40% of mHealth apps have less than 5,000 downloads
The IMS Institute for Healthcare has published a report, Patient Adoption of mHealth, which compares mHealth apps with a published snapshot of the mHealth market two years ago. The mHealth apps may have evolved over the past two years, however their popularity hasn't changed, with 36 apps accounting for almost half of all downloads. Although apps are becoming more sophisticated and have the potential to deepen the level of interaction with consumers, 40% of them have less than 5,000 downloads. 

Two years after the IMS Institute for Healthcare Informatics published a snapshot of the mHealth market, the ratio of useful apps to worthless ones is as large as it was before, if not larger. That’s just one of the takeaways for readers of IMS Institute’s mHealth app report, Patient Adoption of mHealth.

Just 36 apps account for nearly half of all downloads and 40 percent of apps have fewer than 5,000 downloads. But it also showed that apps have gotten increasingly sophisticated and can deepen the level of interaction with users.

Of the 165,000 apps from the iOS and Android app stores that claim a connection with healthcare, IMS Institute focused on the ones with more than 1,000 user ratings — 67, 424 and found only only 26,864 consumer oriented health apps were applicable. Non English apps and apps not available to the general public were kicked to the curb.

Illustrating the progress made in digital health, the report noted that 10 percent of apps can connect to a device or sensor. The majority are fitness apps. MapMyFitness developed a way to unpack data from fitness trackers and UnderArmour acquired the company in 2013. But what’s happening with disease management apps that can connect with blood pressure and blood glucose monitors show is more impressive. The best ones are using their connectivity to give users a better understanding of their health in connection with their exercise diet and mood and visualize that data so that it is easy to see the impact of when they successfully manage their health and what they can do to improve it.

When doctors recommend or prescribe apps, they tend to get used more than those that are not, according to the report. That’s especially true of fitness apps (30 percent) and diet apps (30 percent), apparently. But those observations are based on the use of its app script platform, not a survey.

The report makes note of some of the well-known barriers to increased adoption of apps by health systems such as lack of reimbursement by insurers, lack of HIPAA compliance, relatively little clinical validation, and inability to connect to electronic health records. Its scope is limited because it is only interested in apps from the app stores. It would be helpful to at least quantify how many digital health companies are working directly with hospitals to provide apps to manage chronic conditions such as diabetes management and congestive heart failure. If they did, I suspect that the breakdown of the apps that are prescribed would look quite different.

One of my biggest frustrations with the IMS Institute report is that when it comes to highlighting the most downloaded apps, it shies away from detailing criteria that makes one app better than another. That’s the sort of information that could shift the needle on app development.

Although it usefully highlights the push to do more in the way of clinical validation for mobile health apps, 135 apps were involved in clinical trials in 2013 compared with 300 in the most recent report. But it declines to specify which trials used apps for drug development and which ones simply focused on the effectiveness and reliability of these apps.

It’s striking that the most productive developments to advance and connect apps have come from companies setting up the infrastructure to cultivate an app ecosystem. That way, users can de-silo data from these apps and aggregate it in a way that lets them view their data in context.

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