Engaging Patients: Is an app all that it's cracked up to be?

The number of Americans who now own smartphones continues to increase, with lower-income individuals and those older than 50 years of age representing a large increase in ownership over the past year.1 With this rapid ascension of smartphone use, the number of apps to manage their healthcare is also increasing; as a whole sector of mobile healthcare (mHealth) has risen. Furthermore, a recent survey by Accenture revealed that the use of mobile health apps and devices has more than doubled in the last couple of years.2 The market is now inundated with apps created by healthcare payers, practices, providers, and other healthcare delivery stakeholders that claim their app will successfully engage patients in their care. All while reducing costs and improving overall outcomes.

Wow, this sounds great. But, with all this hope and hype around mHealth apps, there have been some concerns about the value of the products and the ability to actually engage patients. The Commonwealth Fund recently conducted a study that reviewed more than 1,000 mHealth apps for various medical and surgical conditions.3 Of all the apps reviewed, they deemed less than half to be “potentially useful” to patients, when measuring safety, quality, and engagement.



So, why are mHealth apps not being widely adopted or successful in engaging patients? Here are some reasons to consider.


  1. Log-in and Updates. Apps often require initial username and password creation and repeated log-in attempts. With so many password-protected elements that flood a patient’s life, it may be difficult to remember which passwords are being used for specific mHealth apps. Additionally, mHealth apps often require updates that provide new relevant information and features. These may be hidden from patients that do not regularly update their phone applications.

  2. Excessive Data Entry. Many mHealth apps require extensive data entry, asking users to input multiple pages of data points. Studies have shown, that on average, patients only complete half of the data entry prompts without expert assistance. Many patients have also reported unclear explanations of what data the app required.4

  3. Design and Usability Interface Mismatch. In medicine, treatments are successful if they are tailored to the patient so they understand the associated benefits and risks. Many apps have been shown to fall short in this area as they aim to target different audiences by offering varied functionalities. However, app quality and safety do not often align with functionality. Systematic review of mHealth apps have found a large percentage of them sacrificed quality or safety in the pursuit of added functionality.3


As clinicians consider implementing mobile apps into their clinical practice, they must be aware of these inherent shortcomings. Developers of patient engagement platforms should focus on patient and provider usability first, and then consider what data is required from the patient to ensure a successful clinical outcome.

1Pew Research Center. http://www.pewresearch.org/fact-tank/2017/01/12/evolution-of-technology/

2Accenture 2016 Consumer Survey on Patient Engagement.

3The Commonwealth Fund. http://www.commonwealthfund.org/publications/issue-briefs/2016/feb/evaluating-mobile-health-apps

4Georgsson, Mattias, and Nancy Staggers. "Quantifying usability: an evaluation of a diabetes mHealth system on effectiveness, efficiency, and satisfaction metrics with associated user characteristics." Journal of the American Medical Informatics Association 23.1 (2015): 5-11.


Kevin Campbell