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The mHealth App Market is Primarily Useless (For Now)

November 14, 2013
by Gabriel Perna
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By all accounts, the mobile health (mHealth) app market is growing at a rapid pace, but how many of those apps are meaningful and actually functional?

This question was at the heart of a recent report from the IMS Institute for Healthcare Informatics, a division of the Danbury, Ct.-based IMS Health, a research, analytics, business intelligence, and data measurement company. Researchers of the study, “Patient Apps for Improved Healthcare: From Novelty to Mainstream,” analyzed the approximate 43,000 health-related apps available on the iTunes app store to better understand their functionality and usage from a clinical perspective.

What the researchers found was that while there are a lot of apps out there, most have limited functionality. More than 90 percent apps reviewed by the researchers scored less than 40 out of 100 on functionality, based on 25 clinical functionalities. More than half of the available apps have been downloaded fewer than 500 times and five big apps represent 15 percent of all downloads. Additionally, most mHealth apps don’t address the areas of greatest needs around outcomes and age.

To better explain the findings, the executive director of the IMS Institute, Murray Aitken, recently spoke with Healthcare Informatics’ Senior Editor, Gabriel Perna. Below are excerpts from that interview.

What are the most popular mHealth apps out there - what do they do, how do they typically work? What is working right now?

The most downloaded apps are the ones that relate to diet and exercise— things like a calorie counter. MyFitnessPal is the one of the leading apps. It’s highly rated by users and makes it easy for a user to track calorie intake and calorie consumption. It’s well designed, fun to use, and it readily becomes a habit for the consumer.

They are not the sort of apps that would be useful for patients who are on multiple medications, [and could use] some kind of reminder system that can ensure adherence to medication guidelines. They are not the sort of apps that involve remote monitoring of patients’ vital signs.  They are not the sort of apps that can help with a transition from one care setting to another. Those apps are the ones with a serious role to play in healthcare. We see some, but we don’t see thousands of them. We think that’s the direction we will head in, and ultimately, where we can see the apps bring a greater value to healthcare.

What have been some factors holding back these clinical mHealth apps?

One factor is a lack of clarity with regards to the regulatory landscape and what’s required. They also may be held back by being expensive and not being reimbursed by payers or by employers as part of wellness programs. They are also held back by the fact it takes some investment to demonstrate with evidence that the app is bringing clinical value, and we don’t have a well established way of gathering that evidence.

For the report, you also spoke with physicians. Where do they stand on the rise of mHealth apps?

Physicians are leery of formally recommending mHealth apps for a few reasons. One, the evidence that the apps actually help the patient is hard to find, particularly from randomized trials. Physicians are also concerned about the security of personal health information generated and transmitted from the app. They’re leery of recommending them without clear professional guidelines about their use. And they really have no tools to enable them to sort through 43,000-plus apps that are out there, to identify which ones would be best suited for a particular patient. There is no curation of the apps available.

What about problems with integration into the electronic medical record (EMR) and other IT systems? Has that played into the lack of relevant clinical mHealth apps?

Physicians at larger provider organizations have been clear to us that unless there is integration, their provider organization will not be enthusiastic about the use of apps, and in particular, those [apps] that generate information that flows back to the provider organization. So integration with EMR system is very important. Integration with the patient portal, particularly as use of the portal increases along with the meaningful use guidelines, that integration will be important. It will be a challenge as well. Partly, because we know CIOs are already busy with meaningful use, with EMR implementation. One constraint for more rapid app development will be getting the mindshare and timeshare of CIOs to support the integration of the apps and information that may flow from them into the rest of their health IT system.

How do you see everything playing out over the next few years?

We are enthusiastic about the potential of apps in a clinical setting. In the context of the other changes that are occurring in our healthcare system, having at tool, like an app, that can in a cost-effective way be used by patients to help improve outcomes and lower their health service utilization, that’s a very positive move and one that should be supported as we move from a fee-for-service environment to an outcomes-based system.

If we have convergence between payers and providers who are increasingly motivated to care for patients in a way that is cost-effective and where outcomes is the key metric, we’ll see that convergence with the technology that already exists in terms of apps. We just need to clear the roadway of some of the barriers.