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Study: Impact of digital health grows, mobile health apps accelerate

Wednesday, November 8, 2017

The impact of Digital Health on patient care is accelerating with the increasing adoption of mobile health apps and wearable sensors. Health-related mobile applications available to consumers now surpass 318,500—nearly double the number available just two years ago—with approximately 200 new apps added to the market each day. This rapid app expansion, coupled with more than 340 consumer wearable devices on the market worldwide, and 571 published efficacy studies, provide evidence of Digital Health’s accelerating innovation and generation of a subset of proven tools to impact human health, according to a new report released today by the IQVIA Institute for Human Data Science.

While general wellness apps still account for most mobile health apps available, the number of apps focused on health condition management—those often associated with patient care—are increasing at a faster rate, representing 40% of all health-related apps.

The report found the sheer volume of available apps presents an overwhelming amount of options for consumers, resulting in 85% of all health apps having fewer than 5,000 downloads. However, there are some clear category leaders within the space, where 41 apps have registered at least 10 million downloads, together representing nearly half of all app download activity. Separately, there is also now at least one high-quality app for each step of the patient journey—an encouraging finding for patient outcomes. Use of just five of these top health apps could save the U.S. healthcare system an estimated $7 billion per year.

The study, The Growing Value of Digital Health: Evidence and Impact on Human Health and the Healthcare System, is the most comprehensive of its kind conducted to date and extends the Institute’s landmark examination of consumer-focused mobile apps in the health system conducted in 2015. For the new report, researchers drew on IQVIA’s proprietary AppScript data and analytics platform, including the AppScript App Database, the AppScript Clinical Evidence Database, the AppScript Score app quality rating system, and the AppScript Essentials Value Model to provide the first exhaustive global assessment of overall app quality, clinical evidence, and implications for health outcomes and care costs. This includes an analysis of 22,357 unique healthcare apps available in the U.S. Apple iTunes and Android app stores—a representative sample of the most widely used Digital Health apps by consumers. As part of the study, the Institute also conducted additional primary research using the AppScript Device Database, ClinicalTrials.gov Database, as well as structured interviews with health- and technology-focused thought leaders and executives on the role of Digital Health in regards to patient care.

“The research suggests an inflection point is occurring within Digital Health trends regarding innovation, evidence and adoption,” said Murray Aitken, executive director of the IQVIA Institute for Human Data Science. “The convergence of those three digital drivers combined with other macro factors, aligns with the development of the newly defined, and emerging discipline of human data science that combines advances in information, transformative technology and analytics with human data beyond the patient journey to measure and improve health decisions and outcomes. Within that context, we believe the growing innovation, evidence and adoption of Digital Health tools can have an increasingly positive impact on human health outcomes overall.”

The report’s key findings include the following:

  • Potential healthcare savings could be significant in the future.The use of Digital Health apps and wearables across five patient populations where they have proven reductions in acute care utilization (diabetes prevention, diabetes care, asthma, cardiac rehabilitation and pulmonary rehabilitation) could save the U.S. healthcare system an estimated $7 billion per year. This represents about 1.4 percent of total costs in these patient populations. If this level of savings could be achieved across all disease areas, annual cost savings of $46 billion could be achieved. These estimates extrapolate just from existing evidence, but continued investment in evidence generation continues across stakeholders.
  • Clinical evidence regarding Digital Health efficacy has grown substantially.This growing body of work includes 571 published studies, including randomized controlled trials (RCTs) and meta-analysis studies, enabling the identification of a list of apps with increasingly robust clinical evidence. Particularly compelling findings now exist for use in diabetes, depression and anxiety, making these categories strong candidates for inclusion in standard of care recommendations by clinical guideline writers. An additional 24 categories have one or more RCTs with positive results making associated apps strong candidates for adoption across provider organizations and payer networks. Additional evidence-building efforts continue with 860 clinical trials worldwide now incorporating Digital Health tools, including 540 in the U.S., with two thirds of these focused on apps and text message interventions to smartphones. Eighty-two percent of these trials are sponsored by universities, hospitals, health systems and other patient care institutions, demonstrating the increased efforts to fit Digital Health into clinical practice. Digital tools for remote patient monitoring of chronic health conditions are a key focus.
  • Apps appear to be improving based on user experience.Fifty-five percent of apps in the AppScript App Database that launched within the past two years have ratings higher than four stars, compared to 31% of those launched before 2015. With clear market-leading apps in many health categories, developers getting low star ratings may either remove apps more rapidly from the store or invest more continuously in updates based on user feedback—increasing the value of available apps to the consumer. App stores have also begun removing low quality apps, including those that are outdated, abandoned, no longer meet current guidelines or don’t function as intended. Additionally, while 73% of apps are available in English, mobile health apps are increasingly supporting a global audience.
  • Digital sensors linked to apps are bringing innovation and adding value in three key areas: the creation of smart devices, digital diagnostics and new human-centered clinical trial designs.Many of the most popular apps also connect to sensors that detect patient vital signs and activity, no longer relying purely on manual patient inputs. New value will be brought to healthcare by algorithms built on top of such wearable activity monitors to create “digital biomarkers” of health. By tracking parameters beyond sleep and steps that correlate to disease severity, these digital tools will contribute to precision medicine, enabling stratification of patients by symptoms identified by sensors as well as traditional biomarkers. Digital-enabled ‘smart’ devices such as asthma smart inhalers, connected pens for diabetes and smart blister packs are also being developed to track medicine usage remotely and encourage patient adherence. These have shown improved therapeutic outcomes and broad investment in smart inhalers indicates these may become the new standard of care in asthma. Additionally, smart sensors can improve clinical trial designs by enabling the collection of patient experience data in the “real world,” even within the bounds of clinical trials.
  • Barriers still exist to widespread adoption of Digital Health, but initiatives have emerged to accelerate the ongoing adoption of Digital Health tools by care provider organizations.Notably, curation platforms are facilitating the creation of Digital Therapeutics Formularies; privacy and security guidelines are being published; providers are now incentivized to use Digital Health through value-based payments; and data integration vendors are facilitating more integrated use of Digital Health data with existing electronic medical record systems. Additionally, investments by healthcare and provider organizations in Digital Health continue to grow, with an estimated 20% of large health networks shifting from pilot programs to more full-scale rollouts. Within the next five years, this progression is likely to be true for most healthcare companies and, within 10 years, the use of Digital Health is likely to be mainstream for most organizations delivering human health.

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