The lack of evidence in health IT and patient engagement

In health economist/consultant Jane Sarasohn-Kahn’s lengthy analysis of the IMS Research report, Patient Apps for Improved Healthcare: From Novelty to Mainstream, ‘mainstream’ does not necessarily mean that apps deliver value–in health outcomes, health support or behavior change–which is why doctors have largely ignored them. For the 43,000+ ‘health apps’ so categorized in the Apple iTunes store, only 23,000 met IMS’ criteria of a ‘genuine health app.’ Few apps manage chronic disease for the highest health spenders or assist seniors, amazingly 5 apps =15 percent of all downloads with most apps having less than 500 downloads. Most apps provide information only and only 20 percent capture/track user data. Not dissimilar to the Manhattan Research smartphone study [TTA 30 Oct], the bulk of apps address behavioral health, eyes and hearing, endocrine and nutrition, heart/circulatory, musculoskeletal, and cancer. In IMS’ view, the app can fill in the space between the hospital or doctor’s office and everyday life. But the recognition by payers and providers, the ‘who pays’ of the equation, app vetting and curation, integration of app data with care workflows, and what Sarasohn-Kahn calls ‘the co-creation of evidence’ by patients with the health care system still seems like a Lost Horizon–witness the several redirections of app vetter Happtique.  HealthPopuli  Hat tip to reader Ellen Fink-Samnick, MSW, of Ellen’s Ethical Lens.

Leonard Kish of business communications agency VivaPhi looks at the signal-to-noise ratio in both health apps and the endlessly touted Holy Grail of patient engagement–the signal being improved outcomes, reduced cost. Some positive indicators on his VU meter: Wellocracy [TTA 30 Oct], the WebMD acquisition of Avado [TTA today], and Aetna’s CarePass [TTA 12 July]. But then we arrive back at another Holy Grail: “The Holy Grail of Health IT right now is to create a trusted app platform and marketplace.”  Perhaps Happtique was premature, and CarePass and Cigna’s strange GoYou Marketplace (which he doesn’t mention) are the wave of the future. HL7Standards  Hat tip to reader Vince Kuraitis of Better Health Technologies via Twitter.