Contents 3 Viewpoint 4 The industry landscape 6 Healthcare applications for consumers 9 Healthcare professionals 13 About Ruder Finn Healthcare Technology
ViewpointAs global populations age and many devices – smartphones and tablet accelerometry to measure levels of devices to be smaller and lighter,elderly people live with chronic computers – have been widely activity, etc. Some apps use the fact wearable even, and connectivitydiseases, society needs measures to adopted, mainly because of their that these devices have Bluetooth to be faster and more reliable.manage this changing demographic increased connectivity, ease of use or other means of connecting to With new sensing technology,of healthcare users. and long battery lives. Couple this specialist hardware to great effect – most probably implantable, its not Taking healthcare to the patient, with the “app” model, where users e.g. BT blood-pressure monitoring or too much of a stretch to imagineputting them in control of their can pick and choose from thousands weight management scales. mHealth becoming a part of ourillnesses and enabling them to live of applications for their devices, We have a technology that is everyday lives, increasingly not onlymore independently, are ways to and these platforms become prime highly useable and almost ubiquitous; to manage illnesses but to keep usease the burden on healthcare candidates to manage at least one a population that is tech savvy; and well for longer.systems. Mobile healthcare aspect of people’s lives – their health. illnesses that are quite treatable but(mHealth) promises just that. Many such apps already exist and require longer term observations Prof. Christopher James Technological advances mean use a variety of sensing inputs to and care, points addressed by the Professor of Healthcare Technologysmall, lightweight and highly inform the user of different aspects mHealth revolution we see today. & Director, Institute of Digitalconnected devices are in the hands of their health – e.g. the built-in In the future, we can expect Healthcareof much of the population. These camera to measure heart rate, tri-axis battery lives to become onger, WMG, University of Warwick
4The industry landscapeThe healthcare technology team at platforms and applications forRuder Finn commissioned research healthcare delivery could beby YouGov to get a snapshot of designed moving forwards. integrating mobile technologiesconsumer attitudes to mobile health into the healthcare service deliveryboth as users and as patients. Mobile innovation model are clear: better services The results, compiled within this to a larger number of patients;report, examine what we currently Mobile is the most widespread easily standardised care throughuse, which services we want and communication infrastructure centralisation and IT developments;our attitudes to the prospect of in the world. Most of the world’s and greater collaboration to providehealthcare services being delivered population has access to some integrated care by sharing patientremotely. More than a thousand form of mobile communication data with all parties involved.smartphone and tablet users from and mobile healthcare – or mHealth services have theacross the UK were surveyed in June mHealth – describes the use of this potential to further improve2012 and their responses provide infrastructure in the transformation quality and access to care as well assome interesting insights, which of societies’ healthcare services. reduce costs in both developed andhelp inform the way technology The potential advantages of emerging markets.
Top three reasons for not using a health app • I have no need to access health related apps • I prefer to talk to my doctor (healthcare professional) in person about any health related questions • I do not find health apps to be helpful Smartphone and tablet appsThese results suggest Analysts predict that the smartphone as contract packages make own data and upload it remotely.smartphone owners and users application market - one of the smartphones more affordable and The opportunities these newbelieve that smartphone fastest growing sectors of mHealth as our love affair with smartphones platforms create for services totechnology can help with - for mHealth will reach US$1.3 continues, so does our appetite for be delivered in an entirely new billion in 2012 with 247 million users mobile applications (apps). way have been recognised bykeeping doctors in touch with downloading an app worldwide. This At the same time the tablet technology and telecoms / mobileand up to date with a person’s demonstrates a significant increase market is booming. Sitting vendors. Companies are investinghealth status. compared to the 124 million users somewhere between the millions to develop new apps and who downloaded smartphone health smartphone and the laptop, services – both for the consumer applications in 2011.¹ the tablet is designed almost and for the healthcare professional In the UK, we are adopting exclusively for the delivery of – but does the demand warrant new technologies at an increasing tools, services and media via touch such investment? speed. Since the turn of the decade screen. Already widely used in some There is no doubt that mobile there has been an explosion in hospitals for recording and sending apps are incredibly popular – this smartphone ownership such that patient data, as a platform the year downloads from Apple’s App¹Research2Guidance. mHealth App Market more than a quarter (27 %) of tablet has the potential to deliver Store exceeded those from iTunes forTrends and Figures 2011-2016. January 2012 UK adults now own one.² This a far greater array of healthcare the first time. But is there a market²Ofcom Communications Market Report: UK rises to four fifths (81%) among services – from virtual consultations for health apps? And do consumersAugust 2011 healthcare professionals.³ The rise to monitoring changes in the body want to have healthcare services³Manhattan Research 2012 in ownership is set to continue and enabling patients to input their delivered on mobile devices?
6Healthcare applications for consumers Applications smartphone users are most interested in* iPhone 27% 20% 23% 24% 20% 24% 22% 17% 20% Blackberry Android OS Fitness / training apps Calorie counter apps Healthy eating apps 48% 34% 47% 40% 21% 29% 39% 20% 31% Apps to make appointments Apps to view your personal Apps to access test results with your GP medical recordNot all platforms are createdequalAccording to the most recent Ofcom and iPad.⁵ The research suggests Owners of iPhones and iPads about the user to help maintain aCommunications Market Report², that in the world of health apps, not use health apps more frequently healthier lifestyle. In India, Vodafonejust under half (47%) of adult all platforms are created equal. It than users of other types of has launched “Ask a doctor” thatsmartphone users have downloaded seems that regular users of iPhones smartphones. enables users to clarify health-an app. But while we’re busy and iPads are more likely to use related questions with doctors usingdownloading, research suggests the health apps than regular users of their phones.majority of apps, once downloaded, other types of smartphones andare only used once and then left idle. find the technology easier to use. An appetite for health apps Usage of apps, once downloaded, Also, while use of health appsis an important factor for this was lower than nearly all other But while the device makes a *mHealth: Consumer Attitudes Survey ofmarket. In 2011 a quarter (26%) of types of apps listed, usage of health difference to whether or not people 2,000 consumers (RuderFinn/ YouGov Junedownloaded apps were used once.⁴ apps on iPhones was three times 2012). Responses to: Which application would will regularly use the app, the RuderHowever, the Ruder Finn research higher than on Blackberry and twice you be interested in using?, and which of the Finn online survey shows that following health services would you like to besupports a Localytics’ report that that on Android OS. able to access on your smartphone or tablet? respondents in general would beshows the iPhone and iPad had Regardless, the rise of interested in using health apps or ⁴ Localytics 26% of Mobile Application Usersretention rates 52% higher than smartphones has sparked a flurry of services. App publishers take note: are Fickle — or Loyal. March 2011 http://www.those on Android. In addition, the activity in the development of health localytics.com/blog/2011/26percent-of-mo- the public wants apps but you’ve gotaverage Android app has a 24% one- apps. Samsung has released its S bile-app-users-are-either-fickle-or-loyal/ to make them usable.time usage rate compared to just Health app for the Samsung Galaxy ⁵ Localytics App retention increasing: iPhone But in answering this particular21% one-time usage rate for iPhone S III, which collects a variety of data crushes Android (June 2012) question, more than a third of
respondents (36%) said they the ideal way to deliver applications (47%) own a smartphone, not all The popularity of smartphones,would not like to access any health that deliver support, monitoring smartphones offer their users the the fact they go everywhereservices via an application on their or information for patients. And same level of flexibility when it with their owner, and are rarelysmartphone or tablet. This finding, their ubiquity means companies comes to apps. Those makers of apps switched off means they are thehowever, hides some differences developing for smartphones are not who ensure they work easily across ideal way to deliver applicationsrelated solely to devices. expecting people to invest in yet a variety of platforms are the ones that deliver support, monitoring Just over a quarter (27% 26%) more technology. who are going to be successful. This or information for patients.of regular iPhone and iPad users said Our research showed more than a is critical information for developersthey wouldn’t use a health app on fifth (21%) of respondents were very and endorsers, such as the NHS,their phone or tablet, compared to likely or fairly likely to use a service, which is planning to let doctors knowtwo fifths (42%) of regular Blackberry delivered via mobile technology, to of 500+ apps it can recommendusers, more than a third (35%) with better manage their health. to patients to help them managean Android OS, and a quarter (27%) But it’s the companies with the their health (while cutting costs forwith another type of tablet. efficacy studies, apps that work the NHS). Recommending which Taken in the context of the rest of across the range of technology, and platforms to use will be critical.the survey, this answer suggests that companies that build into their appsBlackberry users find using apps on support to help consumers change Apps currently availabletheir devices not worth the bother. their behaviour, who will ultimately However, the popularity of lead this market. It seems not all health apps already ⁷ Ryan D, Price D, Musgrave SD, et al. Clinicalsmartphones, the fact they go The take home message from launched have been useful; earlier and cost effectiveness of mobile phone sup- ported self monitoring of asthma: multi-everywhere with their owner, and are this is that while a quarter of adults this year researchers found that centre randomised controlled trial. BMJ.rarely switched off means they are (27%) and almost half of teenagers patients who used smartphones to 2012;344:e1756.
8monitor their asthma, were not able health apps. More than two fifths a chronic health condition, thereto improve control of their disease (42%) of those with smartphones/ was only a third (32%) who felt noany better than paper monitoring.⁷ tablets who hadnt used a healthy need for a health app and just over rural and urban dwellers. The reasonsSome apps may even need living app in the previous six a quarter (27%) who preferred to given by those living in the countryregulation and approval. In May, months said they had no need for talk with their doctors. This latter for not using apps were the same asdoctors at the Mersey Regional Burns health apps and a fifth (19%) of finding suggests that while those those living in the inner city, townsand Plastic Surgery Unit certified respondents said they’d rather speak with long term health conditions and suburbs. Those in rural areastheir Mersey Burns iPhone app as with their doctor. When broken are keen on apps to manage their were broadly interested in the samea medical device. It seems the rule down these baseline figures reveal health, it won’t necessarily free up kind of apps as those living in citiesof thumb is that if the app is used in that young people are the ones who time with healthcare professionals and suburbs, namely calorie counters,clinical decision-making, then it is don’t feel they need health apps. and save the NHS costs. If a health healthy eating and nutrition apps.most likely a medical device. Just over a quarter (28%) of those service is hoping for cost saving as The one difference was But despite these drawbacks, over 55 felt they had no need to well as improving people’s health fitness apps. A fifth (22%) of allresults from our survey make it clear access a health app. There’s a similar by using mHealth then the trick will respondents said they would usethere is huge potential for health age divide in relation to preference be to develop apps that not only a fitness app if one were available;apps delivered via a smartphone. to speak face to face to a doctor; a offer people the ability to manage this figure dropped to just 16% third (33%) of the over 55s preferred their health but also provide an among those who lived in ruralNot APPropriate for personal consultation but only a element of contact that comes with areas and 10% villages. Perhaps theeveryone... tenth (10%) of those aged 18/24 felt a visit to the GP. hike from the shops home, now that the same. One variation that we had rural bus services are non-existent,Our data show some interesting Among the respondents who expected but our survey results did mitigates against the need fortrends in why people don’t use described themselves as having not show clearly, was that between digital fitness help.
Healthcare professionals Healthcare services smartphone users are most interested in* 100 All respondents All respondents identifying 75 themselves as having a chronic disease or health condition 50 33 25 23 24 17 12 9 0 per cent Reminder apps that Monitoring apps for Medication tells you when you need long term conditions management apps a repeat prescription and reminds you when to take your medicationWho’s using what?Among all our respondents, only talk with a doctor compared to 27 conditions with nearly twice as many to be of interest to the quarter of7% had used a general health and % of those with chronic disease/ people with chronic disease/health respondents (24%) with chroniclifestyle app in the previous six health; and roughly a tenth in each conditions interested in apps for disease/health conditions who saidmonths; of those who said they had group (11 % of all respondents and monitoring conditions or managing they were interested in monitoringa chronic disease/health condition 10 % of those with chronic disease/ medical services. If companies their health.11% had. In general, there was little health) said they didn’t find health can get these kind of apps rightdifference in the use of health apps apps useful. then there is a real opportunity to A healthcare professionalbetween the apparently healthy and The two groups had roughly improve people’s ability to manage tool?those with chronic conditions. the same wish list for apps. The their health. When asked why respondents most popular (42% of respondents; Our online survey indicates that The mobile nature of many medicalhad not accessed health or lifestyle 46% of respondents with chronic a majority of respondents with practices – GPs visiting patients,apps in the last six months, again, disease/health conditions) was one chronic disease/health conditions specialists moving through athe difference between those who that would make appointments are interested in apps; these hospital, paramedics in the field –identified themselves as having a with the GP. There was also some new adopters may well be the means that mobile communicationschronic disease/health condition and enthusiasm for being able to access vanguard of patients who will help have always been of interest tothose who didn’t was not marked. test results, with about a third of pioneer binary network apps (apps these professionals. Doctors, inTwo fifths (42%) of all respondents each group saying they would use that track peripheral devices), particular, are often early adopterssaid they had no need for health an app like this. seen by many analysts as the of new technology and haveapps compared to a third (32%) with The biggest difference between biggest trend in 2012. Wearable embraced smartphones and tabletslong term conditions a fifth (19%) these two groups of respondents censors, apps that diagnose using with enthusiasm. Manhattanof all respondents said they’d rather were in the apps around managing smartphone technology are likely Research, which monitors
10 Top three apps for doctors nurses • Monitoring devices that can alert carers, doctors and nurses if a patient has a health emergency • Access to test results • Smartphone and tablets that enable doctors and nurses to record observations and share information while on home visits or away from the surgery/ hospitalIf companies can get these kind healthcare professionals’ adoption between what they were willing to to take action should somebody’sof apps right then there is a real of new technology, has found that use compared to what they thought health deteriorate. But there is littleopportunity to improve people’s 26% of European doctors now have doctors and nurses could use to to suggest people are expectingability to manage their health. and use an iPad professionally, improve healthcare. a health revolution based on GPs spending a quarter of their online The top three ranked apps for using apps to improve and change time using the device.⁸ healthcare professionals, as rated by patients’ behaviour. A recent US study found all respondents were: access to test There was little difference in smartphones were popular for results; smartphone and tablets that the ranking of these three apps clinical use among clinicians, and enable doctors and nurses to record based on where respondents lived, medical and nursing students, observations and share information whether they had a long term facilitating access to clinical while away from the surgery/ hospital medical condition, or their age.*mHealth: Consumer Attitudes Survey of information at the point of care; drug and virtual consultations for people What the results do suggest is that2,000 consumers (RuderFinn/ YouGov June2012) reference apps, medical textbooks, living in remote areas; and an app the respondents may not have references for disease diagnosis, and that provides information to doctors considered privacy or transfer of data⁸ Tryer D. Twenty six per cent of Europeandoctors own an iPad. February 15 2012 http:// medical calculator applications were about a patient’s health status via the over mobile networks as a potentialwww.pmlive.com/digital_intelligence_blog/ reported as most useful by clinicians monitoring device in patients’ homes. issue. This lack of concern is mirroredarchive/2012/feb_2013/european_doctors_ and medical and nursing students.⁹ These results suggest smartphone by the 30% of respondents who saidipad_use_ownership We asked our respondents which owners believe mobile technology they would like to be able to use an⁹ Mosa AS, Yoo I, Sheets L. A Systematic apps they thought would be helpful can help doctors keep in touch and app to view their medical recordsReview of Healthcare Applications forSmartphones. BMC Med Inform Decis Mak. for healthcare professionals. The up to date with a person’s health from their mobile phone and the2012;12(1):67. results suggested a divergence status, enabling the professional 31% who wanted access to their test
Real life Applicationresults via a health app. But the app Using mobile technology to improve There is a difference between disabilities associated with chronicthe respondents were most likely the well being of people with long- interest and use. 50% more disease, e.g locator devices forto use was a purely practical one – term medical conditions has long respondents said they would be dementia patientsmore than two fifths (42%) wanted been an aspiration for healthcare interested in using healthcare • Patient data collection and analysisan app that would let them make an providers. Of the various mobile- • Quality of life by keeping patients apps as currently use them.appointment with their GP. enabled services, remote health out of hospitals and nursing homes The practical challenges of monitoring (RHM) could have the Our research results paint amaking apps indispensable to greatest impact on chronic disease complicated but informative picturehealthcare professionals are management. RHM services of the market for mHealth. There ismultiple. Useability and platform are likely to deliver the greatest no question that mobile devices –are concerns, but there are also very benefit in terms of improved whether tablet or smartphone – are changing the way we interact withpractical considerations for a doctor disease evolution, patient lifestyle many services already.on the move – battery life, size of and treatment costs by enabling However, the fact these devicesthe screen, security, how to input providers to improve: are relatively new and the mostdata. The app is only as valuable as • Disease diagnosis, complication sophisticated users of them tend tothe information in it and, as with all management, and intervention be the younger generations, meanshealthcare information, it will need ahead of acute phenomena trying to predict take up of mobileto be updated regularly, especially • Treatment compliance through device- based healthcare servicesresources for professionals such as patient/caregiver reminders (both consumer and cliniciandisease diagnosis, drug reference, • Quality of care by giving patients driven) in the future is difficult.and medical calculator applications. and caregivers tools to manage What we can see are some
12What we found what it means for app developers• Consumers online want apps to help them manage the practical aspects of healthcare but they need to be easy to use and accessible on all platforms• Although usage is relatively low, interest is high. Developers need to understand why smartphone users aren’t engaging with health applications• Consumers using Apple devices are the most likely to use health apps. Developers need to understand why… is it the profile of Apple users or the apps themselves? What impact does the platform have on usage overall?• At the moment health apps are the least popular while social media apps are the most popular. Age of app users has an impact but what can developers learn from games and social media apps to make theirs more compelling?• A fifth of our respondents said they were likely to use a health app before the end of the year. The market is there and it is growing but the apps need to be compelling enough to compete for mindshare in a tough market• A third of our respondents would view medical records or get test results through an app. Medical services apps would perhaps have better usage levels than lifestyle apps if made quick, easy and intuitivevery interesting trends that both should consider that Apple has a suggests consumers welcome tools The idea that mobile is ahealthcare application developers 16.9% share of the smartphone to make life easier but not at the panacea for reducing healthcareand those that deliver healthcare market while Android has 36.4%.¹⁰ expense of face-to-face interaction costs and improving efficiency is ashould note: In the tablet market things are very with healthcare professionals. false one.• Gamification is something already different. Apple’s share is almost As the social generation gets being looked at as a method 70%.¹¹ As Android becomes more older there is little doubt that we for engaging and educating aggressive in this space, however, can expect to see usage of mHealth consumers – why not patients? we can expect that to decline. tools and applications rise. The Gamification could also help • There is a big difference between winners in development will be the solve the problem of idle apps interest and use. Twice as many companies who learn why apps are by increasing engagement and respondents said they would be being used now and apply those helping to ensure apps are not just interested in using healthcare lessons to future development. downloaded and then ignored. apps as currently use them. This The idea that mobile is a panacea• Platform is important. The tells us there is demand that is not for reducing healthcare costs and numbers using healthcare apps currently being met. improving efficiency is a false one. changes significantly depending • Interest is highest in tools to The delivery of healthcare services on the platform. This may be to help consumers manage their through mobile devices must always do with the profile of the users interactions with healthcare been seen as an adjunct rather ¹⁰ IDC Worldwide Quarterly Mobile Phone but is healthcare application professionals and give them than a replacement. A mobile will Tracker. July 2012. development skewed towards visibility and control of the never take the place of one-to-one ¹¹ CNET: Apple dominates tablet market in Q2 Apple devices? App developers information about their health. This interaction with an individual doctor. with 70% share. August 14, 2012.
About Ruder Finn Healthcare TechnologyRF Healthcare Technology brings key areas of leadership: Health foundation from which to buildtogether two of our agency’s Wellness, Corporate Public campaign planningspecialist practices to create a single Trust, Technology Innovationglobal division that helps IT and and Consumer Connections. Its DISCOVERpharmaceutical companies realise regional headquarters are in New Data insights: Combiningthe potential of technology as a tool York, London and Singapore and the primary research, desk researchto improve healthcare delivery – both agency is also the second largest in and industry leading tools with afor clinicians and consumers. Clients China with four offices in Shanghai, full range of social media, offlineinclude technology giants such Bejiing, Hong Kong and Guangzhou. media and campaign planning toolsas Microsoft and Fiserv as well as to deliver the insight needed forleading pharmaceutical companies Ruder Finn’s D6 Methodology campaign planning experiential elements to prepare forincluding Novartis and Pfizer. delivery and launch D6 is our bespoke methodology that DETERMINERuder Finn takes us from business problem to Strategy development: Focused DELIVER campaign delivery and measurement. on the role we can play in solving Go live: Launch, disseminate andRuder Finn is one of the Clients can join the cycle at any point the business problem, reach key follow up all campaign activitiesworld’s leading independent depending on the nature of their audiences and change relevantcommunications agencies, with requirement and complete all or part behaviours DECONSTRUCToffices in EMEA, US and across of the programme: Measurement review: Measure theAsia. Headquartered in New DESIGN AND DEVELOP success of all activities, work with youYork, the company supports a DEFINE Content creation: Development of to analyse the results and developbroad range of clients across four Brief and objectives : Ruder Finn’s materials, written content, creative, key learnings to take forward andstrategic pillars that reflect its senior team uses your brief as a apps, websites, 3D build and help define the next campaign.
All figures, unless otherwise stated, are from YouGov Plc. Total sample size was 2148 adults of whom 1204have access to a smartphone/ tablet. Fieldwork was undertaken between 26th -29th June 2012. The surveywas carried out online. The figures have been weighted and are representative of all GB adults (aged 18+).
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