BIGGEST Threat To Telehealth Mobile Apps - Adherence

Guest post from PN Medical


Nina Bausek 


In contrast to patient questionnaires, in which physical activity seems to be overestimated, advances in smartphone sensors offer the opportunity to measure activity directly by always-on, low power motion chips. MyHeartCounts is an app-based cardiovascular health studyadministered entirely via smartphone, incorporating direct sensor-based measurements of physical activity and fitness, as well as questionnaire assessment of sleep, lifestyle factors, risk perception, and overall well-being. Almost 50,000 people participated, with a median age of 36 and a majority (82%) of male participants. 82% of the participants uploaded data. 42% completed 4 of the 7 motion days, and only 9% completed all 7 days. 82% filled out some portion of the questionnaire, and 10% completed the 6-minute walk test. 2.7% completed all fields needed to compute heart age and a 10-year risk score. Individuals’ perception of their activity and risk bore little relation to sensor-estimated activity or calculated cardiovascular risk.

An overview study on the use of smartphones for health research showed that for the first five ResearchKit apps that launched, including MyHeart Counts, the percentage of daily users quickly dropped to 25% or below within the first three months.

App adherence therefore poses the biggest challenge to app-based telehealth and addressing this challenge must be a priority for any app developer. Here are a few general and healthcare-specific strategies that can help patient engagement in mobile telehealth apps:

  1. Incremental Progress Updates - Offering insight into progress only after a certain rate of completion, versus continuous, provides a simple way to encourage a patient to reach a target or goal. 
  2. Family/Friends Participation - Involving the patient's friends and family in the application experience as a members of the care team can help provide the patient with additional support and encouragement.  
  3. Alerts - Notification to the patients when they are meeting or failing to meet their targets. 
  4. Gamification - Pitting patients against other patients (friends or anonymized participants) to compete in attainment of goals is an established way of keeping app users engaged.
  5. Rewards -  Often combined with gamification, providing voucher, coupons, and other incentivies after completion can help drive adherence. Partnering with retail businesses adds another benefit to the app developer in the form of other monetization strategies. 
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