Monday, January 26, 2015

Either You Give Your Patients a mHealth App, or They'll Get One Themselves

That's what the Population Health Blog learned after reading this research paper by Bauer and colleagues that recently appeared in the Journal of the America Board of Family Medicine.

It also confirmed that chronic care management apps are a business opportunity.

What was the research and what did it show?

All adult patients receiving care at six clinics in a northwest U.S. primary care network during a two week window of time (June 2015) were anonymously surveyed about their use of mHealth.

Depending on the clinic, 22% to 62% of the patients were insured by Medicaid.  More demographic info can be found here.

1363 surveys were distributed and 918 (67%) were completed. 

91% had a mobile phone and more than half (55%) owned a smart phone.

Among the smart phone owners, 70% had used "mHealth." 57% had downloaded at least one app. Of these, 69% used it less than 3 times a month, while 11% used it on a daily basis.

There was no association of mHealth participation with health literacy, chronic conditions or depression. Use was more prevalent among persons less than age 45.

One third used "general" health apps, while one quarter used fitness, diet or weight-loss apps. Only 3% used it for chronic disease management.

The authors asked respondents to use a 1-5 scale to rate the desirability of various app features. Appointment reminders came in first, followed by medication reminders and general health information.

10% learned about this from their physicians and only 31% "prioritized" their physician's involvement.

The PHB's summary:

Smart phone and app use may be more prevalent in the northwest, which may make the findings of this survey less generalizable to the rest of the United States.  With that caveat, approximately 40% of the patients sitting in the average primary care clinic waiting room are mHealth users and about 20% are using health apps. And what do patients most prize in their apps?  Reminders about appointments and medications.

What's more, most of this is occurring without the benefit of their providers' participation.

Last but not least, apps have not penetrated the chronic disease population.

The PHB's take?

1) If all those patients with smart phones are going to download apps, they might as well download ones that - at a minimum - are endorsed by their providers. Optimally, they should complement their providers' services.  Used right, they might be able meet their patient's desires for coordinated appointments and increased medication compliance. 

Providers and patients would benefit from better quality and lower costs.

2) And patients with chronic conditions have yet to discover apps.  That may be a function of age, but it may also be a function of the conspicuous silence of their providers as well as the failure of the currently available apps to meet their potential customers' desires. 

That spells opportunity.  Recall the adage of the two shoe salespersons who were sent to Africa.  The more pessimistic of the two found that none of the natives were using shoes and decided to return home.  The optimist likewise found that no one was using shoes, but he called back to the home office and asked for help.

The market for chronic care apps needs help.

Image from Wikipedia

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