6th Global mHealth App Developer Economics Study–early results in

click to enlargeresearch2guidance has shared with the Editors some of the preliminary results of the 6th Global mHealth App Developer Economics Study. Currently at 2,000 participants and open till the end of May (click here to take the 15 minute survey), it has grown to be the largest global market study of the sector. (Last year’s study topped out at more than 5,000 industry respondents and is available as a free download here.) For their time, respondents can view initial results upon completion of the survey, after publication in 2nd Quarter receive a copy of the report and be automatically entered into their prize draw of an Apple Watch or Samsung Gear.

Many of the results to date are neatly summarized in the infographic at left and below:

  • 61 percent believe mHealth solutions can cut costs through therapy adherence
  • 65 percent believe mHealth adoption could save costs by shortening or avoiding hospital visits
  • Market potential as a distributor: app stores still lead (61 percent) but half believe health insurers are now second. Doctors and hospitals trail at 42 percent and 38 percent respectively.
  • Most positive impact: following up and monitoring of conditions; information provision; diagnosis and treatment
  • But goals are still distant: 53 percent of respondents revealed they had only “partly achieved their goals”. 4 percent claimed their mHealth “dreams came true”. (Perhaps those who had their companies acquired? — Ed.)

r2g release.

TTA and DHACA (Editor Charles, Managing Director) are media partners for this study. Hat tip to Sean Phillips of r2g. Previously in TTA, Charles’ original article.

A gallimaufry of short digital health items to start the day with

The WHO has produced an excellent report on the state of eHealth in the European region, including a review of telehealth readiness. Ericsson have produced a very interesting report confirming what I guess anyone will have realised if they’ve traveled by public transport or have children: young people downloading video content are driving a surge in data usage: there’s much detail here though. Both are well worth the read.

Mentioning Ericsson reminds that the Telegraph recently produced a summary of the 20 best-selling mobile phones of all time – takes you back, with the substantial number once produced by Nokia.

The Royal Society of Medicine has it’s fifth annual medical app conference on April 7th – numbers booked have already well exceeded last year’s sellout so they are expecting to fill this year’s much larger conference venue. The focus this year is on the many legislative, regulatory and voluntary measures being introduced that will impact medical apps – there’s still room for old favourites though, such as Richard Brady’s always-topical (more…)

Health tech innovations are doing little for baby boomers

click to enlargeWonder why the duck is upside down and sinking? Maybe it’s looking for all that transformative tech! Versus The King’s Fund sunny article above is Laurie Orlov in Boomer Health Tech Watch. Her POV is that as of right now, health tech innovations are not moving the needle for obese (39 percent) and chronically diseased US baby boomers. They aren’t downloading health apps and wearing wearables. Workplace wellness programs? Au contraire, they make us feel less well (Harvard Business Review) and anxious that we’re getting spied on by the company. Maybe we realize that All That Data isn’t secure (healthcare being a Hacker’s Holiday Camp), so we’re not playing the game. And the cost of care that the ACA was supposed to level off? Not if you’re a self-insured Boomer struggling to pay an ever-higher monthly premium, or even in a corporate high-deductible plan, paying increased deductibles, restricted networks, ever-higher treatment costs and fighting your insurer at nearly every turn. Add to that safety risks of procedures, mistakes compounded by EHRs [Dr Robert Wachter, TTA 16 April]  and (not mentioned) hospital-acquired infections. No wonder investment has cooled. Health and tech innovations do little for baby boomers

Does current digital health meet baby boomers needs and wants?

The answer, according to health tech industry analyst Laurie Orlov (Aging in Place Tech Watch, Boomer Health Tech Watch) is…not really. Despite its massive size (76 million in the US), spending power (by 2017, 70 percent of US disposable income), breadth (1946-64) and need (despite living longer, by 2030 37 million will be managing more than one chronic condition), most health apps, especially fitness apps, don’t resonate with boomers despite over 50 percent having smartphones. The reasons are many–they’re complicated, often hard to follow, view, and abandonment across all ages is still high. Even among Fitbit purchasers, abandonment is fully one-half. As income decreases, smartphone access also becomes a cuttable budget item. Much more in this paper published by the California Healthcare Foundation.

Better’s fast fail, ending health assistance service 30 Oct

click to enlargeBetter is sadly not. This two-year old service that provided personal health assistance, including a real, live health assistant, to guide members through health questions, the thickets of insurance claims, finding doctors and specialists, apps and more, announced earlier this week that it was ending operations as of 30 October. While it was announced via their Twitter feed on Tuesday, most of the industry learned of it through Stephanie Baum’s article in MedCityNews today. Better formally debuted only 16 months ago [TTA 23 Apr 14] and at the time this Editor felt that it was a service in the right direction, a kind of ‘concierge medicine for the masses’ needed when individuals have to direct more and more of their own care.

A solid start, as our Readers have seen, does not guarantee success, but this fast fail is still fairly shocking. A concern at the time was the pricing for the full service model at $49/month, which later became the family price (individuals were $19.99/month). CEO/co-founder Geoff Clapp was among the most Grizzled of Health Tech Pioneers; he had been a co-founder of Health Hero/Health Buddy from 1998 to its sale to Bosch Healthcare, a very long pull in telehealth, and he had spent much of his post-Health Hero time generously advising other startups. Yet despite the involvement of blue chip Mayo Clinic as a service provider, its financial backing from their investment arm and socially-oriented VC Social+Capital Partnership, it managed to raise only its initial seed funding of $5 million (CrunchBase).

So what happened? (more…)

IMS Health report: mainstream health app adoption remains elusive

click to enlargeDespite 165,000 apps (and counting). A followup to IMS Health’s report of 2013, Patient Adoption of mHealth demonstrates how far mHealth has to go. Over 50 percent of apps have a single functionality, but connectivity to external sensors (e.g. wearables) has improved to 10%. 36 apps account for nearly 50 percent of downloads and 40 percent of all health apps have 5,000 downloads or less. Providers give limited if any guidance to consumers on app choice despite greater interest; ‘curation’ efforts, including IMS Health’s own [15 Dec 13], have largely failed. Other barriers to adoption are reimbursement (though many are free), limited healthcare system integration, regulator and privacy unknowns.

Where’s the progress? Chronic condition monitoring (left), with clinical trials more than doubling in the past two years, and focusing on treatment/prevention largely for older adults. These clinical trails are looking at mental health, diabetes, cardiovascular disease, weight management and oncology. IMS Health also recommends that users and stakeholders, including clinical organizations such as the CDC, ASCO and the Cancer Support Community tap into their clinical resources to develop and promote patient-centered apps. Download report (information required.)  A decidedly less cheerful take on the report is Stephanie Baum’s at MedCityNews.

UK, Nordics lead best EU countries for mHealth business: survey

Respondents to research2guidance’s fifth annual mHealth Economics survey rated UK and the Nordic countries the best for mHealth market success, based on factors of market readiness and maturity including doctors and consumers. Other top countries were Sweden, the Netherlands, Denmark and Finland. Germany and France were significant because of market size and investment in healthcare. According to the survey where over 5,000 healthcare app publishers and health professionals ranked countries on multiple points, “In UK, Sweden, Denmark and Netherlands doctor’s acceptance of apps and high level of digitalization are seen as main drivers. Germany is attractive mainly because of its substantial market size and its big number of potential users.”click to enlarge

Findings were presented this week at the mHealth Summit in Riga, Latvia and is the first part of a larger study on developer economics and future healthcare delivery. As a media partner, TTA participated starting in March in inviting respondents to the survey. A free download of the report is available to our readers here (minimal registration required). Release

All about the fitness devices with Parks Associates, Juniper Research

Fitness trackers are hot, hot, hot.

So Parks Associates‘ latest study tells us, with 60 million US households expected to own at least one by 2019 (hey, only 4 years away!) with global revenues exceeding $5 billion. Of that, smartwatches will constitute 100 million units. Given that only 7 million Android-based watches have been sold to date, and that the Apple Watch is projected to be about 10 million (2.3 million sold to date, according to ZDNet which glows away), that may actually be–achievable. POLITICO Morning eHealth also reported from their interview that about one-fifth of smartphone and tablet owners use a health app on a monthly basis, and 19 percent of smartphone owners find a “master” health app that aggregates data from other health apps appealing. Parks release.

In the UK, of Juniper Research’s top five smart wireless devices, three have a relationship to health, with the Apple and Google-TAG Heuer smartwatches on the high end and GOQii Fitness using their or anyone’s watch or fitness band to keep you on track for the price of their subscription. Less karma than when we saw them last June at CEWeek, more coaching. The apps will be the primary generator of revenue in fitness-band land, with hardware margins declining in the next few years. (Speaking of revenue, Juniper’s full study will set you back a tidy £3970.)

The hypealicious, hyperluxus Apple Watch debut–what the healtherati are interested in

click to enlargeL’œil de Gimlet eyes the Apple Watch. What’s down the road is more important than Monday’s unveil. Certainly The Eye, an adorer of all things over-the-top, would love to have the $10,000-and-up 18 karat, Daddy Warbucks, Solid Gold Cadillac edition of the Apple Watch. It is the sheer hyperluxus, Mercedes-Maybach S600-ness of it all that races my pulse. Stop at $4,000? Nein! $10,000 and up lends a golden glow to all those ordinary, plastic-banded, Mickey Mouse-faced $349 and up versions for the Applepolloi that take that pulse, burp your wrist when you’re not moving enough, open the garage door, play tunes and let you draw little thingies on the face that you can send to your friends. (Urp) What’s even better than a Merc-Maybach in Conspicuous Consumption-Ville? That it will be out of date in a year, unless Apple has a trade-in policy.

click to enlarge Cue Tim Cook and the Happy Dance of the Watches. (Photo: Zuma/Rex via Guardian)

click to enlargeCue Shirley Bassey. (Gigaom via Twitter)

Ah, but let us get down to business and cut our swathe through the fog d’hype. (Editor Donna just walked in the door…)

As predicted and projected, the Apple Watch in stores 24 April in Australia, Canada, China, France, Germany, Hong Kong, Japan, UK and US goes light and standard on health measurement features: accelerometer, heart rate sensors, running and weekly activity reports. What’s different? Wrist burps you if you’re a lazy, sitting sod. (Not a great feature for deep meditators or napsters.) The leak from two weeks ago feinted health through downplaying the functionality of the Watch. Back in September, claims included blood pressure and stress monitoring. [TTA 18 Feb]

Now for the right cross. It’s not the Watch, it’s the ResearchKit. Apple gets serious in health apps beyond HealthKit, partnering with the stars in the medical research firmament. As reported: (more…)

Participate in the 2015 Global mHealth App Developer Economics Study

click to enlargeTTA readers are invited to participate in the fifth annual mHealth App Economics survey, sponsored by research2guidance in collaboration with mHealth Summit Europe and HIMSS. The study will look at the mHealth app market, how apps generate revenue, how behavior could be changed by apps, the use of APIs and sensors as well as other related topics–and is the largest industry survey on mHealth app development.

Click here to go to our exclusive link and participate in the survey. The survey is available till 26 April. Share your opinions and experience on how mHealth apps impact healthcare delivery now and in the next five years. Plus, every participant will receive the chance to win one of five free entry tickets to the mHealth Summit Europe in Riga, Latvia 11-12 May, where the results will be presented; a free copy of the 2015 report as well as the possibility to see initial results after completing the survey. Download link for the 2014 study (PDF).

TTA is a media partner of the 2015 Global mHealth App Developer Economics Study, and was a media sponsor of this year’s US mHealth Summit.

UK’s Best SME Mobile Health APP Finals on Monday 2nd February

The shortlist judging for the above, entries for which we sought in December, will take place on the afternoon of Monday 2nd February from 2pm to 7pm in St Bride, St London. Attendance is free, and offers an unparalleled opportunity to listen to the pitches of what are considered the twelve best SME mobile health apps in the UK. Details are here – do be sure to scroll down to click the ‘book now’ button as places are limited.

The judges (disclosure: of whom this editor is one) will select those SMEs to go forward to the finals at the MWC in Barcelona in the first week in March.

The event is sponsored by UK Trade & Investment, techUK, and PatientView/myhealthapps

Health apps presently of little use, says Australian telehealth expert

click to enlarge“Immature” and “focused on low-lying fruit such as fitness tracking and not focused on the big issues of management of disease” are also two of the compliments that Dr George Margelis of the University of Western Sydney’s TeleHealth Research & Innovation Laboratory (THRIL) has bestowed on the current state of health apps. Until the collected data ‘plugs into other digital platforms’–he mentions the Australian government’s PHR, eHealth–apps will not help those who need it the most. “Unfortunately, managing these diseases, in particular the chronic diseases that are a major part of the current burden, requires more than just tracking a few physical parameters which is what the app world is up to.” Dr Margelis called for collaboration between app developers and healthcare professionals; while he scores Apple’s HealthKit, that may be the means to make his vision come true. It should be noted that Dr Margelis (more…)

Insomnia Apps: A replacement for sleeping pills?

sleepstation

For those of us suffering from insomnia there’s no denying it can be a real pain! For some it means wakening up a number of times throughout the night, while others are unable to get back to sleep after only a few hours rest. In my case it means drifting off into a peaceful slumber before inevitably waking just minutes later with a jolt, looking like Frankenstein’s monster and wondering if someone just hit me up the face with a bolt of lightning!

The latest NHS approved sleep app is Sleepstation. It’s one of three listed on the NHS Choices Health Apps website, the others are Sleepio and Sleep Diary. (more…)

A ‘disruptive’ US primary care delivery app with UK roots

This past week, this Editor spoke with Jason Hwang, MD, one of the three co-authors of The Innovator’s Prescription and noted here recently [TTA 31 Mar]. Since leaving the executive director spot at Innosight Institute (now The Clayton Christensen Institute for Disruptive Innovation), he and a team have been developing a smartphone app, PolkaDoc, that may bring a little disruptive innovation to simple primary care. The intent is to make remote primary care for basic needs far more accessible to the general public 24/7, helping to alleviate the shortage (and workload) of US primary care physicians (GPs). The individual first installs the free app from Google Play or Apple’s App Store, answers a simple questionnaire, records a short video to confirm name and date of birth as a verifier/signature, and pays the exam fee via debit or credit card. A doctor then evaluates and prescribes, if appropriate, with prescription pickup at your local pharmacy. According to Dr. Hwang, the first use of this app will be for birth control, charging a modest $10 exam fee, exclusive of the prescription. Technically, the 24/7 coverage is achieved via asynchronous store and forward, which enables significant scalability; any participating physician may ‘see’ thousands of patients a day if desired. The app is fully HIPAA-compliant and on US-based secure servers. The ‘soft’ launch of the PolkaDoc service will start in about two to three weeks.

For our UK readers, this may sound like a variation on something familiar. The ur-model is ‘DrThom‘ acquired by Lloyds Pharmacy in 2011. The eponymous service was developed by one of the partners of PolkaDoc, UK-based OB/GYN Dr. Thom Van Every, to provide sexual health services first by mail and later online. In the UK, this was a premium service at £50. According to Dr. Hwang, the objective is to adapt for the US what has been successfully done in the UK, Australia and other countries, learning from the lessons of its predecessors. With the idea that “simple things are taken care of as simply as possible”, it also matches that concept with low price to be affordable for nearly all women.

My discussion with Dr. Hwang also ranged on the app’s potential use in other healthcare areas and plausible partnerships. More to come on this, certainly.

Attitudes and behaviours of apps users

Health apps are often in the news these days. Ofcom, the UK telecommunications regulator, commissioned Kantar Media to carry out qualitative research on attitudes and behaviours of apps users when using devices such as smart phones and tablets. The resulting report, Apps Environment, published today by Ofcom makes interesting reading.

Although the report was commissioned by the UK regulator, I think the findings are applicable to any country. What’s more, the generic nature of the conclusions make them relevant to health apps as much as to any others.

The report says that “among app users, several perceptions were found to be influencing behaviours, attitudes and the low level of concern in the app environment. These perceptions were:
• official app stores monitor and vet the apps they make available;
• well-known brands provide a safe, secure and reliable user experience, and;
• apps are safer than browsers due to their more limited and contained nature compared to browser-based internet use.”

Another finding was that many app users said they paid very little attention to permissions requested by apps – nothing new there then. How many times have you ticked that “I Agree” box to the terms and conditions without reading them?

Very few participants in the research are reported to have raised spontaneous concerns about apps. The researchers say that when prompted, in-app purchasing and advertising were of greatest concern to parents, and at most, a frustration or annoyance to others.

This shows that when it comes to more critical apps such as health apps or those that are designed to provide a safety net in a care environment a stronger regulation may be needed as well as a pro-active educational effort to emphasise the need to be aware of issues such as data privacy.

Certifying health apps: is it at all possible?

This article in iMedicalApps takes a look back at the controversy that swirled around Happtique only four weeks ago–when Harold Smith III of Monckton Health and Fixmo went public on major data security flaws in two of their 19 certified apps–and moreover how Happtique did not respond to his concerns either in December or on the process in March [TTA 13 Dec]. It was the talk of the last big US gathering prior to International CES, the mHealth Summit.

Unfortunately, Satish Misra, MD, one of their editors, provides an argument best described as a ‘circular firing squad.’ Dr. Misra is absolutely correct on the enormity of curating and certifying tens of health/medical apps. But the point of the article seems to be that any kind of evaluation mechanism or certification is a fool’s errand.

The logic presented as this Editor interprets the article: Since Happtique’s certification process had standards which were complicated and arbitrary (plus, as it turned out, flawed), it proves that it’s useless to pursue standards and certification. In addition to being ‘resource intensive’ for reviewing tens of thousands of apps, standards cannot decide what app is the right choice, even if that was not the intent of the certification. So doctors and ‘end users’ have to become ‘app-literate’; hang the fact that the point of curation and certification is to do at least some of the heavy lifting (pre-screening) job for them beforehand! Back to the start: reading all the peer review stuff on thousands of medical apps, if it’s reviewed at all, as iMedicalApps does for some. (And will these reviews be 100% accurate? Will they subject every app to data security screening? What are their standards?) Back to Square One: DIY and Dodge City. Apps present too much (unpaid) work for docs to think about, patients use (then abandon) apps that can be privacy risks, because they don’t know any better and they aren’t white-hat hackers after all….

Remaining unconsidered by iMedicalApps is the plausibility of what Master Data Cruncher IMS Health is taking on with AppScript and AppNucleus [TTA 15 Dec]: a proprietary 25-point methodology (AppScore) that automates the classification and evaluation of health apps plus a hosting platform that uses IMS information to assist developers in creating secure, effective apps.

A far more detailed exploration of why at the very least an objective certification/evaluation process is needed is explored by Editor Charles in his continuing series Driving Up Medical App Usage in the UK, especially Part II (Part I here.) Watch for Part III shortly.