30 things to know about mHealth

Mobile health is a burgeoning industry within the health IT sphere, spurred by the proliferation of personal mobile devices. While industry experts expect to see the mHealth industry continue to grow, its path will not be without setbacks.

Here are 30 things to know about mHealth.

The mHealth market
1. The global mHealth market is expected to be worth $49.1 billion by 2020, growing at a compound annual growth rate of 49.7 percent over the next six years. The market in 2012 was valued at $1.2 billion.

2. An estimated 500 million smartphone users worldwide will be using mHealth apps by 2015.

3. Those 500 million smartphone users will have a plethora of mHealth apps to choose from, as there are more than 100,000 mHealth apps available for the iOS and Android platforms.

4. The growing popularity of mHealth is highlighted by the rising dollar amounts invested in such technology. Venture capital investment in mHealth technology increased 35 percent from the first half of 2012 compared to the first half of 2013, jumping from $229 million to $310 million.

5. Mobile giants Samsung, Apple and Google all announced mobile health and fitness tracking app platforms in late spring. Samsung's S Health and Google Fit collect data from external sensors and user input and compiles it onto a dashboard, presenting an overall view of a user's health and fitness.

6. Apple's HealthKit is similar to S Health and Google Fit, but the company's partnerships with Epic Systems and Mayo Clinic take it one step further. Mayo Clinic will provide health information and content to users, and users can send data to Mayo physicians and establish communication. With Epic, the platform has the capability to provide a completely comprehensive picture of patient health by incorporating user-facing mHealth app data right into the electronic health record.

7. Hospitals and health systems themselves have begun releasing apps, largely focused on patient and visitor information, such as hospital maps and emergency room wait times. A number of hospital and health systems have also released general health apps helping and encouraging users to adopt and maintain healthy lifestyles.

Barriers to mHealth
8. However, recent trends suggest mHealth may not continue upon its trajectory of unparalleled growth. The use of mHealth varies significantly with age, gender and socioeconomic status.

9. Another major problem is user retention. Even though a large number of Americans have downloaded mHealth apps, not many stay engaged. According to an MIT Technology Review report, about two-thirds of consumers who have downloaded an mHealth app have stopped using it.

10. Additionally, only 28 percent of smartphone users and 18 percent of tablet users report being "very satisfied" with the quality of available mHealth apps, according to a report from Booz & Company.

11. The problem is the apps currently on the market aren't offering what consumers want, according to a report from McKinsey&Company. Many app developers are focusing on new and flashier mobile products and services to offer consumers. However, consumers' mHealth desires are more foundational — they want reliable access to their health information, time-savers like online appointment scheduling and the ability to connect with a person when they need something the digital offerings don't provide, according to the report.

Physicians and mHealth
12. From the provider side, the number of clinicians using mHealth is on the rise. A MedData group found the majority of physicians — 48 percent — used mHealth to determine medication interactions, followed by 27 percent for diagnosis tools and 19 percent to access EHRs.

13. The Epocrates mobile app was found to be the most popular medical reference app for the fifth year in a row, according to findings from Manhattan Research. The findings indicate approximately half of all physicians in the U.S. use Epocrates, and nearly one-third of users access the app at least three times a day.

14. Physicians are also finding ways to incorporate mHealth into patient care. More than one-third have reported recommended an app to patients within the last year, and 47 percent have used their own devices to show patients images, according to a Manhattan Research survey.

15. Not only are these physicians using more mHealth, but they are interacting with mobile health in a larger variety of ways. Epocrates, an athenahealth service, calls such clinicians "digital omnivores," those who regularly utilize a variety of digital tools in a professional setting. The presence of digital omnivores is projected to jump to 74 percent in 2015, up from 2014's 41 percent, according to an Epocrates mobile trends report.

16. Apps aren't stopping at consumer-facing and clinical-facing apps, at least as long as Apple has something to do with it. The Silicon Valley giant announced a joint global partnership with IBM to develop business-facing mobile apps harnessing IBM's big data capabilities. The companies plan to develop apps and services exclusively for Apple's product offerings to offer enhanced work-related apps. With more than two-thirds of providers and practices using iPhones for professional services, the Apple-IBM partnership is poised to make waves in the workspace.

Patients and mHealth
17. The use of mHealth and fitness apps in 2013 far exceeded the use of the overall app industry, according to Flurry Analytics, an app analytics and ad platform. In the first half of 2014, consumer use of health and fitness apps on Flurry's platform increased 62 percent, while overall app usage increased only 33 percent.

18. About 80 percent of consumers are open to interacting with their healthcare providers through their smartphones, according to a survey by FICO, a predictive analytics and decision management software company.

19. More specifically, 76 percent of respondents to the FICO survey said they would like to receive alerts reminding them of medical appointments, and 69 percent said they would like alerts reminding them to make appointments or take their medications.

20. A number of recent studies found texting interventions were beneficial and helped improve health outcomes. For example, a texting intervention with personalized recommendations helped teens better manage their chronic illness symptoms, one study found. Another study found pregnant women who received regular text messages regarding neonatal health reported adopting healthier behaviors during their pregnancy as well as an increased belief in the importance of maintaining regular healthcare provider visits. The immediacy and customer know-how with their personal mobile devices could be an important factor in such programs, and it presents an opportunity for continued development in the usability of texting in treatments.

21. Remote patient monitoring devices present another way to collect biometrics without requiring patients to come to the hospital, and the market of such clinical-facing devices is poised to surpass the consumer-facing mHealth market. Researchers project clinical mHealth devices including clinical vital signs monitors and in vitro diagnostic devices will be valued at $16 billion by 2023, compared to consumer-facing devices which are expected to be valued at $7 billion by 2023. Additionally, with the advent of apps that connect to personal mobile devices, such remote monitoring offerings may become more convenient and user-friendly.

mHealth and Regulation
22. The rise of mHealth has sparked concern over data security and privacy. Nearly 40 percent of commercially available free mHealth apps and 30 percent of paid apps sent user data to third parties and did not disclose this happenstance in the privacy policy or within the app, according to a report from Mobiquity, a mobile engagement provider.

23. In late July, Julie Brill, Federal Trade Commissioner, spoke before Congress citing concerns that mHealth apps share PHI with third parties and urged Congress to strengthen data collection laws.

24. Researchers project clinical mHealth devices will start proliferating in the industry partly because certain devices have moved passed regulatory processes and are now actually in the marketplace where physicians can use them. The regulatory arena houses a tug-of-war within the industry. While some in the industry fear extensive regulatory framework inhibits growth and innovation, others are pushing for more regulatory oversight. A report in the New England Journal of Medicine found only 100 of the 100,000 mHealth apps available are FDA-cleared.

25. The FDA certainly can't regulate every single new mHealth app that pops up on the market. The quantitative amount of activity surrounding mHealth apps doubles each year, the NEJM report says. Instead, the FDA is "taking a tailored, risk-based approach that focuses on the small subset of mobile apps that meet the regulatory definition of 'device,'" including those that are deemed an "accessory" to regulated devices and those that use a mobile platform as a regulated device, according to the FDA's website.

26. The FDA's latest issued draft guidance suggests certain Class I and Class II devices that are deemed low-risk devices, such as apps that turn smartphones into monitoring devices, do not need to undergo the 510(k) premarket review process. Such a change in regulation would allow products to be brought to commercialization and market more quickly and perhaps better allocate the FDA's time and resources.

27. A wearable can be a device like a watch or even a garment like a shirt that tracks biometrics. The market for biosensing wearables has three main drivers: wearables' ability to directly send information to smartphones and apps, falling sensor prices and healthcare's renowned focus on preventative medicine instead of reactionary medicine.

28. Currently, the most popular biosensing wearables are those measuring movement, sleep and heart rate, but new biosensing niches are entering the market, such as devices measuring glucose levels, respiration, blood pressure and other indicators of a user's health.

29. Venture capitalists have taken a noticeable interest in the space — investments in biosensing wearable companies have increased five-fold since 2011. Last year, $229 million was invested in these companies.

30. However, the biosensing wearable market shares a main hurdle with the overall mHealth market: poorly sustained user engagement. An Endeavour Partners survey cited in the Rock Health report found after two years, less than 50 percent of biosensing wearable owners still used their devices regularly.

More articles on health IT:

20 healthcare investment niches and 3 things to know: The evolution of healthcare as an investment area 
Healthcare Administrative Technology Association formally launches today 
Impact Advisors joins Epic, IBM's DoD bid 



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