There are more than 97,000 mobile health apps available for download on your phone and tablet. From fitness trackers to heart rate monitors to nutrition planners, mobile health apps boast incredible benefits to its users. But how many can actually deliver on their promise? Victoria Jimenez wants to find out.
A graduate student in Weill Cornell Medicine Department of Healthcare Policy and Research's Division of Health Informatics, Victoria dove into the world of mobile health apps for a final research project, "Review of Mobile Applications for the Detection and Management of Atrial Fibrillation," for a final course project in the Health Behavior and Consumer Informatics course taught by Dr. Ruth Masterson Creber, assistant professor of healthcare policy and research.
Atrial fibrillation (AFib) occurs when the heart beats in a fast, slow, or irregular manner. It is estimated that up to 6.1 million people in the U.S. have AFib, and the number is expected to increase as the population ages. Because there are no specific medical guidelines on early detection or prevention for this condition, many developers have taken it upon themselves to find a solution.
Currently, the only way to detect AFib is through a Holter monitor test. Worn around a patient's chest for one to two days, the Holter monitor is clunky and difficult to comply with. It's usually given to high-risk individuals who already exhibit other worrying symptoms. Diagnosing AFib could be more readily accessible through a mobile app. "There has been preliminary work done that suggest you can use the native smartphone hardware and firmware to calculate someone's rhythmic activity through a thumb press," explained Victoria.
While the technology exists, the quality isn't always there. Without clinicians reviewing the content or functionality, the apps are merely guessing at what people should be monitoring and don't necessarily track the things that are relevant. "They might be giving feedback that everything is fine when that's absolutely not the case," said Victoria. Meanwhile, users are swamped with a litany of options that could potentially negatively affect them.
Although the app stores have some control over the types of products that are being pushed out, anyone can upload their app until it is reported for malice or spam. With no FDA approval, it's ultimately up to the user to make the decision if the app worked for them or not when they aren't necessarily in a position to do so. Victoria hopes her research will raise awareness on the dangers of unregulated health apps: "I hope that encourages patients to have conversations with their doctors on the kinds of apps they are using."
Victoria joined Weill Cornell Medicine in 2016 as a research assistant and received hands-on experience in data management. Under the tutelage of knowledgeable colleagues, she witnessed first-hand how information systems can be instrumental in connecting a vast network of people. She also knew that those information systems can sometimes get lost or buried due to the gap of understanding between clinicians and software development. "I've seen a lot of really brilliant people...not being able to come to a consensus," Victoria shared. "I think when you make information systems and manage data in a way that's intuitive to people in practice, you end up with results that are more useful and more accessible."
The idea and methodology for Ms. Jimenez's research stemmed from a class assignment in With support from two classmates, Samuel Isaac, Dr. Munther Alshalabi, course teaching assistant, Dr. Meghan Reading Turchioe, postdoctoral researcher, and Dr. Ruth Masterson Creber, the project went far beyond the walls of the classroom. In fact, Victoria presented on the topic at this year's Society for Advancing Chicanos/Hispanics & Native Americans in Science (SACNAS) conference in Hawaii where she also received the award for outstanding oral presentation. Victoria is also presenting this work at the American Medical Informatics Association.
"SACNAS pulls different viewpoints into the scientific sphere. People in underrepresented groups don't necessarily have a voice at the table when we are talking about innovation. There are a lot of important cultural viewpoints that aren't being discussed that could really change how things are done and make things more applicable to more people if only those voices are heard," said Victoria.
Victoria will receive her Master of Science in Health Informatics in May 2020. Meanwhile, she is transitioning to a data specialist role at Weill Cornell Medicine where her work will focus on rapid cycle quality improvement. "I want to stay working on the public institution level. I want to stay working on informatics," stated Victoria. "Huge institutions gather so much information about hundreds of thousands of people and being able to use that data in a sophisticated way can help make meaningful changes to the practice very quickly. That's really where I want to be."