Connected Health Trend Countdown: #4 Reaching the Mobile 91%

Quick, grab your mobile phone. It’s pretty close at hand, I’m guessing. Hence, our next trend in the 2014 Connected Health Trend Countdown:

Trend #4: Gamification, Quantified Self, and the Internet of Things

You are undoubtedly part of the 90% of the world’s population that is covered by a commercial wireless signal. According to Pew research, there is 91% U.S. adult adoption of mobile technology and 56% adoption of smartphones. This behemoth adoption rate means a couple of things for the healthcare industry:

1. In any attempt to reach as many consumers as possible it is necessary to be where consumers are in order to “get into the conversations they are already having in their head” as we say in marketing speak. There is no easier way to reach 91% or more of the population using one medium. I dare you to find one.
2. In a world with severe healthcare resource constraints, mobile technology can be a major “force multiplier” by empowering both patients and clinicians with the information they need to make informed decisions that range from healthy living habits to the monitoring of a disease state.

With a cellphone in almost every hand, the expansion of wireless networks presents us with an opportunity to reach those who are currently isolated by distance and lack of communication. How amazing is that?

Now to some definitions. If you haven’t heard of them before, then here they are:

• Mobile Health (also called mHealth): the use of mobile and wireless devices to improve health outcomes, healthcare services, and health research.
• Gamification: applying game design thinking to non-game applications to make them more fun and engaging (Read Perficient’s white paper “Healthcare Gamification: Is it time for physicians to prescribe gaming to patients?” )
• Quantified Self: a movement to incorporate technology into data acquisition on aspects of a person’s daily life in terms of inputs, states, and performance. (Read Perficient’s white paper “Beyond Gamification: Revolutionizing Healthcare with the Quantified Self“)
• The Internet of Things: an environment where everyday physical objects are connected to the internet and are able to identify themselves to other devices

Care Everywhere

A report titled Gaming to Engage the Healthcare Consumer points to three trends driving healthcare organizations, and health plans in particular, towards gamification. These include:

• the trend toward value-based care
• the increasing role of the patient as consumer
• the millennial generation as desirable health insurance customers.

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As mentioned by mobihealthnews in Four Factors Driving Gamification in Healthcare, a fourth trend, namely the increased proliferation of smartphones and tablets mentioned above, was not mentioned in the report but does underscore the conclusions in the report.

Another study ranked the top ten patient groups that reported the highest adoption of mobile health solutions, which you may find interesting:

• Cystic fibrosis
• Growth hormone deficiency
• Acne
• ADD/ADHD
• Hepatitis C
• Migraine
• Crohn’s disease
• Chronic kidney disease
• Generalized anxiety disorder
• Bipolar disorder

Mobile Preventative Health

My personal favorite topic in the area of mobile health is preventative medicine. A comprehensive review of mobile health studies, including those created by CINAHL, PubMed, EMBASE, MEDLINE, and PsycINFO between January 2005 and August 2010, focused on the effectiveness of mobile health to impact preventive health behaviors. Study results show that app and text messaging interventions resulted in reductions in body weight, waist circumference, body mass index, sugar-sweetened beverage intake, and television screen time. You can check out more details on the effectiveness of text messaging programs in a post that I wrote entitled “Texting Bridges the Mobile Health Digital Divide.”

A really interesting growth area for both mobile and preventative medicine comes in the area of “wearables”. These are all of those digital devices, FitBits, JawBones, etc. that consumers, as the name implies, wear. Juniper Research projects that the wearable technology market will be worth $19 billion by 2018. There is ongoing debate over whether mobile health applications and wearables should be governed like traditional medical devices. Anyone who knows anything about the medical device industry knows that there is barely a movement that can be made without compliance lawyers getting involved. The FDA issued final guidance on the topic stating that they intend to exercise discretion for the majority of mobile apps since they pose minimal risk to consumers. However, the FDA intends to focus its regulatory oversight on the subset of mobile medical apps that present a greater risk to patients if they do not work as intended. These are defined as apps that:

• are intended to be used as an accessory to a regulated medical device – for example, an application that allows a health care professional to make a specific diagnosis by viewing a medical image from a picture archiving and communication system (PACS) on a smartphone or a mobile tablet; or
• transform a mobile platform into a regulated medical device – for example, an application that turns a smartphone into an electrocardiography (ECG) machine to detect abnormal heart rhythms or determine if a patient is experiencing a heart attack.

Mobile medical apps that undergo FDA review will be assessed using the same regulatory standards and risk-based approach that the agency applies to other medical devices. One such app is BlueStar. BlueStar is a prescription only diabetes app that provides reminders for nutrition and medication adherence. The app works on computers, smartphones, and tablets.

The private market has also generated a Health App Certification Program named Happtique. Happtique has been around for several years, and the program intends to complement the work of the FDA. They have introduced a set of standards for health apps that fall into that “not so risky” medical app territory.

Are you still there? Good.

Getting patients to engage with their practitioners and medical protocol isn’t just some luxury we should all aspire to. The price tag associated with the disengaged consumer has cost too much for too long. Now there are great options like gamification that help make adhering to better health practices attractive to consumers. Whether is it making it easier for the already exhausted cancer patient to follow complicated medical protocol or letting a child win a cartoon monster for taking their asthma medication on time, mobile health provides cost effective options for healthcare’s most expensive problems.