Let's talk about R&I

Carme Carrion, researcher: "Doctors will soon prescribe the use of apps as treatment"

Interview with the eHealth Lab research group leader

What is your academic background?

I started off by completing a bachelor’s degree in Chemical Sciences at the University of Barcelona (UB), specializing in Biochemistry. I then decided to do my PhD in the same department, in Biochemistry and Molecular Biology. While completing my PhD, I also completed two master’s degrees, one in Biotechnology, which was a joint master’s degree between the Universitat Politcnica de Catalunya (UPC), the UB and the Universitat Autnoma de Barcelona (UAB), and then a master´s degree in Conflictology at the UOC.

What is your research expertise? And your group’s?

Our research group is called the eHealth Lab, so the word that defines it is e-health. What is e-health? Well, everything that brings together technology and health. And I mean health in the broadest sense possible, not just the healthcare provided in hospitals, for instance, but also work done to empower people to take care of their own health. My expertise is closely linked to tools that aid decision-making, which can help patients, carers and professionals to find the best way of managing a specific health situation or disease.

What is the main research project you are working on?

We’re currently at a really inspiring moment in one project we’re developing, which means it requires more effort now than ever. We’re just beginning to attain more results for this project, which is called EVALAPPS. The aim is to design a tool – which we now know will be an app – that enables professionals and patients to assess the quality of apps that manage overweight and obesity. In other words, it’s an app that will serve as a complementary tool in patients’ personal management of their health. It will be useful for patients as well as professionals working in endocrinology, for example, who will be able to recommend its use.

Are apps useful for patients and professionals?

Apps can be useful for patients and professionals alike, yes. Patients that use apps often don’t tell their healthcare professional about them because they don’t think they are part of the treatment strategy, although of course they are. And the other way around too; there are professionals who immediately recommend an app, but without following any specific criteria. So, what might or might not be useful is all quite vague at the moment, and it´s obvious there’s work to do.

It’s wrong to think that it’s fine if an app doesn’t work. First of all, it’s a lost opportunity. Moreover, if you use an app and it doesn’t work, you may give up using it after just two weeks. Then, if someone suggests using a new one, you’ll be far more reluctant to try it than before. It’s important to know a priori whether or not certain apps can be trusted because there are apps recommending practices that are not based on scientific evidence, which may end up being harmful for patients. Likewise, other apps don’t take each person’s individual profile into account, when each person is totally different from the next.

In the near future, will doctors prescribe apps?

If there’s one thing we know, it’s that we are overly medicated. There are some interesting things happening in other countries, which are neither generally nor fully implemented. For example, there’s this bar, like the Apple Genius Bar, where patients go because the doctor has recommended an app for them to use. There, they can get help downloading and learning to use it, and if they have problems they can go back. It’s a kind of technical service, so to speak. It’s quite curious and anecdotal, but representative of what’s to come.

Will the introduction of apps imply new professional profiles in the world of health?

New professional profiles will most likely crop up, yes, and health professionals (doctors, nurses, pharmacists, etc) will have to update their knowledge and skills. An app can be prescribed like medicine, yes. But the doctor doesn’t give you medicine without asking to see you again. There is a process of monitoring the impact this medicine has on your health. Well, it would be similar with an app; it’s another tool to be used for treatment. But an app in isolation is unlikely to be really effective in the mid- and even short-term.

And what is the state of the app in your project for treating overweight and obesity?

We hope, in about a month, to start to pilot it with a small group of people. Based on their experience and opinion, we will rework it to develop the pilot product and properly test it with a group of 100 or 150 people from the general population, including people who visit the doctor and others who do not.

You participated in an international health cooperation project with Morocco: what did it involve?

This project, which has already come to an end, was done with the World Health Organization (WHO) and the Moroccan government. Its aim was to help set up clinical practice guides to manage a specific disease called cutaneous leishmaniasis, which is endemic in Morocco. This project meant helping professionals become familiar with the guide and assessing what changes should be made to healthcare practice, not only on an individual basis, but rather considering organizations as a whole. Also, a highly important practice – data collection – wasn’t happening in Morocco. Thanks to this project, professionals recognized the need to establish a more effective system of reporting data.

What would you recommend to learn more about your field of expertise?

On the one hand, I’d recommend the film Gattaca, which deals with all the possibilities provided by bioinformatics for data management and genetics. There’s also this book called Everybody Lies, which talks about collecting data, its quality (or lack thereof), how it’s used and what information we are being given, in all aspects but particularly relating to health. I think it’s inspirational, so well worth a read.

 

EVALAPPS project is funded by the IInstitute of Health Carlos III, the Ministry of Science, Innovation and Universities and ERDF, Nº EXP: PI16/01764