When Critical Apps Stop Working Patients Are Put At-Risk

“Knowing I don’t have that constant check, it feels like going back to when I was first diagnosed and having to finger prick a few times a day.”

Sonja Sleator, Freestyle Libre user, Belfast
Image Credit: Shutterstock.com

People with diabetes using a popular app have lost their usual way of checking blood sugar after an update caused it to stop working on some Apple devices. Some users in the UK were experiencing a disruption in the functionality of the FreeStyle Libre 2 blood sugar monitoring app following an update, underscoring the vulnerability of our digital lives. After a recent app update, it stopped working on some iPhones — but only for some people in the UK. Abbott didn’t explain this and insists that it was working for users in all other countries. Abbott also pulled the app from the UK version of the App Store while an Android version was still available.

Abbott released this YouTube video to assist users in reloading the app from their app store purchases:

YouTube Video Credit: FreeStyle UK & Ireland channel

As expected, there has been a backlash online from people who rely on the technology for their wellbeing. People with Type 1 diabetes use the CGM to monitor their blood glucose levels – or blood sugar – around the clock, meaning they don’t have to constantly take blood samples by pricking their fingers for readings. By monitoring glucose levels in real-time, people can make better-informed decisions about when to eat or exercise. Critically, it can also alert the user or their family members when their blood sugar level is too low or too high.

“The data also goes to my wife, so if something happened she’d know, but I don’t know if that is going to happen at the moment. I’m sure there are going to be people who aren’t getting critical alerts about their loved ones.”

David Burchell, UK User

Abbott said the problem emerged after it updated the LibreLink app to give users a significant quality-of-life improvement, removing the need to scan the disc with a device manually. Instead, the new update would allow the CGM to send the app data continuously, removing the need for a scan. Abbott’s competitor Dexcom already allows this. But an issue with the update caused some iPhone users to report the app had stopped working for them altogether, leaving them unable to monitor their blood sugar levels.

Where this stands today – Abbott has announced that a new version of the FreeStyle LibreLink app (2.10.1) is available to download from the iOS App Store. Abbott said people should upgrade to the latest version as soon as possible. Once downloaded, Abbott has urged Apple users to check their alarm settings and any insulin pen connections and sign back into their LibreView account to re-establish any connections. Abbott said an update to the app had caused it to stop working for some users altogether, leaving them unable to monitor their blood sugar levels.

Some thoughts – This situation clearly illustrates the crucial need for thorough software testing before releasing updates and highlights the potentially significant impact of technology, especially in health management. Patients with diabetes rely on CGM technologies to manage their condition, and any disruption to their daily testing routine can have dramatic consequences. The saving grace in this instance is the fact that the app in question was created by a reputable company in health care.

The bigger challenge lies in the fact that there are over 350,000 apps currently available for consumers according to research done by IQVIA. Furthermore, apps are increasingly focused on helping consumers manage their health conditions rather than on wellness management. Consumer disease management apps now account for 47 percent of the most widely used digital health apps in 2020, up from 28 percent in 2015. Apps for mental health, diabetes, and cardiovascular care account for almost half of the disease-specific apps. Simultaneously, digital therapeutics and digital care products are growing in volume and gaining reimbursements.

So, before using a health care app, it’s important to do your research. Here are a few points to consider:

  • Check the company behind it: look it up in company databases, browse through its appearance in relevant news sites. Some of his recommendations include MedPage TodayHealthlineMedgadget, and WebMD.
  • Find out how often an app’s updates come out.
  • Read a few user reviews by checking whether MobiHealthNews or Medgadget reviewed the app.
  • Be vigilant about how many things it requests your access. For example, why would an app providing information on diabetes want to connect to your camera and photos?

Effective and purposeful mobile health apps must be evidence-based, they have to be validated, they should be actionable, and they should be connected to allow interoperability with your electronic health records. Otherwise, you’ll have data dumps into a vacuum where it’s not processed, and it’s not helpful. On the other hand, if you have tools that are evidenced based and validated, they’re actionable, and then they are connected to the health record and organized within it. That’s the kind of data that will be useful.

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