In December 2012, the Deloitte Centre for Health Solutions’ report ‘Telecare and telehealth- a game changer for health and social care’ focussed on the costs and benefits of scaling up the adoption of traditional telecommunication technology. Given that the adoption of mobile technology in healthcare was still in its infancy we proposed returning to the use of mobile technology at a later date.
Since then, mobile applications (apps) have become ubiquitous in many aspects of our lives, largely as a result of the widespread availability of tablet computers and smartphones, as well as 3G and 4G networks. Indeed the smartphone, with 24/7 access, has changed irrevocably how we interact with technology. This, in turn, has boosted the use of mobile healthcare apps (mHealth apps). In 2012 there were around 40,000 mHealth apps, today there over 100,000.
The mHealth apps market is classified into health apps and medical apps. Health apps comprise exercise, weight loss, nutrition, sleep and meditation, and medication reminders which all encourage adherence to healthier lifestyles. Medical apps on the other hand are segmented into:
- medical reference apps that provide information about drugs and how to take them, diseases and symptoms, and the locations of pharmacies or doctors
- medical condition management apps that track, display and share user´s health parameters, medication intake or provide information on a specific health condition such as diabetes, mental health or asthma.
Remote monitoring and consultation apps still represent only a small share of the current market, however this category is expected to have the highest business potential in the future. Fitness apps, which currently have the most business potential, are expected to diminish in relative importance. Meanwhile, mHealth apps that reduce non-compliance and hospital readmission costs are expected to have the biggest impact on healthcare commissioners and providers.
Of increasing importance is the fact that mHealth apps allow the collection of considerable medical, physiological, lifestyle, daily activity and environmental data to provide the basis for evidence based practice and research activities. They also facilitate patients' access to their own health information and empower them to manage their health more actively, while supporting them to live more independently in their own homes.
MHealth apps can also help the healthcare workforce to be more efficient by supporting real-time communication with patients, e.g. via the exchange of app users’ data, thereby helping healthcare systems deal with constrained healthcare resources. They also allow more medical and care interventions to be done remotely or by the patients themselves, guided by monitoring and reporting systems, thereby reducing hospitalisation and providing an efficient method of managing chronic diseases.
In reality, however, while there is a great deal of interest in mHealth apps and enthusiasm for their use, they have yet to be mainstreamed as part of healthcare provision, and in many respects are still viewed as a novelty. Part of the problem is that patients face a confusing array of mHealth apps with little guidance on their quality or advice and support from their doctors. While doctors can see the potential benefits of mHealth apps, they remain wary of formally recommending them to patients. Barriers include a lack of evidence of their benefit, limited professional guidelines on their use in practice, concerns over security of personal health information that may be generated or transmitted by the app, and uncertainty over regulatory requirements. Furthermore, commissioners, providers and others, such as employer wellness programmes, rightly expect clear evidence of the benefits before considering funding, reimbursement or promoting the use of such apps.
Over time, it is likely that mHealth apps will progress from being recommended on an ad hoc basis to systematic use in healthcare, and ultimately to becoming a fully integrated component of healthcare management. In this respect, mHealth apps are not intended to replace healthcare professionals, who remain central to providing healthcare, but rather intended as a supportive tool for managing health conditions. There may also be the added bonus of helping overcome patients' reluctance to seek help because of stigma or shame, as it is the case with mental illnesses, where about every second person experiencing a disorder seeks treatment.
MHealth solutions have the potential to change patients from being largely passive to taking a more participative role while enhancing their responsibility over their own health. They will also raise people’s awareness of health issues through easy-to-understand information, thus helping them to take more informed decisions on their own health. This shift towards patient-centric care will inevitably change the role of healthcare professionals who are more likely to monitor patients remotely and interact with them via e-mails more often. Whether the healthcare service is ready for this change – only time will tell – however the explosion of mHealth apps suggests patients are already embracing this technological assisted approach to self-managed care. As we said in our Telecare and Telehealth report, the question as to whether this will be with or without the involvement of health care commissioners and providers remains to be answered?