices that will track everything from steps to sleep. Dr. Hill advises choosing one that "displays information in a simple and useful fashion." The data should also be essential to the goals the doctor and patient have planned.

Apps and other measurement tools are only helpful when the user knows what to do with them. Effective measurement is useless without an effective program for the patient to follow, such as from a doctor or fitness professional. "I think that apps can be a great help when used in conjunction with a specific program, but the app does not take the place of a program," says Dr. Hill.

How to Choose (Relatively) Reliable mHealth/Fitness Apps

So, how do you help your patient choose an mobile health/fitness app that won't give sketchy advice and is reasonably accurate?

From a medical perspective, "the most important factor [in choosing an app] is that it is based on good behavior modification science and that the advice be fundamentally sound," says Dr. Katz. "Ideally, doctors would have access to evidence about the actual results from using various apps. Then, we could judge these as we judge drugs and procedures, by reviewing relevant evidence. In the meantime, the best we can do is judge apps based on their apparent merit—the theories, approaches, and information base."

Until meaningful data about mHealth/Fitness apps can be aggregated and data published in the peer-reviewed literature, doctors and patients both will have to do their homework to stay informed about the available technology.

Here are a few simple things healthcare providers, and patients, can do:

• Read reviews: When viewing an app in the iTunes or Android store, read reviews from other users to see if the app actually does what it's supposed to do. Look at the app's date last updated to be sure the app won't provide potentially risky out-of-date information.
• Visit the developer website for the app: Look for a valid behavioral theory and sound content.
  Look at the developer team. Ideally, you want to see medical advisors, not just engineers, with appropriate health/medical credentials behind the development of the app or device.
• Steer Clear of Apps that Claim to Diagnose: Providing advice to do something specific, like take a certain drug, eat certain foods, or suggest restrictive or strict programs should be a red flag. Patients should be reminded that apps are intended to support health behavior change, not provide medical guidance.

Resources

• Exercise is Medicine encourages primary-care doctors and other health-care providers to include physical activity when designing treatment plans for patients.
• Healthcare Providers Action Guide
• Infographic on 'Health Trackers': How often are people tracking their personal health data?

Apps Worth Checking Out

• My Net Diary (free; iPhone, Android, Windows Phone, and BlackBerry) Of all the food and exercise apps out there, My Net Diary stands out with its huge food database and easy-to-use barcode scanner so users don't have to manually enter everything. All entered data can be turned into charts, which makes it easy to notice patterns and progress. 
• MedHelp App Family (most are free on iPhone or Android). MedHelp has developed a family apps that provide tracking for sleep, nutrition/diet, exercise, and other health parameters. The My Diet Diary app can track food, weight, exercise, and water intake. Data can be connected with FitBit and many other popular devices. It allows for customize goals and support forums are available through the MedHelp social network. Data can be printed and shared with a doctor.
• Moves (Free iPhone; Android). Moves makes it easy for users to reach 10,000 daily steps by using a smartphone's motion sensors to determine how many steps are taken in a given period. Keep the app running in the background, ideally in your pocket or strapped to an arm band, and it tracks. Users also get a text each morning stating yesterday's step count and record for the month. (It also logs cycling and running as well as calories).
• Move Your App (Free iPhone). Sitting for extended periods of time can be detrimental for anyone's health. This app is designed to remind users to get up and move around. At the end of the day, users can see how much time they spent being sedentary versus active. Users can set timers for reminders such as how frequently to be cued to get up, how long to be mobile once on your feet, etc.
• Human (free iPhone). An all-day activity tracker that inspires users to move for at least 30 min daily. It tracks minutes in motion. The app refreshes automatically in the background of the device and provides feedback the following day.

The apps listed above should be evaluated by users and medical professionals before use and their inclusion in the list should not be viewed as an endorsement by the individuals quoted in this article or the publication itself.