Health System, Apps Must Evolve for Mobile Health Adoption To Take Off

Technology tools continue to play an important role for patients, particularly those with chronic and life threatening illnesses. Seven in 10 people with a chronic condition went online to find information about it, according to research by the Pew Research Center. And, as the number of medical issues a person has increases, so too does their use of the Internet to gain information about their conditions.

In another survey, the Pew Research Center reports that nearly two-thirds of U.S. adults own a smartphone. Ownership is highest among younger adults, the affluent and educated individuals. Slightly more than six in 10 smartphone owners have used their phone to get information about a health condition in the past year, according to the survey.

As a society, our reliance on mobile technology and content-specific applications is clear. Yet, when it comes to gaining information about how to manage chronic illnesses, condition-focused websites and blogs remain the top technology tools patients turn to. That was the finding of a recent survey of nearly 14,000 members of the medical social networking site Inspire. Of those surveyed:

  • 78% said condition-specific websites or blogs were the most helpful source of information used to better understand their health conditions; and
  • 76% turned to online search engines. 

"It's so easy to type a question into Google or Yahoo, which is step one before ending up on a website or blog or social media site," Dave Taylor, research director at Inspire, said.

Specific mobile apps, by contrast, were sought out far less frequently. More than 70% of respondents said they never use mobile apps as a source to better understand their illness. Fewer than half felt that mobile tools would be helpful in managing their health conditions. 

Of the nearly one-third of patients who do use mobile apps, the survey found that 59% do so to prepare for a doctor's visit. Fifty-six percent tap their smartphone to search for health information online, and nearly the same percentage (55%) use mobile apps to remind them to take their medication.

Additional trends emerged among those with chronic health conditions that use health tools on their smartphones:

  • Women use their smartphones more frequently to complete health-related tasks than men;
  • Respiratory patients are most likely to use a smartphone to prepare for doctor's appointments, search for information online and take notes while visiting with their doctor; and
  • Autoimmune patients are most likely to use a smartphone to take photos of their symptoms.

Not surprisingly, those using health apps skewed younger, with 42% under the age of 30 reporting that they'd used a mobile app for health care with at least some frequency. In comparison, just 18% of respondents ages 65 and older used apps to manage their health conditions.  

But that age gap is likely to diminish over time, experts say.

"Facebook started out with college kids and young adults, but one of the larger growing demographics seems to be grandparents who can't see pictures of their grandkids any other way," said David Harlow, a health care attorney and author of the HealthBlawg

Developers should pay more attention to interface and design to make mobile apps more accessible to older adults, Harlow said. After all, it's this group that is far more likely than young adults to have chronic illnesses and, therefore, could gain the most benefit from the use of mobile health management tools.

"The amount of money involved, the amount of potentially improved health and ability to engage them in activities of daily living more easily is just tremendous," Harlow said. "As the population ages, it's only going to increase. We're talking about a high burden of disease, so building apps for healthy 20-somethings is just not going to move the needle."

Barriers to Going Mobile

The track record of mobile health apps holding consumers' attention has thus far been somewhat dismal.

"Most folks who download a health app will end up using it for not more than 90 days," Harlow said.

Among the many reasons for this is that early mobile health tools simply haven't been that useful. 

"People tried them and don't like them and have a bad taste in their mouth about anything put out subsequently," Taylor said.

In addition, the apps tend to be fragmented and difficult to link to other tools that live on the smartphone that capture different but related health information.

For example, Taylor pointed to his own use of one mobile app to track his workouts and another for his caloric intake. One app would automatically capture his run, but he had to manually enter information to capture his caloric intake. "I'm young and tech savvy and couldn't get it to work. You hear that from the market as well," he said.

Another barrier to mobile app adoption is cost.

Despite the fact that nearly two-thirds of Americans currently own a smartphone, many people say their cost for both the phone and monthly plan is too high.

In fact, a Pew Research survey found that nearly one-quarter of smartphone owners have canceled or suspended their cellphone service because the cost was too expensive. Among those in households with annual incomes below $30,000, 44% have discontinued their service.

In addition, the privacy and security of the information captured on a smartphone remains a large concern among patients. The health information entered into a smartphone app is generally not protected by health care privacy rules.

"A diet app, or even your own pill-reminder app, that's not going to be covered by HIPAA unless it's been provided to you by your health plan," Harlow said.

But that's not the only privacy concern patients worry about, Taylor said.  

"Beyond the A-to-B transfer of data, we've heard people are concerned about those close to them picking up their phone and opening the app and finding out information they purposefully have not shared with others," Taylor said.

The Future Looks Mobile

Despite current barriers, experts say mobile technology will continue to be integrated into health care delivery.

"The increase in the number of mobile users has reached an all-time high, and it's an untapped market for the industry to reach out to," Taylor said.  

In addition to advancements in technology, policy changes will encourage the adoption of mobile health care tools.

Harlow pointed out, for example, that the new chronic care management benefit under Medicare -- which allows doctors to be reimbursed for coordinating patient care -- is likely to bring about revolutionary change.

The use of mobile apps and other technology allows seniors with multiple chronic conditions and health care providers, to coordinate disparate medical records and have the information readily available during office visits.  

"Being able to have a smartphone app in the hand of the physician, the smartphone app in the hand of the patient and in the hand of the chronic care management nurse with all this information available is just a tremendous benefit," Harlow said.

The technology will also grow in importance for physicians to monitor the health status of their patients and adjust treatment based on the data captured.

Patricia Ganz is an oncologist and breast cancer researcher with the University of California-Los Angeles who recently co-developed a breast cancer survivor app with Apple. The app captures daily assessments of patients' fatigue, pain, cognitive function and physical activity, among other measures.

Ganz also pointed to a Parkinson's disease app recently developed by her colleagues, which includes a tapping exercise that tests the rigidity of patients' muscles, and cognitive tasks to test memory and how patients function within a half hour of taking their medication.

"The technology is really there," Ganz said. "The issue is how do we bring it to an antiquated health system which is still into paper and pencil."

The answer, she said, rests in part with doctors adopting these tools and encouraging patients to use them.

"As we have this younger generation of physicians who are tech savvy they will become the adopters," Ganz said. "I think it's going to be a generation shift where they'll be using all of these things as part of their care for patients." 

Source: iHealthBeat, Wednesday, August 26, 2015

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