Majority of mHealth apps fail to engage patients

Studies show that potential remains unfulfilled, even among high-cost, high-need populations.


While many healthcare professionals have harbored high expectations for mobile apps to energize patient engagement, only a minority of the applications appear to hit the mark.

An analysis of about 1,000 patient-facing health apps targeted at individuals with chronic illnesses has found that only 43 percent of iOS apps and 27 percent of Android apps are useful for that purpose.

Funded by The Commonwealth Fund, the study evaluated 376 apps available in the Apple iTunes store and 569 apps in the Android Google Play store to determine usefulness based on the following criteria: description of engagement, relevance to the targeted patient population, consumer ratings and reviews, and most recent app update.

Overall, 161 (43 percent) iOS apps and 152 (27 percent) Android apps were deemed as being “possibly” useful; of that total, 126 apps exist on both platforms.

“There were a lot apps that we call ‘limited engagement’ on Android—about 90, compared with about 25 that were iOS,” observes Karandeep Singh, MD, an author of the study and assistant professor in the University of Michigan Medical School’s Department of Learning Health Sciences.

According to Singh, there were significantly more Android apps than iOS apps that were not recently updated—200 Android apps (35 percent) were last updated before 2014, while 63 iOS (17 percent) apps were last updated before 2014.

The study found that 33 iOS apps (9 percent) were found to have poor ratings or reviews, compared with eight Android apps (1 percent).

“While apps have tremendous potential to engage high-need, high-cost populations, a minority of patient-facing health applications on both the Apple and Android stores appear likely to be useful to patients,” concludes the study.

This lack of app usefulness for consumers is particularly disconcerting given that a separate recent study by research2guidance found that app stores like Apple iTunes and Android Google Play will remain the main distribution channel for mHealth apps until 2020. That reverses a trend seen in several previous surveys by the firm, which predicted that hospitals and physicians would be top distributors of apps.

The research firm concludes that both Apple and Google are “complicit” in the marketing hype around many of these apps.

“One of the main promises of mHealth apps is that they help their users change their behavior,” according to the firm. “The majority of mHealth apps today don’t even come close to living up to this promise because they lose their users after a few days and thus have no chance to change any behavior.”

Most of the apps currently available in the marketplace are published by Apple and Google, with each of the two main app stores offering almost 70,000 apps within the “Health and Fitness” (56 percent) and “Medical” (44 percent). Of medical apps, 12 percent target chronic diseases. Within that group, apps that claim to help obesity management represent the largest therapy field (29 percent) including the large section of weight loss apps, followed by diabetes (20 percent) and cancer (19 percent).

“The focus on chronic diseases is largely based on the high cost of treating those patients and the promise that apps could help reduce these costs by changing the behavior of patients over a longer period of time,” states the firm’s report. “In most cases, this is still an unfulfilled promise, as most of the apps are failing to retain their users for even a few weeks.”

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