Healthcare Mobile Apps and the "Connected Patient" ??

You probably use your smartphone for email, chat, social sharing, games and online shopping. And you must have definitely considered using mobile technology for managing and improving your health. It’s not just health care, mHealth is self-care. 350,000 mHealth applications are hosted across different app stores. There are over 41,517 health, fitness and medical apps in the Apple App store, and around 47,890 such more on Google Play Store. Such is the pace of development and interest in this sector that has been traditionally a laggard compared to FMCG, Retail and Banking when it comes to technology adoption.

??The mhealth market size was valued at US$63.88 billion in 2022 and is expected to cross US$243 billion by 2030 at a CAGR of 18.2% for the period 2022-2030, as per Precedence Research. In India, the size of the Health Apps market is projected to reach US$146 million in 2023. This market is expected to show an annual growth rate (CAGR 2023-2027) of 17%, resulting in a projected revenue of over US$274 million by 2027. The corresponding user penetration in India will be 1.53% in 2023 and is expected to grow to 1.76% by 2027. China is expected to be the largest market with over US$500 million revenue in 2023.

Health apps today offer a mind-boggling array of health support, such as:

• Calculating calories burned during exercise
• Creating soundtracks to help people fall asleep
• Displaying pictures that can elicit memories from Alzheimer’s patients
• Quantifying pain over time

There are many mobile apps and wearable devices that are currently focused on fitness and wellness tracking activities. This usage is expected to expand into the home monitoring segment as remote patient monitors, and eventually be integrated into hospital beds and tables. The devices will also evolve from tracking single features (e.g., track body temperature) to multiple ones (e.g., sleep tracker, calories, pulse oximeter). Healthcare wants to become more accountable and the drive towards patient centricity is creating a need for patient relationship management solutions. The world of patient management will see apps that serve to build relationships, engage patients, and track patient satisfaction.

In the healthcare industry, electronic data capture went mainstream due to a combination of stimulus legislation in the US, and cost pressures. The ARRA act of 2009 ushered the Electronic Medical Record (EMR) systems era and resulted in a US$20 billion market in 2013. Currently, a majority of hospitals have one kind of EMR system or another and this has resulted in the availability of healthcare data in electronic form. The need for sharing data with patients as part of Meaningful Use Stage 2 requirements is pushing the deployment of cloud-based patient portals to the top of the priority list.

Mobile Apps as Empowerment Tools for Patients

The concept of mobile apps for patients is continuously evolving. From their humble beginnings as an online diary or tracker, the current thinking is that an app should empower the patient to take more control of his or her health and be able to take decisions with the support of the provider team, and even involving close friends and family if needed.

For example, Sanofi-Aventis created GoMeals to support people managing their diabetes. The app has calculators and tools that make mealtime decisions easier. More than 3,000 people visit the GoMeals site monthly. The app itself has 264 reviews across two app stores with an average rating of 3.5 – 4 stars.

?Apps are also moving beyond medical care. When UCLA developed the first patient app, it provided entertainment services like games?and Netflix and access to social media, email, and a web browser. They also provided patients with access to their lab data and feedback surveys, both about their general hospital experience and about the tablets. Patients’ favourite features were checking labs and searching online for information about their condition, so in the next iteration they added more educational tools, including personalized information about the patient’s care team and daily schedule. Such apps when used in a hospital setting try to take the fear out of being hospitalized and give patients?an idea of what to expect.

Another inpatient app, for patients needing a prostate cancer screening, provided patients with information about the relative risks and benefits of two screening options and allowed them to indicate which one they preferred. That information would then go to their physician.

Enhanced recovery after surgery (ERAS) programs have gained momentum as they reduce the length of hospital stay and patient morbidity. SeamlessMD app behaves like a “virtual companion” for patients undergoing surgery. It supports them for surgical preparation and recovery with reminders, tasks, progress tracking and feedback. Instructions alleviate confusion or doubt about what patients should and shouldn’t do before and after surgery.

The pre and post surgery TapCloud app uses machine learning to respond with the appropriate guidance for specific pre- and post-surgical procedures. It tracks patient progress over time, checking for unexpected pain or side effects. The MyRecovery app, developed by orthopaedic surgeon Thomas Harte, helps patients take a proactive role in their care when recovering from procedures. Prime app helps post-surgical patients track the progress of their recovery. They track heart rate?and?activity, answer a questionnaire about pain daily, and take daily photographs of their wound.

Apps should be Actionable and based on Patient Insights

However, it’s not enough to just collect information. It has to be actionable and clinically relevant. So the best apps have an algorithm or intelligent triage engine that alerts providers if there’s a condition or a trend that indicates a worsening of a patient’s status. And that whole picture together makes it actionable for the clinician. Doctors can decide if they need to call that patient for a consultation to keep them from being admitted to the hospital.

Pharma company Pfizer currently has 15 apps in the US iOS app store, ranging from a chapstick companion app to an app for people with kidney cancer. Its app for smoking cessation, called?Quitter’s Circle, developed in partnership with the American Lung Association, incorporates?a social feed with a curated network because Pfizer found that quitting smoking can be?isolating and that family and friends were top motivators. The app includes help scheduling and remembering doctor visits, because they found that just consulting with a healthcare provider doubles someone’s chance of quitting successfully.

HemMobile is an app for people with hemophilia. The app enables logging of bleeds, transfusion, and activity, which can be tracked automatically via HealthKit. It also aims to make?it easier for the patient to share that data with their healthcare provider.

While logging is important to treatment, this action can be very demotivating at times. So, imagine if you’re a 10-year-old hemophiliac and you have to write down every time you have a bleed and every time you deliver an infusion. You could imagine the compliance with that would be really low. I can’t get my son to tell me if he has homework due tomorrow. Logging something that occurs multiple times per day is asking for too much.

More than 1000 apps promise to help consumers lose weight. Moreover, few, if any, research-tested apps have been widely disseminated or commercialized. A good strategy is therefore not to just build features blindly in the mHealth space, but to start with insights to know what people want and overcome those barriers using the best tools available. Make sure the solution is easy, friendly, and engages with patients in the way they want to be engaged with.

Mobile Apps that can Help Manage Chronic Disease

There are several mobile apps available for managing chronic diseases such as diabetes, hypertension and allergies. Gather is one mobile app that is quite unique since it connects a diabetic patient 24/7 with the doctor, clinic and family for convenient support……anytime, anywhere. This app provides medication alerts to a patient, allows him or her to Chat with the doctor or diabetes counsellor, Track health improvement and even Share the progress with family and friends who are keen to see how the patient’s health is improving. Thus this mobile app from Gather Health provides continuous and active diabetes care.

Gather Health App offers a Range of Benefits for Diabetics

• You are never alone as you share your progress with a loved one on the app - your close family member or friend cares for your well-being. The app makes it easy for them to track your health through the app. Friends and family receive alerts and they can also chat with you. They can also motivate and support in many situations.
• ?View your health data easily in the form of tables or charts - Diabetes management becomes more interesting as a patient can see improvement trends over weeks. The blood sugar or blood pressure data in the form of tables or charts makes it easy to spot trends early on.
• App alerts the doctor automatically when blood sugar levels go very low or high - The app will alert the clinic / doctor immediately and automatically if your blood sugar reading is not within the limits decided by your doctor. Your doctor can decide faster what action needs to be taken.
• Doctor provides continuous care with online medical advice on the app -The Gather app lets a patient chat with the doctor / clinic staff, ask questions and get online advice to many queries that are not possible to be covered during a clinic visit.

• Patients never miss a medication with real-time alerts - Patients can view the medications prescribed by the doctor and record (log) whenever a medication is taken. This assures that they never forget when to take medicines with real-time phone alerts, leading to higher medical adherence and health improvement.
• The app alerts when to test blood sugar and shares the results with a doctor when logged in - Gather app alerts patients when it’s time to check blood sugar, so that they can record the results regularly. This leads to active management by the doctor even before a clinic visit and improvements are seen sooner in diabetes control. Patients can conveniently select the reason why sugar was high or low. Now the doctor immediately knows the reason for the fluctuation through the app.
• Receive medication or insulin adjustments from your doctor online - It may not be possible to visit the clinic every week for minor medication or insulin dose adjustments. Now a doctor can make changes to medication / insulin dose immediately after seeing the patient’s health data. No need to wait till the next visit!
• App can be used to record health data, oral medication and insulin units taken - You can conveniently save data related to your diabetes on the app – blood sugar and blood pressure – and see how it has improved over the months. Now immediately record whenever you take your medication. You can save the dose of insulin taken at different times, and even change the units taken if needed, while your doctor gets informed real-time.

Health Apps are being built into Cars

Ford and Toyota are creating in-car health management systems that monitor real-time biometrics:

1. ECG (electrocardiogram) tracking through the steering wheel
2. Bluetooth integration of Medtronic’s?continuous glucose monitor
3. Reminders and touchscreen control of WellDoc’s disease management support
4. Real-time allergy indexes from SDI Health

The "Connected Patient" Model for Health Apps

The mHealth industry has begun moving towards a model of “Connected Patient” – with the patient at the center of the care team and connecting the various stakeholders. This connected virtual team helps in delivering personalised disease management plans and managing the total cost of care.

We saw a detailed example of this concept execution in the Gather Health app, piloted in 5 major cities of India. The emerging medical devices market is creating devices that sense various health parameters and sync with mobile apps that create feedback loops or communicate seamlessly with healthcare providers. Thus, the Connected Patient can be proactive rather than reactive.

Your patient is no longer alone!

??...to be continued.?Part 3: Mobile Apps Design Trends 2023

Read Part 1: Mobile Apps – in the palm of your hand today! Where next?

Also read Part 3: Mobile Apps: Changing Landscape & 9 Design Trends in 2023

About the author:

Tanjai Kapoor is a marketing professional with an MBA from IIM. He has over 25 years of industry experience in healthcare, hospitals, telecom and manufacturing. He was recently the head of marketing at Paras Health, AIG Hospitals and Apollo Hospitals, and earlier the India head for Gather Health. He can be reached on +91 99800 96205 /?[email protected] for healthcare consulting projects.

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