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Director's Letter

As VA works on solutions that will allow Veterans to use their mobile devices to interact with their health care team, learn about their medical needs, and access tools to help improve their health, it is important to consider the role of research in this fast-changing field.

Research assessing the individual effectiveness of the thousands of health apps already in circulation isn't possible, or even useful. Although one can simply assume the market will sort it out—that patients and clinicians will gravitate to those products they feel work best for them—this view sells short the value of research and research-derived knowledge.

One role for research is to steer app developers to effective strategies for supporting behavior change. Apps should incorporate functions that increase self-efficacy, assist problem-solving, and provide context-sensitive prompts—all strategies shown to be effective. Similarly, research has proven the effectiveness of peer support, nurse-led care management, and caregiver support, approaches that can be facilitated by well-designed apps. To be fully effective, VA apps will need to communicate appropriately with the team members who can adjust treatments and determine need for follow up. So, what are key research questions for the development of mobile health applications?

• How can we use mobile apps to collect patient-reported outcomes to better inform treatment decisions, performance measurements, and real-world effectiveness studies?
• How can mobile apps and Internet tools enhance approaches using peer support and community-based care?

I will expand on these ideas in my blog, where I invite you to suggest additional questions worthy of research. VA readers can send comments to my blog and non- VA readers can send suggestions to cider.boston@va.gov.

David Atkins, M.D., M.P.H., Director, HSR&D