E-health is the promise and the epidemic of this Century. Health is the second most frequently searched term in Google, resulting in 57% of the more than two trillion searches in 2016. Currently, there are more than 300,000 health apps listed on the Internet.

Block quote: WHO and NIH should publish an inventory of toxic health apps.

Quantity does not equate with quality. Health apps deliver much less than they promise. A systematic review of 23 trials of health apps showed a meaningful effect in less than half of them and most of the trials were only small studies over short periods of time.

Toxicity can take many forms: out-of-date information, inaccessible or expired sites, lack of supporting references and author information. We are on the verge of a level of e-health epidemic that has the potential to distract and confuse people rather than help them. We have to move beyondjust evaluating health apps.

Global and regional health agencies such as WHO and NIH should establish mechanisms to protect the public. These agencies must review health sites continually to provide the public with current information about which health sites are toxic.  Regulatory agencies also should possess the power to require the removal of sites that are polluting our E waves.

Studies of men’s health problems reveal a dangerously high level of toxicity. For example, only one in four prostate cancer websites identify the author of the information.  More than half had no references and when references were provided, less than a quarter cited were reliable.

Half of recently reviewed health apps for gout, a predominantly male condition,were either no longer available to download or had not been updated since their release (over a year or more before).

Poor health apps steal time from everyone, but particularly from traditionally underserved populations, such as people living with disabilities who are chronically ill. They need to spend double the amount of time online. For simplicity and ease of use, many E-health apps focus on single topic areas.

The health issues of any given patient, however, are much more complex and often involve multiple morbidities, such as depression, substance abuse, obesity and cancer.  Health apps would best assist individual patients and improve public health if they used their enormous computational power to manage the multiple conditions most patients confront.