Mount Sinai Health System is trying to do something unprecedented in the world of digital health: create a sustainable, enterprise-wide platform that allows physicians to prescribe medically reviewed mobile health apps to patients.
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Wednesday, the New York City health system and its affiliated Icahn School of Medicine is publicly announcing its platform, called RxUniverse. The in-house Sinai AppLab and Mount Sinai Innovation Partners also are launching a startup company, Responsive Health, to commercialize and license the technology to other healthcare providers.
“This is the first time a health system has embraced a platform where prescribers can prescribe apps,” Dr. Ashish Atreja, chief technology innovation and engagement officer in Mount Sinai’s Department of Medicine and director of Sinai AppLab, told MedCity News. “This is a turning point in digital medicine.”
In addition to apps, users can prescribe personalized educational material, patient satisfaction surveys and other documents to individuals or populations, according to Sinai AppLab.
Clinicians at Mount Sinai have indeed embraced RxUniverse. When the organization started a series of six-week pilots of the platform in August, Sinai AppLab had set a goal of getting practitioners to prescribe apps to 100 patients.
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“We ended up prescribing to 2,500 patients in five sites in Mount Sinai — way more than we thought we would achieve,” Atreja said. “It seems like there’s so much hunger among patients to use digital medicine,” he added.
Outside of Mount Sinai, Responsive Health will make the RxUniverse platform available starting at the beginning of 2017. The idea is that other health systems can adapt the platform to their own needs. “We are not [a] marketing or delivery arm so we cannot support this kind of toolkit outside of Mount Sinai,” Atreja explained. That is the role of Responsive Health.
Sinai officials are calling RxUniverse just one part of an ecosystem dubbed NODE Health — for Network of Digital Evidence. NODE Health is intended to “be an academic home for evidence in digital medicine,” according to its website.
Medical and IT leadership at Mount Sinai are vetting all the apps listed for their own clinicians. “We only wanted curated apps,” Atreja said.
RxUniverse and Responsive Health users can filter apps by several measures, including medical evidence, FDA clearance and whether the apps connect to patients, physicians or both. The AppLab also is fitting the prescribing process into clinician workflow, including linking the RxUniverse platform with the health system’s electronic health records.
Patients get text confirmations of app or information prescriptions and a link where they can download them. Sinai clinicians can track whether messages are opened, Atreja noted. “We are just solving a delivery problem,” he said.
While Sinai’s approach may be novel, the idea of prescribing apps has been around for several years. In a much-viewed interview with NBC in 2013, Dr. Eric Topol of Scripps Translational Science Institute in La Jolla, California, said he prescribed more apps than drugs. That was a remarkable statement for a cardiologist, considering how many meds are prescribed for heart ailments.
Nonprofit health information content provider Healthwise came up with the term “information therapy” and trademarked the shorthand “Ix” in the early 2000s, then created a Center for Information Therapy to promote the idea of prescribing information to patients. The center was dissolved in 2009.
A startup, Happtique, developed a certification program for health apps, but pulled the plug in late 2013 after a health IT executive exposed security flaws in that program. SocialWellth bought Happtique a year later, but has not yet restarted app certification.
Atreja is cognizant of the Happtique failure and has taken steps to avoid the same fate. He said that Happtique did not have the proper security protocols to vet mobile health apps for certification, so when a few apps the group said were secure were not actually secure, that undermined Happtique’s credibility, the Sinai AppLab director said. “Execution was where they fell,” he noted.
RxUniverse is not trying to be as comprehensive as what Happtique wanted to be. “We curate many apps and give them an evidence score [based on] proven evidence,” Atreja said.
Responsive Health will leave the curation up to each customer. “We defer to each organization to curate their own apps. We just give guidance,” Atreja said. “We are giving empowerment back to the health systems.”
Vishnu Saxena is a director for digital medicine and business innovation at NODE Health. Asked if he expects other health systems to follow in Mount Sinai’s footsteps, he said in an email: “I would not be surprised if RxUniverse sets the stage for digital medicine adoption and transformation among many other health systems in some shape or form — in fact, that is the intended broader goal.”
Here is a video from Mount Sinai demonstrating RxUniverse:
Photo: Mount Sinai Health System