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KLAS Report Finds Hospitals Still Aren’t Embracing mHealth Apps

While doctors are using digital health apps on their own, many health system executives are still taking a cautious approach to mHealth, They're often worried about privacy and security with third-party apps.

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- Most doctors are using an mHealth app these days – but that doesn’t mean their bosses are jumping on the digital health bandwagon just as quickly.

A KLAS report finds that only half of healthcare organizations surveyed formally use apps at the point of care, though individual clinicians likely are using digital health tools. And of those organizations with an mHealth platform in place, most are using only basic apps to view data in the electronic health record.

The survey, done late last year in conjunction with the Substitutable Medical Applications, Reusable Technology (SMART) Health IT Project out of Boston Children’s Hospital, involved executives at 47 health systems around the country. It points to an industry-wide reluctance to embrace mHealth apps at the enterprise level, even as app use is high among individuals.

“The app market is still immature,” the report concludes, “but providers are looking forward to adopting solutions that will positively impact clinical outcomes.”

According to KLAS, aside from EHR data viewing, enterprise apps are most often used as diagnostic tools or reference tools or for patient engagement. Farther down on the list are clinical decision support tools, documentation tools and secure messaging apps.

Only a few organizations are inputting clinical data, KLASA says, but those who are taking that step are finding that it “streamlines their ability to initially assess a patient.”

“Other providers are hoping to input clinical data into currently available apps in the future as their healthcare app strategy evolves and becomes more formalized,” the report states.

Looking ahead, the KLAS survey found that health system executives are most interested in apps that promote patient engagement, including apps that allow patients and their providers to monitor their health and apps that improve access to a patient-facing portal.

“Monitoring apps particularly stand out as an area in which providers would like to see development,” the report states. “This type of app has the potential to improve management of chronic diseases, such as diabetes and heart disease, and some organizations are already leveraging these types of apps to ensure patients and families are properly managing care.”

Farther down on the list are clinical decision support and documentation apps, followed by reference tools and dictation apps. Few respondents showed an interest in secure messaging apps, while roughly one-fifth of those surveyed said they weren’t interested in any apps.

When asked what criteria they use to evaluate an app, health system executives ranked usability at the top, followed by cost, clinical impact, integration, functionality and credibility.

“The product has to be usable, as this will impact the product's utility in clinical care,” one health system CMO told KLAS. “Ease of use will also greatly outweigh any upfront or maintenance costs. If I end up wasting 30 minutes per patient using an unfriendly interface, then I don't care how much money I am saving; I am going to lose it in the end.”

One factor that should move up the list is integration. “t will likely become even more important as providers move beyond the initial adoption,” KLAS noted. “Because one of the goals of using healthcare apps is to streamline care and reduce clinician documentation time, the ability to integrate is critical to long-term app satisfaction.”

Perhaps more ominously, KLAS noted that health system executives are all over the map in shopping for apps. “The process of procuring an app for an organization is somewhat ambiguous and few healthcare providers have a formal department and procedure for deciding what apps to purchase,” researchers found.

When asked how they would like to find out about new apps on the market, health system executives focused on pilots and trials, vendor demonstrations and peer recommendations.

“Unlike some healthcare IT segments that have a limited number of reputable players, the number of companies who can develop and market a healthcare app is unlimited and knowing how these apps will perform can be next to impossible.,” KLAS pointed out. “Fortunately for providers, an app deployment is often simple compared to a standard HIT implementation, allowing product pilots to become the preferred method for app discovery. For many, a pilot helps mitigate the risk of purchasing an app.”

Some respondents said they look for healthcare organizations or associations to create their own app vetting protocols, much like the Xcertia partnership launched last December by HIMSS and the American Medical Association, among others.

“There are thousands of apps out there and I am sure that the people who built them all meant well,” a CMIO told KLAS. “But it seems that a lot of apps die out about six months after their release dates when the apps don't do well. It would be nice to have a professional organization vet them out. I would be pretty excited to tell patients about apps created by professional organizations, available at no cost or a reasonable cost and vetted by professional resources in the recent past.”

Finally, when asked what concerns health system executives the most about adopting third party apps, the overwhelming answer was privacy and security. After that, the concerns focus on app credibility (including both the vendor’s sustainability and the quality of the app’s content), ongoing maintenance, integration/data aggregation and data ownership.

“For apps and other entrepreneurial efforts that involve someone accessing and working with our data or with our systems, we have a pretty rigorous screening process,” one health system CMIO told KLAS. “We have a security review, a privacy review, and a legal review, and we look for an internal champion who can look out for the effort and speak for it. We obviously have concerns about security and privacy around PHI. I don't know if there is anything novel about that, but we have a rigorous process that handles those things.”