Mobile health is taking off but what’s still in its way?

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First, the good news: a growing class of mobile health apps are helping people do everything from lose weight to manage diabetes to chat and talk with doctors in real time. Investment in the sector is expected to increase by 25 percent for the next five years and, according to Chilmark Research, it could exceed $1.1 billion by 2017.

But healthcare innovation experts say the vast majority of mobile apps fail to engage consumers and the category as a whole has yet to win over doctors.

“Most of these apps are actually awful. There may be 12,000 apps out there but they’re not 12,000 good apps,” Chris Wasden, Global Healthcare Innovation Leader for PwC, said at the MedCity Converge health tech conference Tuesday. “They’re mostly bad apps that people rarely use.”

According to the Pew Internet & American Life Center, only ten percent of adult cell phone users in the U.S. have downloaded a health app, with some never using it or only using it once.

Wasden said effective apps reflect six principles – interoperability, integration (with doctors’ workflows and patients’ lives), intelligence, outcomes, socialization and engagement – but very few actually do that.

Aside from the issues with the apps themselves, he said recent research conducted by PwC found that even though patients are eager to adopt mobile health, doctors and the larger system surrounding them are reluctant to change things up.

“Consumers are demanding it,” he said. “Doctors see mobile healthcare being much more transformative and disruptive to their practice. This transformation and disruption is so painful that they’re very resistant to doing those changes.”

Interestingly, while some say it comes down to money, Wasden said it’s not just about paying doctors to accept the new technology because research shows that insurance companies are more willing to pay for mobile healthcare services than doctors are willing to provide them.

When asked, he added, physicians say their biggest concerns are the lack of training around mobile health, liability concerns and discomfort related to the new data it generates and its disruption to their workflow.

Brad Weinberg, MD, co-founder of NY-based health tech accelerator Blueprint Health, said another challenge founders of health apps (and other health tech products) face is a cultural mismatch between the traditional values of the medical community and accepted tenets of launching a startup.

“One of the biggest hurdles … is the balance between needing documented proven outcomes – which have their role and their place in the development of a company’s product – and just getting the initial validation that you’ve gotten something that people want and is really solving a key pain point,” he said.

Another challenge for mobile health, which was only briefly noted in the panels I listened to but cited as an issue by other health tech innovators I spoke to later, is the looming concern that FDA regulation will stifle innovation and investment. In July of last year, the agency issued its first draft guidance on the regulation of mobile health apps and only reviews a very small percentage of the total released to market. (When an app is used to diagnose patients or replace the role of a physician, it gets an FDA review.) But as the potential for more advanced functionality increases, the regulatory impact is likely to become a bigger concern.

Even now, Wasden said, the threat of FDA intervention incentivizes entrepreneurs to create apps that aren’t as useful as they could be. Even though consumers indicate that they want “intelligent” apps that can not just aggregate user data but also generate recommendations and insights, app developers deliberately avoid the opportunity.

“It’s a real weakness of most apps,” he said. “They’re so afraid of the FDA that they create themselves as dumb apps on purpose, so they can avoid an FDA review. “

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