As has been tradition for some time now, every year around this time the digital health community gets a wake up call. The Pew Internet & American Life Project published its latest report on mobile health this morning and while it is filled to the brim with helpful, encouraging statistics related to mobile health adoptions, buried deep within is an outright discouraging one. Health app adoption has remained flat.
Since 2010 about 10 percent of American adults with mobile phones have had some kind of app on their phone that helps them track or manage their health, according to Pew's survey. While the figure presented in Pew's reports has ticked up or down one percentage point this year and last year, it's within the survey's margin of error.
Pew's Associate Director Susannah Fox told MobiHealthNews that this year's survey has a bit more of a focus on smartphone users, which have about twice the adoption rate for health apps when compared to the general population. About 19 percent of smartphone users have some kind of health app that helps them track or manage their health.
Of course, not all of the consumer health-related apps available today explicitly help people to "track" or "manage" their health, some simply provide helpful tips or reference materials. Pew's question seems to hit on more interactive apps. Fox said that's for a reason.
"When we wrote that survey question back in 2010 it was about wanting to find out about people's engagement," Fox said. "The Pew Internet Research Project studies the social impact of the internet and back in the year 2000 it was very much about people's changing relationship with information. As the Internet evolved our project evolved to study not only how people access information but how they engage with information as well as with each other and instutions. That was the context of writing that question. This comes to the point again where we can examine what a survey question is good for and what it is not good for. We write a survey question in the hopes that just the general population can understand what we are talking about."
The question also specifically asks about a "health app" and does not explicitly include fitness as part of the question. Even Apple makes a distinction between the two as demonstrated by the name of its AppStore category Health & Fitness. Still, of the survey respondents who said they used a health app to track or manage their health, the largest cohort said they used a fitness tracking app. Did other fitness app users say "no" because they didn't consider their running app a "health" app?
Pew's surveys are the gold standard for mobile and digital health metrics. Few would disagree with that sentiment. That said, Fox is open to improving this survey if possible. Any helpful suggestions for rewording or similar surveys that might inspire new questions are welcome, she said.
Assuming Pew's survey results are correct and there still is a large portion of the population that would benefit from health apps, what might drive adoption moving forward? There has been a significant proliferation in the number of health apps available, but seemingly no increase in adoption.
"What is going to be the trigger for health app adoption given the fact that for three years running we have not seen significant growth?" Fox asked. "The trends that I am watching -- I don't make predictions -- but [there are three] trends that I am watching. [The first is] smartphone adoption. If smartphone adoption continues increasing and we see continued engagement with smartphones users getting health apps, then looking for increased health app adoption among smartphone users seems to make sense."
While there is something intuitive about the growing adoption of smartphones leading to a larger base for health apps, if you examine Pew's data on overall health app adoption among all mobile phone users -- not just smartphone users -- you find flat adoption for three years, despite the significant gains in smartphone adoption that occurred between 2010 and 2012. Fox didn't disagree with this but made clear that this isn't the only trend worth watching, other factors are important, too.
"The other aspect is media portrayal of apps," Fox said. "I perceive that there has been an increase in mainstream media coverage of health apps."
This is without a doubt true. Big name newspapers and blogs of all stripes have been promoting suggested health app lists throughout 2012.
"The third aspect of this that I am watching for is clinical integration," Fox said. "That is when your doctor prescribes an app. That is going to have a different effect on your interest in trying it, over you just downloading it, or it coming pre-installed on your phone. Those are the trends I'm watching -- again, they are not predictions, just some of the trends I am keeping an eye on."