Decision Support System for Individualized Prescription of mHealth Devices and Apps – ApiAppS

The project includes a technical/software development component and an SHS component in order to study and take into account the psychosocial context of use and, a fortiori, the prescription/recommendation of mHealth devices (impact on the doctor-patient relationship; perceptions, expectations and appropriation of mobile technologies for health by both parties). The mHealth prescription tool developed covers several health areas in the context of general medicine. An evaluation will be carried out at the end of the project to study both the prescription and the effective use of certain mHealth devices on a panel of users.

Qualitative studies by interviews with general practitioners (GPs) and patients were conducted. 2 focus groups were conducted in Nice and Rouen respectively, which allowed data triangulation and an article on the perception of apps by MGs is being written in collaboration with the MG department of Nice and Rouen and SESSTIM. In addition, a literature review on patients' perception of apps was published.
Concerning the SHS/quantity part: On the basis of the results obtained during the semi-structured interviews, a first questionnaire was designed for the use of GPs. A second questionnaire for citizens was also constructed based on the results of the semi-structured interviews, to which standardized scales assessing social support, health literacy and e-health were added. The online distribution of this questionnaire is planned via the Seintinelles platform.
The D2IM carried out the two terminology coverage studies: on the one hand, on the recommendations concerning the chosen pathologies and on the other hand on a set of data from GPs consultations. The results are consistent with those previously observed on medical corpuses (UHC health documents) or on a corpus of scientific literature (LiSSa): the predominant terminologies are MeSH, SNOMED and NCIt.
The D2IM has also integrated new terminology resources associated with apps: TIAB v2 and DHI. These resources have been partially translated into French and are available online on the multi-terminology server HeTOP (https://www.hetop.eu/).
SESSTIM has developed a Web Service ables to receive information from a patient in the body of a VSM (textual information + codified information) and of interoperating with the ECMT (developed by D2IM Rouen) and the DMD store in order to select the categories of apps that correspond to the terms found in the VSM.

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V. VO, A. Sarradon-Eck, L. Auroy. Patients’ perceptions of mhealth apps: a meta-synthesis of qualitative studies. JMIR Mhealth Uhealth. 2019;7(7):e13817.
L. Auroy, A. Sarradon-Eck. The digitally engaged doctor : the discourse and the reality. SGA-SSE-SSA Annual Congr. Zurich. (2018) - (Abstract + Communication orale)
D. Dufour-Coppolani, P. Hassanaly, JC. Dufour. Impact des objets connectés de santé sur la gestion des maladies chroniques. Data Value Chain in Science and Territories. CoData France. Paris. (2019) - (Article + Communication orale)
JC. Dufour, J. Grosjean, S. Darmoni, M. Yasini, G. Marchand, C. Simon, A. Sarradon-Eck, M. Préau, D. Darmon, M. Schuers, P. Hassanaly, R. Giorgi. ApiAppS: A Project to Study and Help Practictionners in Recommanding mHealth Apps and Devices to Their Patients. Medinfo. Lyon (2019) - (Abstract + Poster)

Mobile Health (mHealth) is a developing field that can play an important positive role in various domains affecting the individual's health condition (well-being, prevention, management, monitoring or follow-up of known or suspected pathologies) while being economically beneficial to the healthcare system. The use of mHealth (apps or devices) can reduce the number of medical visits, maximizing convenience for the patient while minimizing the cost to the healthcare system. However, various factors prevent to reach this promising potential. The objective of the ApiAppS project is to identify, explore and remove existing scientific obstacles so that general practitioners (GPs) can use a system to be of help in the prescription of mHealth apps/devices adapted to the patient's profile. This system will be interoperable with the information sources used (EMR and medical knowledge databases). Moreover, ApiAppS implementation will take into account the psychosocial context of this prescription (impact on doctor-patient relationship; perceptions, expectations and appropriation of mHealth technologies for both GPs and patients). The assumption we make in the ApiAppS project, is that physicians can play a central role in guiding the choice processes when mHealth use is a possibility/option for better patient health. We believe that it is necessary to move towards a mechanism of technical integration (in practice and patient management softwares) and human integration (in the physician-patient relationship) of mHealth comparable to the mechanism of a usual medical prescription. The Decision Support System for the Prescription of mHealth technologies will cover various health areas and pathology categories. However, at the end of the project, an experiment on a specific chronic disease will be carried out in order to study prescription, effective use and contribution (effectiveness) of certain mHealth apps. This experimentation will be carried out with two panels of users (GPs and patients).