by Sue Montgomery, RN, BSN, CHPN
According to industry estimates, 50 percent of the more than 3.4 billion mobile device users globally will have downloaded mobile health applications (apps) by 2018. These apps are software programs that run on smartphones and other mobile devices, accessories that attach to them—or a combination of both. Propelled by a variety of drivers—such as the proliferation of mobile devices, the consumerization of healthcare, and a shift toward value-based payment models—medical apps are playing an increasingly important role in care delivery no matter where it occurs.
Healthcare To Go
Since Apple launched the first generation iPhone in 2007, the explosion of mobile devices has provided health care professionals with the ability to use new point-of-care technologies to improve efficiency and enhance patient care. Providers have been using medical apps for some time to accomplish a variety of tasks—typically those related to administration, health record maintenance and access, communications and consulting, reference and information gathering, and medical education. However, there’s been a great deal of reluctance about trusting patient-facing technology and apps when it comes to patient care—largely due to lack of clinical validation and concerns about the accuracy of the data they produce.
More than half of health consumers (54 percent) would like to use their smartphones more to interact with their providersClick to tweet
For consumers, it may be a different story. As the world becomes more digitized, the “liquid expectations” that seep from one industry to the next means that patients increasingly expect the same when it comes to their healthcare, too. A 2015 Accenture report noted that “more than half of health consumers (54 percent) would like to use their smartphones more to interact with their providers,” and the Research Now Group found that of the 1,000 health app users surveyed in the U.S., 96 percent felt that health apps help to improve their quality of life. Although popular health and fitness apps such as Runkeeper, Yoga Studio and Calorie Counter PRO don’t qualify as medical apps, they’ve helped to create a world in which better health is available at our fingertips. Runkeeper’s success is touted by a community of 45 million runners; Yoga Studio has endorsements by a number of top media outlets—including MacLife, The Guardian and MSN; and many of Calorie Counter Pro’s customers give it five stars and rave reviews for versatility, simplicity and effectiveness. Such sentiments and a gathering body of evidence indicate that if providers are serious about patient engagement efforts, they’ll need to find a way to meld clinical responsibility with the mobility that many patients want.
To gain further insight, I asked an expert in the digital health sector what she is seeing in terms of health app trends. Lorena Macnaughtan, MBA, MA is the ICEEhealth Event Director, a new track dedicated to Digital Health at ICEEfest, Bucharest, Romania—one of the biggest festivals for digital technologies in Central and Eastern Europe. Additionally, she is advising omixy, a data and genomics driven, personalized health company—and writing up her multidisciplinary PhD thesis focused on Digital Health with the Horizon Digital Economy Institute, at the University of Nottingham.
Here’s what Macnaughtan had to say:
“I’ve just recently read some stats about healthcare professionals being ‘the most threatened’ by health apps (research2guidance 2016) . And I admit, I stopped for a minute—surprised that we are still qualifying health apps as a ‘threat’ for the medical arena. We all know the many reasons for digital health to still be in a liminal space—cultural reasons (a rearrangement of the patient-provider relationship), safety, privacy, and ethical considerations. On top of that, there are many types of apps out there, so regarding health apps (anything from content, to fitness/wellness, to medical conditions), I guess you would elicit a skeptical stance from healthcare professionals.
But, there is clear progress towards embracing the amazing opportunities that health apps offer, and it is perhaps time to frame them as such. For healthcare professionals they offer ways to manage and streamline the relationship with the patient (i.e. Mayo Clinic’s app), they support better health outcomes (MySugr – a range of apps diabetes management and education-or 11Health), and support data collection needed for patient management (Pain Squad is ‘a cop style game’ for kids who need to document pain as cancer patients).
That doesn’t even begin to touch on Big (health) Data and using it for prevention, lifestyle change, and the hopes for new medical breakthroughs or even personalized approaches (omixy). Such apps just make sense for many current healthcare scenarios. Fortunately, according to a 2015 IMS report, ‘Multiple research projects are in progress at university and hospital levels that will further support the best practices and business case for implementing enterprise mHealth solutions.’
Regarding new trends, we will see telemedicine apps for specialized areas, patient support and gamification (ayogo, mira rehab) tailored for curtained medical problems, and automated diagnostics (i-nside, SkinVision). Overall, we will see more robust apps targeting well-defined medical problems. Such apps will, in theory at least, be able to generate better business and use cases for themselves, being both more targeted and usually with health professionals involved.”
Other system-specific apps include those in the ophthalmology sector, such as D-EYE—a portable eye and retinal imaging system that attaches to an Apple or Samsung smartphone; and DigiSight—that offers several app-based mobile products for point-of-care diagnostics and sharing of patient data. In other sectors, such as maternal health, mobile apps are making a vast difference to help improve care in developing nations.
In addition, uniquely structured apps include VitalSnap™ that was recently launched by Validic. It captures real-time data from non-connected legacy in-home medical devices with the smartphone camera and transmits it to provider health IT systems. Another is London-based Your.MD, an app that uses natural language processing to provide “artificial intelligence health advisors.”
Overcoming Provider Reluctance
Although provider reluctance has been common, change may be afoot. A September 2015 report by IMS Institute for Healthcare Informatics, Patient Adoption of mHealth: Use, Evidence and Remaining Barriers to Mainstream Acceptance, noted that of the more than 165,000 mobile health applications available to consumers , one in ten of them now has the capability to connect to a device or sensor—which enables the provision of biofeedback and physiological function data from the patient. Such functionalities make data collection through apps much more accurate and convenient.
In addition, when the U.S. Food and Drug Administration (FDA) provided its guidance about the regulation of mobile medical apps in 2013, it provided new credibility and clarity for their use. In fact, the FDA recognizes the increasingly valuable role they play as a component of care: “ The FDA encourages the development of mobile medical apps that improve health care and provide consumers and health care professionals with valuable health information.” The availability of sites such as iMedicalApps—that offers peer reviews of popular medical apps—also help to support physician use; and Becker’s Health IT & CIO Review recently put out a list of 40 healthcare apps that they say clinicians and consumers should know about.
As physicians become more comfortable with the reliability of the apps that are available, they may be more willing to integrate them into patient care. In fact, a 2015 survey of 500 healthcare professionals in the U.S. revealed that although only 16 percent of healthcare professionals surveyed were using mobile apps in their practices at that time, almost 50 percent planned to introduce them by 2020—with a majority citing a variety of benefits they feel apps can provide.
As a report in the National Institute of Health (NIH) journal concludes, “Medical devices and apps are already invaluable tools for HCPs, and as their features and uses expand, they are expected to become even more widely incorporated into nearly every aspect of clinical practice.”