3. Contents
3 Viewpoint
4 The industry landscape
6 Healthcare applications for consumers
9 Healthcare professionals
13 About Ruder Finn Healthcare Technology
4. Viewpoint
As 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 connectivity
diseases, 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, it's 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 imagine
putting them in control of their can pick and choose from thousands weight management scales. mHealth becoming a part of our
illnesses and enabling them to live of applications for their devices, We have a technology that is everyday lives, increasingly not only
more independently, are ways to and these platforms become prime highly useable and almost ubiquitous; to manage illnesses but to keep us
ease 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 Technology
small, lightweight and highly inform the user of different aspects mHealth revolution we see today. & Director, Institute of Digital
connected devices are in the hands of their health – e.g. the built-in In the future, we can expect Healthcare
of much of the population. These camera to measure heart rate, tri-axis battery lives to become onger, WMG, University of Warwick
5. 4
The industry landscape
The healthcare technology team at platforms and applications for
Ruder Finn commissioned research healthcare delivery could be
by YouGov to get a snapshot of designed moving forwards. integrating mobile technologies
consumer attitudes to mobile health into the healthcare service delivery
both 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 through
use, 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 provide
healthcare services being delivered population has access to some integrated care by sharing patient
remotely. 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 the
across the UK were surveyed in June mHealth – describes the use of this potential to further improve
2012 and their responses provide infrastructure in the transformation quality and access to care as well as
some interesting insights, which of societies’ healthcare services. reduce costs in both developed and
help inform the way technology The potential advantages of emerging markets.
6. 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 apps
These 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 new
believe that smartphone fastest growing sectors of mHealth as our love affair with smartphones platforms create for services to
technology 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 by
keeping doctors in touch with
downloading an app worldwide. This At the same time the tablet technology and telecoms / mobile
and up to date with a person’s
demonstrates a significant increase market is booming. Sitting vendors. Companies are investing
health 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 App
¹Research2Guidance. mHealth App Market more than a quarter (27 %) of tablet has the potential to deliver Store exceeded those from iTunes for
Trends 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 market
²Ofcom Communications Market Report: UK rises to four fifths (81%) among services – from virtual consultations for health apps? And do consumers
August 2011
healthcare professionals.³ The rise to monitoring changes in the body want to have healthcare services
³Manhattan Research 2012 in ownership is set to continue and enabling patients to input their delivered on mobile devices?
7. 6
Healthcare 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 record
Not all platforms are created
equal
According to the most recent Ofcom and iPad.⁵ The research suggests Owners of iPhones and iPads about the user to help maintain a
Communications Market Report², that in the world of health apps, not use health apps more frequently healthier lifestyle. In India, Vodafone
just under half (47%) of adult all platforms are created equal. It than users of other types of has launched “Ask a doctor” that
smartphone 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 using
downloading, research suggests the health apps than regular users of their phones.
majority of apps, once downloaded, other types of smartphones and
are 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 apps
is an important factor for this was lower than nearly all other But while the device makes a
*mHealth: Consumer Attitudes Survey of
market. In 2011 a quarter (26%) of types of apps listed, usage of health difference to whether or not people
2,000 consumers (RuderFinn/ YouGov June
downloaded apps were used once.⁴ apps on iPhones was three times 2012). Responses to: Which application would will regularly use the app, the Ruder
However, 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 be
supports a Localytics’ report that that on Android OS. able to access on your smartphone or tablet? respondents in general would be
shows the iPhone and iPad had Regardless, the rise of interested in using health apps or
⁴ Localytics 26% of Mobile Application Users
retention 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 got
average 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 particular
21% one-time usage rate for iPhone S III, which collects a variety of data crushes Android (June 2012) question, more than a third of
8. 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 everywhere
services via an application on their or information for patients. And same level of flexibility when it with their owner, and are rarely
smartphone or tablet. This finding, their ubiquity means companies comes to apps. Those makers of apps switched off means they are the
however, hides some differences developing for smartphones are not who ensure they work easily across
ideal way to deliver applications
related 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 developers
they 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 know
two fifths (42%) of regular Blackberry delivered via mobile technology, to of 500+ apps it can recommend
users, more than a third (35%) with better manage their health. to patients to help them manage
an Android OS, and a quarter (27%) But it’s the companies with the their health (while cutting costs for
with 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 apps
Blackberry users find using apps on support to help consumers change Apps currently available
their 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. Clinical
smartphones, 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.
9. 8
monitor their asthma, were not able health apps. More than two fifths a chronic health condition, there
to improve control of their disease (42%) of those with smartphones/ was only a third (32%) who felt no
any better than paper monitoring.⁷ tablets who hadn't used a healthy need for a health app and just over rural and urban dwellers. The reasons
Some apps may even need living app in the previous six a quarter (27%) who preferred to given by those living in the country
regulation and approval. In May, months said they had no need for talk with their doctors. This latter for not using apps were the same as
doctors at the Mersey Regional Burns health apps and a fifth (19%) of finding suggests that while those those living in the inner city, towns
and Plastic Surgery Unit certified respondents said they’d rather speak with long term health conditions and suburbs. Those in rural areas
their Mersey Burns iPhone app as with their doctor. When broken are keen on apps to manage their were broadly interested in the same
a 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 cities
of 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 all
results 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 use
there 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 rural
Not APPropriate for personal consultation but only a element of contact that comes with areas and 10% villages. Perhaps the
everyone... 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 for
trends in why people don’t use described themselves as having not show clearly, was that between digital fitness help.
10. 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 medication
Who’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 of
7% had used a general health and % of those with chronic disease/ people with chronic disease/health respondents (24%) with chronic
lifestyle app in the previous six health; and roughly a tenth in each conditions interested in apps for disease/health conditions who said
months; of those who said they had group (11 % of all respondents and monitoring conditions or managing they were interested in monitoring
a 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 right
difference in the use of health apps apps useful. then there is a real opportunity to A healthcare professional
between 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 medical
had 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 a
the 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 communications
chronic disease/health condition and enthusiasm for being able to access vanguard of patients who will help have always been of interest to
those who didn’t was not marked. test results, with about a third of pioneer binary network apps (apps these professionals. Doctors, in
Two fifths (42%) of all respondents each group saying they would use that track peripheral devices), particular, are often early adopters
said they had no need for health an app like this. seen by many analysts as the of new technology and have
apps compared to a third (32%) with The biggest difference between biggest trend in 2012. Wearable embraced smartphones and tablets
long term conditions a fifth (19%) these two groups of respondents censors, apps that diagnose using with enthusiasm. Manhattan
of all respondents said they’d rather were in the apps around managing smartphone technology are likely Research, which monitors
11. 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/ hospital
If companies can get these kind healthcare professionals’ adoption between what they were willing to to take action should somebody’s
of apps right then there is a real of new technology, has found that use compared to what they thought health deteriorate. But there is little
opportunity to improve people’s 26% of European doctors now have doctors and nurses could use to to suggest people are expecting
ability 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 that
2,000 consumers (RuderFinn/ YouGov June
2012) 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 data
⁸ Tryer D. Twenty six per cent of European
doctors own an iPad. February 15 2012 http://
medical calculator applications were about a patient’s health status via the over mobile networks as a potential
www.pmlive.com/digital_intelligence_blog/ reported as most useful by clinicians monitoring device in patients’ homes. issue. This lack of concern is mirrored
archive/2012/feb_2013/european_doctors_ and medical and nursing students.⁹ These results suggest smartphone by the 30% of respondents who said
ipad_use_ownership
We asked our respondents which owners believe mobile technology they would like to be able to use an
⁹ 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 records
Review of Healthcare Applications for
Smartphones. BMC Med Inform Decis Mak.
for healthcare professionals. The up to date with a person’s health from their mobile phone and the
2012;12(1):67. results suggested a divergence status, enabling the professional 31% who wanted access to their test
12. Real life Application
results via a health app. But the app Using mobile technology to improve There is a difference between disabilities associated with chronic
the respondents were most likely the well being of people with long- interest and use. 50% more disease, e.g locator devices for
to use was a purely practical one – term medical conditions has long respondents said they would be dementia patients
more than two fifths (42%) wanted been an aspiration for healthcare interested in using healthcare • Patient data collection and analysis
an 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 a
making apps indispensable to greatest impact on chronic disease complicated but informative picture
healthcare professionals are management. RHM services of the market for mHealth. There is
multiple. 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 with
practical 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 devices
the screen, security, how to input providers to improve:
are relatively new and the most
data. The app is only as valuable as • Disease diagnosis, complication sophisticated users of them tend to
the information in it and, as with all management, and intervention be the younger generations, means
healthcare information, it will need ahead of acute phenomena trying to predict take up of mobile
to be updated regularly, especially • Treatment compliance through device- based healthcare services
resources for professionals such as patient/caregiver reminders (both consumer and clinician
disease 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
13. 12
What 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 intuitive
very interesting trends that both should consider that Apple has a suggests consumers welcome tools The idea that mobile is a
healthcare application developers 16.9% share of the smartphone to make life easier but not at the panacea for reducing healthcare
and those that deliver healthcare market while Android has 36.4%.¹⁰ expense of face-to-face interaction costs and improving efficiency is a
should 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.
14. About Ruder Finn Healthcare Technology
RF Healthcare Technology brings key areas of leadership: Health foundation from which to build
together two of our agency’s Wellness, Corporate Public campaign planning
specialist practices to create a single Trust, Technology Innovation
global division that helps IT and and Consumer Connections. Its DISCOVER
pharmaceutical companies realise regional headquarters are in New Data insights: Combining
the potential of technology as a tool York, London and Singapore and the primary research, desk research
to improve healthcare delivery – both agency is also the second largest in and industry leading tools with a
for clinicians and consumers. Clients China with four offices in Shanghai, full range of social media, offline
include technology giants such Bejiing, Hong Kong and Guangzhou. media and campaign planning tools
as Microsoft and Fiserv as well as to deliver the insight needed for
leading pharmaceutical companies Ruder Finn’s D6 Methodology campaign planning experiential elements to prepare for
including Novartis and Pfizer. delivery and launch
D6 is our bespoke methodology that DETERMINE
Ruder 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 and
Ruder Finn is one of the Clients can join the cycle at any point the business problem, reach key follow up all campaign activities
world’s leading independent depending on the nature of their audiences and change relevant
communications agencies, with requirement and complete all or part behaviours DECONSTRUCT
offices in EMEA, US and across of the programme: Measurement review: Measure the
Asia. Headquartered in New DESIGN AND DEVELOP success of all activities, work with you
York, the company supports a DEFINE Content creation: Development of to analyse the results and develop
broad range of clients across four Brief and objectives : Ruder Finn’s materials, written content, creative, key learnings to take forward and
strategic pillars that reflect its senior team uses your brief as a apps, websites, 3D build and help define the next campaign.
15. All figures, unless otherwise stated, are from YouGov Plc. Total sample size was 2148 adults of whom 1204
have access to a smartphone/ tablet. Fieldwork was undertaken between 26th -29th June 2012. The survey
was carried out online. The figures have been weighted and are representative of all GB adults (aged 18+).
16. For more information on Ruder Finn
Healthcare Technology please contact:
healthcaretechUK@ruderfinn.co.uk
Tel: +44 (0) 20 7438 3050
Ruder Finn
1 Bedford Street
London
WC2E 9HG
www.ruderfinn.co.uk
