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Consumer Health Apps
          & mHealth

           Nadine Fisher, MS RD LD
             DBC DPG Webinar
              January 23, 2012




Putting It All Together: Taking Nutrition To The Client
                  Using Mobile Apps
What is mHealth (Mobile
             Health)?
• mHealth (also written as m-health or mobile
  health) is a term used for the practice of medicine
  and public health, supported by mobile devices. The
  term is most commonly used in reference to using
  mobile communication devices, such as mobile
  phones and PDAs, for health services and
  information. (Wikipedia 2012)
mHealth Users
Fitness, Wellness or
          Healthcare App?
• Fitness Apps are for those who want to get in
 shape or who are training for an event
 (marathon)
• Wellness Apps are for those who want to live
 healthy lifestyles through diet and exercise
• Healthcare Apps are for professionals
 managing their work or for patients to deal
 with a specific health condition
Future of Consumer Health
          Apps & the Registered
                  Dietitian
• Patient

• Providers

• Creative Cutting
  Edge
  Professionals
Future of Consumer Health
             Apps
• Growth prediction is EXPLOSION of consumer
  health apps (IOS) by July 2012 = 13,110
Types of Apps Downloaded?
Health Apps

• Diabetes

• Weight Loss

• Gluten Free
• The Surgeon General’s
  Healthy Apps challenge,
 announced during her Tuesday morning keynote at the
                         handy tools
 mHealth Summit, is designed to develop
 with tailored information that will
 encourage those “who may not be tech savvy and who
                        to become
 wouldn’t ordinarily want to get involved

 healthy and fit, and to make it
 easy and fun.”
Desirable App Characteristics
 for Managing Chronic Conditions


• Personalize, Track, Remind, Affirm
• Adhere to Evidence Based Practice
  (Connect to provider, EHR?)
  • Educational component that is updated?

• Engage & Incentivize Client
• Connected to DB (external live)
• Provide for Social Support
Health & Fitness App Life
         Cycle
Popular Health Apps
• Weight Loss
 • Lose it
 • http://www.loseit.com/

• Diabetes
 • **GluCoMo- addresses co-morbid client & has
   back-end connectivity
   http://www.glucomo.com/

• Gluten Free
 • Eating Out Gluten Free
 • http://itunes.apple.com/us/app/eating-out-g-
   free/id410718619?mt=8
Will They come?

• Three in five patients, regardless of age, said they’d
  be interested in using a wireless medical device to
  send information to their physician, and younger
  patients expressed interest in using their
  smartphones for that purpose.
mHealth App Advantages
  • Helps Client Manage Health

  • Care Coordination Opportunities

  • Immediate Exchange of Accurate Objective
    Information from Client to Provider

  • Earlier and More Accurate Diagnosis

  • Remote Monitoring Opportunities
Current & Future Challenges

 • FDA Approval

 • Device versus App

 • Cost of Device/App Development

 • Client Compliance
Resources
1.    http://www.imedicalapps.com/top-apps

2.    http://www.eatright.org/appreviews/

3.    http://www.happtique.com/

4.    Pew Internet Data Smart Phone & App Use

5.    Draft Guidance for Industry and Food and Drug Administration Staff- Mobile Medical Applications

6.    http://www.mhimss.org/

7.    App Connections for Health Professionals

8.    Apple iTunes Health and Medical Apps Category

9.    Massive Health – The Eatery

10.   Preventice

11.   WellDoc

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Consumer Health Apps & Mobile Health

  • 1. Consumer Health Apps & mHealth Nadine Fisher, MS RD LD DBC DPG Webinar January 23, 2012 Putting It All Together: Taking Nutrition To The Client Using Mobile Apps
  • 2. What is mHealth (Mobile Health)? • mHealth (also written as m-health or mobile health) is a term used for the practice of medicine and public health, supported by mobile devices. The term is most commonly used in reference to using mobile communication devices, such as mobile phones and PDAs, for health services and information. (Wikipedia 2012)
  • 4. Fitness, Wellness or Healthcare App? • Fitness Apps are for those who want to get in shape or who are training for an event (marathon) • Wellness Apps are for those who want to live healthy lifestyles through diet and exercise • Healthcare Apps are for professionals managing their work or for patients to deal with a specific health condition
  • 5. Future of Consumer Health Apps & the Registered Dietitian • Patient • Providers • Creative Cutting Edge Professionals
  • 6. Future of Consumer Health Apps • Growth prediction is EXPLOSION of consumer health apps (IOS) by July 2012 = 13,110
  • 7. Types of Apps Downloaded?
  • 8. Health Apps • Diabetes • Weight Loss • Gluten Free
  • 9. • The Surgeon General’s Healthy Apps challenge, announced during her Tuesday morning keynote at the handy tools mHealth Summit, is designed to develop with tailored information that will encourage those “who may not be tech savvy and who to become wouldn’t ordinarily want to get involved healthy and fit, and to make it easy and fun.”
  • 10. Desirable App Characteristics for Managing Chronic Conditions • Personalize, Track, Remind, Affirm • Adhere to Evidence Based Practice (Connect to provider, EHR?) • Educational component that is updated? • Engage & Incentivize Client • Connected to DB (external live) • Provide for Social Support
  • 11. Health & Fitness App Life Cycle
  • 12. Popular Health Apps • Weight Loss • Lose it • http://www.loseit.com/ • Diabetes • **GluCoMo- addresses co-morbid client & has back-end connectivity http://www.glucomo.com/ • Gluten Free • Eating Out Gluten Free • http://itunes.apple.com/us/app/eating-out-g- free/id410718619?mt=8
  • 13. Will They come? • Three in five patients, regardless of age, said they’d be interested in using a wireless medical device to send information to their physician, and younger patients expressed interest in using their smartphones for that purpose.
  • 14. mHealth App Advantages • Helps Client Manage Health • Care Coordination Opportunities • Immediate Exchange of Accurate Objective Information from Client to Provider • Earlier and More Accurate Diagnosis • Remote Monitoring Opportunities
  • 15. Current & Future Challenges • FDA Approval • Device versus App • Cost of Device/App Development • Client Compliance
  • 16. Resources 1. http://www.imedicalapps.com/top-apps 2. http://www.eatright.org/appreviews/ 3. http://www.happtique.com/ 4. Pew Internet Data Smart Phone & App Use 5. Draft Guidance for Industry and Food and Drug Administration Staff- Mobile Medical Applications 6. http://www.mhimss.org/ 7. App Connections for Health Professionals 8. Apple iTunes Health and Medical Apps Category 9. Massive Health – The Eatery 10. Preventice 11. WellDoc

Editor's Notes

  1. mHealth represents an entirely new way of patient care quite different than what we have previously experienced,Taking care to the patient is the wave of the future and right now.Instead or bringing clients in to the physicians offices we will see more efforts and care and communication between client and provider using mobile devices including smart phones.
  2. 64 percent of physicians own a smart phone.30 percent own an iPad with another 28 percent ready to buy one in the next six months.33 percent use the smart phone to input patient data from the EHR.                                   Manhattan Research, Taking the Pulse®, 2011
  3. As a Patient - WE will manage our health using a Device or AppAs Providers - WE will transmit information between client and EHR using a Device or AppAs Creative Cutting Edge Professionals - WE will use new methods of engagement to motivate our patients64 percent of physicians own a smart phone.30 percent own an iPad with another 28 percent ready to buy one in the next six months.33 percent use the smart phone to input patient data from the EHR.                                   Manhattan Research, Taking the Pulse®, 2011
  4. About 10% of the people downloading apps – download health apps- this number has been flat over the past year.Based on actual data forecasting prediction.
  5. News weather stocks the top categoryCommunicate with friends or familyData from August 2011Helped you learn something you were interested inHelped you get more information about somethingHelped with work related tasksAllowed you to watch moviesEvent informationManage your health --- Least popular category for downloading
  6. The major categories of health apps on the market currently.Cardio fitnessDiet related apps second largest Stress and relaxation – yoga soothing soundsWomens health apps trainingSmoking cessation, cardio, relaxationNone of these apps have the ability to transmit data or exchange data w an EHR
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  8. Provides reminders and trackingTransmits information to and from EHROffers ability to interact with a community (Social Networking)Many 2011 studies published on Consumer health apps evaluated apps available in 2009, based on their description only, used antiquated methods of measurements, and did not consider new mechanisms of engagement or incentive for making behavior changes.Old world metrics and rubricks Many health apps are evaluated based on descriptions.Social Element KeyResults two years later is too late for mobile apps- need 2 have a quick cycle for evaluation because many apps have a low staying power or may fail and no longer be on the market within a year of launching so who cares if they are reviewed two years later- review is no longer relevant.Chronic disease apps are more connected- sensors- backend flow of current health care processes.Needs service layer- personalization, cloud based, plan care, hipaa compliantFMH family health manager- your spouse your partner etc… helps manage health.
  9. Many fail 1.5 year laterWhat is the point of a study if the apps are no longer available?
  10. Lose it"It's free, it helps you to count and budget calories, plan meals, factor in exercise, and lose weight at a safe, sustainable pace," says CBC medical specialist Dr. Karl Kabasele.GluCoMo™ is a state-of-the-art mobile health solution providing diabetes monitoring and patient coaching services. It consists of customized front-end mobile client applications, an interactive web portal and a secure telematics platform as its back-end infrastructure.Sensei- now focusing on weight lossMost tracking appsTracking blood sugar etc…Does your app stand the test of time?Rewards like employer health co pay- for one month – healthy score, coupons etc…Improve health care outcomes.Platform with plug and play capabilitiesWeather- uv for skincare, pollen for asthmatics.Inotegration of siri with voice Encryption and security standards must be hipaa covered entity
  11. FhmFamily health managers- spouseHCP – health care professionalsMedication adherence—inhealthcare tens to be the biggest problem- cheapest part of healthcareSms did not take or record his medication- FHMBusiness rule in cloud if kye has not taken or recorded med my HCP may need to know thisSafety and finance- education Data Kyle did or did not take his medications data driven client behaves bettermultimobile worldPlan nutrition and recipes on web portal and execute on mobile phone.View results either placeEducation and behavioral change watch it where I want to watch it.ubiquitous communication in car, in house, in airport, in mobile environment- need connectivity to support.Personalized – reminders you send sms--- get my attention---trigger message of phone recording that says dad did you take your meds today.Where is the profile about me– muti mobile- can profile be used both places- who see what data- data import- where is the weight information- dashboard profile.Co morbid patient – need to have app for both issues diabetes and app- html 5 create in checklist they want to manage and build app just for them.Deliver education at point ot need.Recognize readiness-Like gaming- I have made a certain amount of progress now I need to go to the next level- create leader boards for competition- incentives- moving data around and syncing dataSensor integration- ease data burden – wearing body patch for glucose transmission and improves quaity- more and better informationCardiac sensors, body position motion. Blue tooth , Front end needs to be as generic as possible- plug and playSensors include better diagnosis- an app the integrates and ecg heart monitor can diagnosis and get info earlier- early detection more accurate dataMonitor someone via sensor remotely- get them home earlier- less cost w hospitalizationCare plan inplementaton.Rule based triggers – alerts, instructions, family support, hcp supportCare plan on mobile phone watching my behaviors.
  12. At the patients fingertipsImmediate exchange of information from client to physicianBetter tracking and diagnostic criteriaOpportunity for client remindersEarlier diagnosis of health problemsFewer medical errorsSafer care – lower cost – more effective care
  13. Health apps are the least popular category of app downloaded on itunes today.Even the most popular apps struggle with staying power meaning that most people lose interest in the app after the first month and by the 12th month a user may only have 4 percent of the apps he originally downloaded 12 months ago- these are considering popular apps – health apps may suffer from quicker loss of interest or they may be better – overall their general popularity is the lowest of all apps. People struggle with wanting to manage their health.RTC- WellDocFDA approval for health app related to intent of device- Agile versus waterful method of development--FDA will lose good developers with a process that is outdated.
  14. Do you need