Current State of mHealth: Anatomy of a Survey

A well-conducted survey on the use of cell phones for healthcare was released yesterday by the Pew Internet and American Life Project. The study was conducted in August-September of 2012. I will review some of the major and more interesting statistics from the study then discuss my views on them as well as the opportunities the survey presents for the mHealth app sector.

Eighty-five percent of adults in the USA own cell phones, and 53% of these own smartphones (representing 45% of all adults surveyed). In 2010 17% of cell phone owners used their phones to research health or medical information online. This rose to 31% at the time of this survey, with the vast majority of those being smartphone owners.  42% of 18-29 year-olds, 39% of 30-49 year-olds, 19% of 50-64 year-olds, and 9% of those over 64 used their phones for mHealth purposes.  Hispanics had the highest relative use of phones to look up health or medical information (38%), with African-American and White use at 35% and 27% respectively. Positive correlations were seen for annual income and education levels, with significant thresholds at $50,000 and having at least a high school diploma respectively.

Caregivers, those without chronic medical conditions, and those with a recent change in medical condition had a significantly higher utilization of cell phones to acquire health information. Only 9% of cell phone owners receive health-related text messages or alerts.  Caregivers, those with chronic conditions, and those with significant changes in health were more apt to receive text messages or alerts.

According to the survey 19% of smartphone owners have downloaded a health app. The typical health app downloader is a better-educated, woman under 50 with a household income over $75,000.  Of those who have downloaded health apps, a significant factor was a recent change in health condition. Exercise, diet, and weight apps were most popular.

This survey indicates to me that people are discovering the potential of smartphones for obtaining health information and for potential uses of mobile health apps. The growth of smartphone use in general has no doubt been the biggest driver of this. This survey does not do any sub analysis. It is noteworthy, however to see the previously observed gender difference in the utilization of healthcare IT is carried over to health-related online searches utilizing cell phones. The paucity of text-related messages and alerts (which constitute the backbone of mHealth in underdeveloped countries) is interesting.  I believe this reflects the immaturity of mHealth in general in the USA.  Text messaging has been found to be effective in medication adherence for TB and HIV, for prenatal care and other uses in Africa.  The industry needs to walk before it runs.  Text messaging initiatives have already begun via the NIH (text4baby, quitnow).  The mobile health and medical apps sector might benefit from using or partnering with text messaging platforms in the wellness or preventive health areas to acclimate users to the concept of mHealth before the introduction of more complex technologies (which can, in parallel be initiated at points of care in the healthcare system).  Some start-ups are realizing the potential of text messaging mHealth offerings.

The survey discussed here is important because it demonstrates what people intuitively know: That there is a huge market for mHealth. We just have to provide the best ways to promote and foster adoption. THAT is the Holy Grail of mHealth at this time. Educating consumers/patients and providers, furnishing efficacy studies (which need not be as complex as drug or device clinical trials), getting payers on board (including Federal and State) to pay for effective technologies, and obtaining private investment are all  prerequisites. These need to be conquered, relinquishing the “Build it and they will come” mentality.  Let’s get going.

About davidleescher

David Lee Scher, MD is Founder and Director at DLS HEALTHCARE CONSULTING, LLC, which specializes in advising digital health technology companies, their partners, investors, and clients. As a cardiac electrophysiologist and pioneer adopter of remote patient monitoring, he understood early on the challenges that the culture and landscape of healthcare present to the development and adoption of digital technologies. He is a well-respected thought leader in mobile and other digital health technologies. Scher lectures worldwide on relevant industry topics including the role of tech in Pharma, patient advocacy, standards for development and adoption, and impact on patients and healthcare systems from clinical, risk management, operational and marketing standpoints. He is a Clinical Associate Professor of Medicine at Penn State College of Medicine.
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