Healthcare, Mobilized

The healthcare industry boasts some of the highest prices in the service sector. Technology, however, is an inexpensive method of cutting costs, and the healthcare marketplace has taken note. Today, the healthcare mobile apps market is a booming field populated by start-ups and late M.D.-to-entrepreneur converts, with more than 10,000 apps currently available through outlets such as Apple App Store and Google Play.
But will this momentum actually lead to a substantial improvement in the efficiency of healthcare delivery? Right now, it seems the answer is no. There are two factors preventing healthcare apps from reaching their full potential: first, the public is not yet comfortable with the fact that technology will make sharing patient data much easier for healthcare companies. Second, without major players bringing organization to the market, individual healthcare apps will not build up a pool of data large enough to make an impact on the market as a whole.
Big Potential… but for What?
The Affordable Care Act has provided the fuel for a switch between two models of healthcare: systems based on the volume of care provided, and systems based on the value of care provided (as assessed through individual treatment results). As payment systems based on effectiveness gain traction, the potential for technology to play a role in shaping the future of healthcare is dramatically increasing.
The drive to lower costs has also contributed to a movement towards preventative, as opposed to reactive, treatment. According to David Voran, a physician at Heartland Health and associate professor at the Truman Medical Center, this shift in thinking has accentuated the importance of healthcare tracking so that patients can avoid unnecessary hospital visits that drive up costs. In an interview with the HPR, he noted that “apps and mobile devices are playing an increasingly important role” in preventative care efforts.
Recent innovations in the app market deserve credit for standardizing physician-patient relationships. In an interview with the HPR, Iltifat Husain, editor of iMedicalApps.com, said that apps serve different purposes for physicians and patients, but can prove useful to both: “From the patient’s perspective, apps are great for helping to keep track of diet and their fitness schedules, and checking blood pressure and blood sugar levels. From a physician’s side, apps are great for looking up content to, for example, finding the right antibiotic for a patient.”
Meanwhile, usage is not a problem. According to a 2011 report by physician staffing firm Jackson & Coker, eight in 10 physicians now employ mobile apps through their phones or tablets during their customary practices. But if the aim of these mobile apps is to reduce overall healthcare costs and the number of ineffective treatments performed each year, the market has a long way to go. Currently, patient data collected by apps are not contributed to bigger data sets that might prove useful for future healthcare research or broader-scale cost planning.
At present, we are essentially still in a buffer period between the introduction of this new technology and public acceptance of its consequences. Even Husain, who runs a website dedicated to medical apps, has expressed reservation about the privacy-related aspects of healthcare apps. Voran is also concerned that the current, mainstream interpretation of the Health Insurance Portability and Accountability Act of 1996 “overly stresses privacy rather than portability, leading to discomfort with patient data being transmitted through consumer-type products.”
Although the Food and Drug Administration has been slow to catch up to rapid developments in this area, its progress should not be ignored. On September 25 of this year, the FDA released
a memo entitled, “Mobile Medical Applications: Guidance for Industry and Food and Drug Administration Staff,” which discussed how it was taking a “tailored, risk-based approach” to regulating the app market. However, while the FDA has made significant progress on this issue, it still treads stormy waters in the business of mobile health apps.
Infrastructural Problems
While app users are hesitant about the privacy implications of this new technology, a lack of infrastructure has also slowed the spread of medical app data. The app marketplace is currently dominated by start-ups, and an effort to standardize and organize apps to create change in the healthcare world has not yet emerged.
As it stands, groups that pay for care on others’ behalf, like insurance companies or the government, own the most comprehensive patient datasets. And according to Rob Cosinuke, the president of a physician-oriented medical app called Epocratesca, making a positive connection with a network of payers is crucial for developers. Apps in the market are beneficial for each patient’s tracking of his or her lifestyle and medical activity, but “they don’t really … [coordinate with] how healthcare is provided and being paid for today,” he said in an interview with the HPR.
While companies like Continua Health Alliance have notably been working on guidelines for the medical community to collect and share information from mobile apps, the government will ultimately need to play a significant role in regulating the industry. Bruce Darrow, the chief information officer of Mount Sinai Hospital, told the HPR that “regulation is below the radar because people don’t see computers or apps as medical devices [able to be regulated by the FDA].” He added that he believes that it will not be until there is some “mishap blamed on an app or a computer system” that the issue will “elevate the consciousness of this industry.”
But is this the only way that the mobile app industry will start organizing and standardizing? In an in environment in which, as Husain points out, “more than 200 million people will have instant access to an application once it is put on the market,” the consequences of such a mishap could be severe.
While the entrance of big players would introduce more structure and top-down influence to the market, that might not happen for a while. And although companies like Qualcomm have started getting involved, according to Brandon Workman,
a journalist for Business Insider Intelligence, “Bigger players will get involved mostly through acquisition.” Meanwhile, many such “big players,” like Google Health, who have already tried to enter the healthcare market have failed.
Right now, mobile apps and their data have been contributing to healthcare in a static sense: helping consumers keep track of their personal patient history. But if our aspirations truly lie in progressive healthcare—in a dynamic industry geared towards prevention and broad-based public health initiatives—mobile apps cannot be left out of the equation. Although there are 
many factors that are currently keeping these mobile apps from building up to anything truly “progressive,” we are getting there, slowly, in the buffer zone between introduction and integration.