mHealth is booming, so why are CDM apps lagging behind?

The use of mobile health apps is skyrocketing, with the global mHealth market projected to reach the equivalent of €23.2bn this year. So why have apps for chronic disease management (CDM) never yet made it off the ground?

In the last decade we’ve seen an explosion in the use of mobile health (mHealth) apps. With healthcare costs rising globally, some analysts see personal mHealth tools as a way not only to keep healthcare organisations costs down, but also as a means of making healthcare more accessible and convenient for consumers. And, despite the fact that many such tools remain untested, many forecast that consumers will keep plugging into health apps for the foreseeable future.

So why, despite chronic disease figures rising across Europe and globally, ask Harvard professors Robert S Huckman and Ariel D Stern in a piece in the Harvard Business Review this month, are apps for chronic disease management (CDM) not following suit? 

“Chronic diseases are prevalent [….] and take a large toll on public health,” say Hickman and Stern. “But while chronic disease management (CDM) apps have had some initial success, they have not yet lived up to their potential.” This is due not to any shortcomings in the technologies themselves, they say, but to certain “institutional barriers” to their sustained use.

One challenge facing CDM apps is that they are difficult to sell directly to patients – making this group an unlikely source of paying customers, they say. “Given that individuals are not used to paying for chronic disease treatment beyond standard co-pays for physician visits and prescription drugs, the costs of acquiring individual patients as customers are likely to be quite high.”

“Potential users see CDM apps that monitor health conditions and give medical advice as something for which the healthcare system – insurers or providers – ought to pay,” say Huckman and Stern. With relatively few patients willing to pay for such digital health tools, the most likely source of revenue for app developers becomes healthcare organisations – the prime candidates being providers (health systems or primary care practices) or payers (self-insured employers or health insurers).

So what is the way forward? The authors suggest that app developers focus their attention on organisations that see the value proposition of paying for an app and will encourage clinicians and patients to use it: “They need to make a compelling enough argument to get a client organisation to adopt a new digital health product – that is, to agree to offer the app to its associated providers and patients.”

Then, the developer must work with the client to “diffuse” the app throughout the organisation, convincing individual staff members and patients to try it out.

Of course, achieving “sustained use” of the app requires it to be “integrated with the natural flow of the provider’s and patient’s daily activities” and this is another step change, say the authors.

You can read the piece in full here.

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