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mHealth Still Missing the Comfort Zone for Chronic Care Patients

Studies indicate people with chronic conditions want to use mHealth devices at home for care management, but the devices and apps they're trying are too complex or confusing.

Source: ThinkStock

By Eric Wicklund

- More and more people with chronic conditions want access to mHealth devices at home to help them with care coordination. And they’re not happy with what’s available.

A report from digital health analyst Parks Associates indicates 27 percent of those surveyed with a chronic condition want a mobile health device that tracks their condition – yet significant numbers also report that the devices they now have are too complicated to use or don’t work properly.

"Nearly one-half of type I diabetics and one-third of type II diabetics are interested in health monitoring devices such as glucometers, but a steep learning curve and difficult or counterintuitive directions could inhibit their usage of these devices and also prevent them from buying other connected health devices," Harry Wang, the group’s senior director of research, said in a press release accompanying the report. "Device and application manufacturers would benefit from improving the ease-of-use of these devices." 

The study points to a continuation of missed opportunities in mHealth for both patients and their caregivers.

Earlier this year in advance of the Health Information and Management Systems Society (HIMSS) conference, West unveiled a study that indicated 91 percent of people with a chronic condition want help with care management and 88 percent said it would make a difference in their state of health. But that survey also found that only 30 percent were using an mHealth device – and only 5 percent of physicians were using mHealth to keep tabs on their patients at home.

READ MORE: How to Design and Develop a Mobile Health Application

“What the survey findings … show is that much more needs to be done to help patients manage chronic conditions so that unnecessary hospitalizations can be prevented,” said Chuck Hayes, vice president of product management for TeleVox Solutions at West. “In fact, there are opportunities for providers to do more to engage patients in their daily lives and at home, and there is evidence to support that those efforts would lead to better patient health outcomes.”

The West survey indicates providers would do well to take a closer look at RPM platforms, including automated surveys. Almost 60 percent of the patient surveyed said they’re not confident in managing their condition, with one in five saying their doing a poor job. In fact, one in five surveyed said they need 24-hour-a-day support to manage their chronic condition.

“A lot of patients simply do not have a good grasp on health metrics – meaning they either don’t know what their current health metrics are, or they do not know what they should be,” the survey noted. “Plus, even when patients do know their numbers, it is not guaranteed that they understand what those numbers mean. To make sense of health metrics and chronic disease management, patients need support from their healthcare providers.”

Part of the problem can be traced back to mHealth developers who push products to the market that aren’t fully thought out or fail to take patient engagement seriously.

In April, a study of mHealth apps for cancer patients by the Cancer Prevention Institute of California and Stanford University found that few “implemented empowerment elements, underwent rigorous design approaches or included assessment of use in the cancer survivor population.”

READ MORE: What Features are Needed to Make an mHealth App Effective?

“There is tremendous potential for mobile health apps to improve long-term health outcomes among cancer survivors, but the field of mobile health research is in its infancy,” said Lorene Nelson, an associate professor of health research and policy at the Stanford University School of Medicine

And in July, a study conducted by the University of California at San Francisco found that some of the most popular mHealth apps on the market aren’t all that easy to use.

“I consider myself a pretty tech-savvy guy,” said Gato Gourley, the study’s project coordinator. “But I had trouble using several of these apps as well – they just weren’t very intuitive.”

“We have such a great opportunity now for patients to use mobile technology to interact with their medical providers and to become more involved in their own care – which we know results in improved health outcomes,” added Urmimala Sarkar, MD, a UCSF associate professor of medicine who coordinated the research with Gourley. “Nowhere is this more important than for vulnerable populations who often suffer disproportionately from a multitude of chronic, serious conditions. If we can give them the tools to manage their health between medical visits, the benefits could be tremendous.”

In the Parks Associates study, 40 percent of people with diabetes who have a glucometer that works with a smartphone app reported having problems using the device, while 20 percent of those using a connected pillbox reported difficulties.

READ MORE: KLAS Report Finds Hospitals Still Aren’t Embracing mHealth Apps

Brad Russell, a senior analyst at Parks Associates, expects interest in mobile health and connected devices to rise as more people look to address care coordination at home.

"The U.S. spends almost $90 billion each year on home health, but home health spending accounts for only 3 percent of total healthcare spending," he said in a press release. "All signs point to increased spending in this category as care delivery continues to shift from high-cost institutional care to low-cost home care." 

But if that market is to thrive, patients and providers have to find mHealth products that they can use.

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