The number of clinical trials making use of apps has more than doubled in the past two years, according to a recent study. And while that means more clinicians are jumping on the mHealth bandwagon, the same oft-cited drawbacks are still there.
An IMS Institute for Healthcare Informatics study finds that there are more consumer-facing mHealth apps than ever yet only 10 percent of them are connecting to a device or sensor. Nearly a quarter of all apps now target disease and treatment management, with two-thirds focus on fitness and wellness. But providers still have questions about reliability, interoperability and reimbursement.
"While much progress has been made over the past two years, mHealth apps are still far from being a fully integrated component of healthcare delivery," Murray Aitken, IMS' executive director, said in a press release. "Healthcare providers are actively addressing the remaining barriers. These include developing and adopting trusted platforms for ongoing apps curation and evaluation, creating practical reimbursement models and ensuring true interoperability within and across healthcare systems."
[See also: Prescribing the right apps to the right patients]
According to IMS, while there are more research studies using apps, a majority still focus on how the app is used rather than how it might improve clinical outcomes or reduce healthcare costs.
"Too many people are comfortable with the fact that mobile health is just being used," said Brian Clancy, a senior project manager in IMS' AppScript platform, adding that an app's ROI is still a hazy concept. "They need to link to specific metrics" to prove an app's value beyond the fact that providers and consumers use it.
Clancy does see some evidence of that happening. Observational studies and randomized clinical trials are starting to show value for apps that address type 2 diabetes, cardiovascular disease, obesity and mental health. That's not yet the case, he said, for apps that link to patient portals, or those addressing patient satisfaction, asthma and COPD and, to a lesser extent, medication adherence.
The number of available apps – Clancy said IMS studied 165,169 – also present a few problems, in that both consumers and providers are overwhelmed. In some cases, consumers will just Google a condition or an app and go from there. That may make an app popular, but there's no guarantee that it will work in the long run. According to IMS, just 12 percent of the apps studied account for more than 90 percent of consumer downloads – and nearly half of those downloads are confined to 36 apps.
Clancy said physicians are still reluctant to prescribe apps because they need clinical validation, and those platforms for assessing accuracy, appropriateness and efficacy are still few and far between (though slowly gaining in prominence). While almost 90 percent of doctors have thought about prescribing an app, surveys report, only about a third have done so.
"There are definitely signs of significant interest … but there's still very little formal app prescribing taking place. The mobile health industry has done a very poor job of naming their apps" and proving their value.
Once an app is prescribed, though, it stands a better chance at success. According to the IMS survey, physician-prescribed apps have a 10 percent better chance of success with patients beyond that well-documented 30-day time period than those selected by consumers (among prescribed fitness apps, that success rate is 30 percent better).
One final point: Consumers are very interested in sharing these apps with their friends and family – over the past two years the number of apps that link to social networks has jumped from 26 percent to 34 percent. Studies have shown that social networking plays a strong role in building consumer engagement, but the provider community has been hesitant to embrace that avenue. Many doctors are hesitant to embrace social media themselves, and there haven't been enough studies linking the use of social media to clinical outcomes.
That said, while more and more apps are tied into social networks, far fewer enable consumers to connect and communicate with their healthcare providers.
"There's still a struggle to be relevant" to clinicians, Clancy said.