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The Value of Patient-Facing Apps in Engagement
February 29, 2016
Jennifer Shine Dyer, MD, MPH & Lygeia Ricciardi, EdM
Conflict of Interest
Jennifer Shine Dyer, MD, MPH
Salary: up to $25,000/year for academic contracted research
Receipt of Intellectual Property Rights/Patent Holder: EndoGoal App
Consulting Fees (e.g., advisory boards): $100/hour
Fees for Non-CME Services Received Directly from a Commercial Interest or
their Agents (e.g., speakers’ bureau): in past, none currently
Contracted Research: Stanford University
Ownership Interest (stocks, stock options or other ownership interest excluding
diversified mutual funds): none
Other: own COPEDS pediatric endocrine private practice
Conflict of Interest
Lygeia Ricciardi, EdM
Salary: Clear Voice Consulting, LLC
Royalty: NA
Receipt of Intellectual Property Rights/Patent Holder: NA
Consulting Fees (e.g., advisory boards): Clients include Altarum Institute, Amida
Technology Solutions, Gerson Lehrman Group, HIMSS New Jersey Chapter,
Humetrix, Millbank Memorial Fund, PriceWaterhouse Coopers, Yodlee
Fees for Non-CME Services Received Directly from a Commercial Interest or
their Agents (e.g., speakers’ bureau): NA
Contracted Research: NA
Ownership Interest (stocks, stock options or other ownership interest excluding
diversified mutual funds): Amida Technology Solutions
Agenda Digital Health from a 30K Foot Perspective • The digital health landscape • Snapshot: mHealth app use today In-Depth Perspective on Diabetes Apps • Apps currently available (diabetes-specific) • Dyer diabetes app development story and lessons
Strategies for Boosting App Success • Engage providers • Use gamification • Test for evidence • Focus on the patient’s needs
Questions/Discussion
@Lygeia
@EndoGoddess
Learning Objectives
1. Explain the rapidly changing landscape of digital health
tools, where apps fit within that context, and how the app
market overall is developing
2. Discuss app design successes and pitfalls, and analyze the
feasibility and challenges of developing one’s own apps
3. Describe how to design and incorporation of health apps
into your life and /or practice
@Lygeia
@EndoGoddess
The Digital Health Landscape
80% of Consumers Use One or More Forms of Digital Health
Source: RockHealth 2015
@Lygeia
@EndoGoddess
Search Rates by Category
Source: RockHealth 2015
@Lygeia
@EndoGoddess
40% Overall Act on Info They Find
Source: RockHealth 2015
@Lygeia
@EndoGoddess
How People Track Health Factors
Source: RockHealth 2015
@Lygeia
@EndoGoddess
Areas of Anticipated Growth
Source: RockHealth 2015
@Lygeia
@EndoGoddess
Snapshot: mHealth App Use Today
> 165K Consumer mHealth Apps on iOS & Android Combined
Data: IMS Institute for Healthcare Informatics, 2015
Image: Freecodesource.com
@Lygeia
@EndoGoddess
Growth in # of iOS mHealth Apps
Source: IMS 2015
@Lygeia
@EndoGoddess
mHealth Apps by Category
Source: IMS 2015
@Lygeia
@EndoGoddess
What mHealth Apps Do
Source: IMS 2015
@Lygeia
@EndoGoddess
Capability of mHealth Apps to Connect to Social Networks
Source: IMS 2015
@Lygeia
@EndoGoddess
10% of Apps Have Capacity to Link to a Sensor or Device
Source: IMS, 2015
@Lygeia
@EndoGoddess
Location of Wearable App Use
Source: IMS 2015
@Lygeia
@EndoGoddess
Consumer Cost for mHealth Apps
Source: IMS 2015
@Lygeia
@EndoGoddess
In-Depth Perspective on Diabetes Apps & Development
What Apps Do Patients Want?
• 42%: An app to see their test results.
• 33%: Remote monitoring devices.
• 30%: Access to patient health records via mobile device.
• 13%: Didn’t think apps would help improve care
Source: Ruder Finn mHealth Report
@Lygeia
@EndoGoddess
http://www.himss.org/ValueSuite
@Lygeia
@EndoGoddess
http://www.himss.org/ValueSuite
Patient Reasons For Not Using Apps:
• 27%: Didn’t have a need to.
• 26% Preferred in-person communication with doctor.
• 11%: Privacy concerns.
• 9%: Didn’t find them useful.
• 7%: didn’t know they were available.
Source: Ruder Finn mHealth Report
@Lygeia
@EndoGoddess
5 Pitfalls In Designing A Medical App
http://davidleescher.com/2013/01/31/five-pitfalls-of-designing-a-medical-app/
• The motivation for the app development is misguided
• Lack of clinician involvement
• Poor attention to usability
• Not knowing the healthcare landscape
• Not building to regulatory specifications
@Lygeia
@EndoGoddess
@Lygeia
@EndoGoddess
Hypothesis:
Personalized interactive engagement
via weekly texting
between teen and his/her physician:
Improve meal bolus mindfulness
Reduce hgba1c % within 3 months
@Lygeia
@EndoGoddess
@Lygeia
@EndoGoddess
Bolus Adherence Decreased Over Time
• Needed more reminders
• Needed motivation
• Needed more support
@Lygeia
@EndoGoddess
@Lygeia
@EndoGoddess
This is Paige.
Paige has insulin-dependent diabetes.
…and loves her smart phone.
A SMS texting pilot study that Paige was
a part of helped her to remember to
check her blood sugars and to take her
insulin.
However, texting stopped helping Paige after
3 months…
First, Paige
downloads EndoGoal
on her smartphone…
To activate the rewards, Paige sends email link to her friends and family!
Friends and family make $ donations.
Paige redeems points once a week!
@Lygeia
@EndoGoddess
Strategies for Boosting App Success
1. Engage Providers
@Lygeia
@EndoGoddess
Apps Prescribed by Providers
Source: IMS 2015
@Lygeia
@EndoGoddess
Top Apps Average Fill & Sustain Rate
Source: IMS 2015
@Lygeia
@EndoGoddess
2. Use Gamification
@Lygeia
@EndoGoddess
The integration of the mechanics that make games fun and
absorbing into non-game platforms and experiences in
order to improve engagement and participation
LEVEL 1:What is gamification?
Source: Findlay & Alberts, 2011
“Badgification” or “Pointsification”
LEVEL 2: What it’s not
“Badgification” or “Pointsification”
LEVEL 2: What it’s not
Jesse Schell,
Researcher & CEO of Schell Games
If your idea is to create a bribery system to get [users] to
try something, it can backfire. When the bribes go away,
people are less inclined naturally to do the thing you
want, even if it's fun.
Rewards for effort
Source: Findlay & Alberts, 2011
LEVEL 3: Hacking the brain
Rewards for effort
Other people (social)
Rapid, frequent feedback
Overlapping goals
Experience systems
Source: Findlay & Alberts, 2011
A lot of overlap in the way that these
‘mechanics’ tap into our brain’s reward centers
3. Test for Evidence
@Lygeia
@EndoGoddess
http://www.himss.org/ValueSuite
http://www.himss.org/ValueSuite
@Lygeia
@EndoGoddess
mHealth Evidence for Select Therapies/Populations
Source: IMS 2015
@Lygeia
@EndoGoddess
4. Focus on the Patient’s Needs
@Lygeia
@EndoGoddess
Patient Reasons For Not Using Apps
• 27%: Didn’t have a need (or want) to.
• 26% Preferred in-person communication with doctor.
• 11%: Privacy concerns.
• 9%: Didn’t find them useful.
• 7%: didn’t know they were available.
Source: Ruder Finn mHealth Report
@Lygeia
@EndoGoddess
5 Pitfalls In Designing A Medical App
http://davidleescher.com/2013/01/31/five-pitfalls-of-designing-a-medical-app/
• The motivation for the app development is misguided
• Lack of clinician involvement
• Poor attention to usability
• Not knowing the healthcare landscape
• Not building to regulatory specifications
@Lygeia
@EndoGoddess
Questions?
• Email: drjenshinedyer@gmail.com
• Medical private practice website:
www.copeds.com
• Twitter: @EndoGoddess
• LinkedIn: Jennifer Shine Dyer, MD,
MPH
• Email: Lygeia@clear-voice.com
• Website: www.lygeia.com
• Twitter: @Lygeia
• LinkedIn:
https://www.linkedin.com/in/lygeiaricci
ardi
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