the future of mobile healthcare

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The Future of Mobile Healthcare November 2012

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I suspect the news my smartphone will soon turn into my doctor is exaggerated. While a consultation with my phone will always be easier to arrange than an appointment with my GP, I know for a fact that even the techiest among us still want to see a living, breathing, qualified person when they’re under the weather. I say this with confidence as this is one of the key findings from the first ever mHealth report by Ruder Finn. The report, based on a survey of more than 1,000 smartphone and tablet users, shows that while there’s an appetite for healthcare applications, and consumers generally love a good app, developers of health applications have not convinced the public of this kind of app’s value to them. The survey’s results show that apps for social media, games and news are the most popular with users of smartphones and tablets; healthy living apps languish in last place in terms of popularity. The survey, conducted on our behalf by pollster YouGov, reveals some interesting links between type of device and the likelihood of the user to use health & lifestyle apps. The research suggests apps that help take away some of the pain associated with healthcare – booking appointments and getting hold of test results for example – are more popular than those to actually manage health. Our results suggested a great deal of caution around apps to help patients manage long term health conditions – significantly even among those suffering from chronic disease/ health problems. These findings may come as a disappointment to the World Health Organization, which along with The International Telecommunication Union (ITU), is launching an mHealth initiative to help combat noncommunicable diseases, based on the fact that mHealth is cost effective, scalable and sustainable. In our survey, there is a difference between the generations and the impact that might have on app usage. While 75% of respondents between 25-34 owned a smartphone fewer than 30% in the 55+ category did. Although everyone accesses healthcare it’s usually the oldest among us who use it most. It will be interesting to see how usage patterns change as the gamers and Tweeters of today get older. This presentation also contains slides from Prof. Christopher James Professor of Healthcare Technology (University of Warwick) and  Director, Institute of Digital Healthcare; Dr Tom Barber Associate Professor and Honorary Consultant Endocrinologist,  University of Warwick and UHCW NHS Trust and Owen Booth Head of Content, Diabetes UK. The event can be seen at the hashtag #rfmhealth too.

TRANSCRIPT

Page 1: The Future of Mobile Healthcare

The Future of Mobile Healthcare

November 2012

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©Ruder Finn 2012

The mHealth panel

Prof. Christopher James Professor of Healthcare Technology (University of Warwick) and Director, Institute of Digital Healthcare

Dr Tom BarberAssociate Professor and Honorary Consultant Endocrinologist, University of Warwick and UHCW NHS Trust

Owen BoothHead of Content, Diabetes UK

Jon HoeksmaEditor, eHealth Insider

Emma SindenHead | Healthcare technology practice, Ruder Finn UK

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©Ruder Finn 2012

Ruder Finn 2012 mHealth Report

Summary of key findings

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©Ruder Finn 2012

Ruder Finn mHealth Report• The survey was conducted by

YouGov among its online panel of GB adults

• Total sample size was 2,148 adults of whom 1,204 had access to a smartphone/ tablet

• Fieldwork was undertaken between 26th -29th June 2012

• The survey was carried out online. The figures have been weighted and are representative of all GB

adults (aged 18+)

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©Ruder Finn 2012

What are people using?

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©Ruder Finn 2012

Current healthy living app use

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©Ruder Finn 2012

Reasons why respondents don’t currently use health apps

• I have no need to access health-related apps

• I prefer to talk to my doctor in person about any health-related questions

• I do not find health apps to be helpful

But 21% said they were very or fairly likely to use a service delivered via mobile technology, to better manage their health by the end of the year

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©Ruder Finn 2012

What did respondents want from mHealth?

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©Ruder Finn 2012

Top three apps

For me….• An app to book an

appointment with the GP• An app to view your

medical records• An app to check test

results

For my doctor…• Monitoring devices that can

alert carers, doctors and nurses to a health emergency

• An app to access test results

• Devices that enable doctors and nurses to record observations and share information while away from the surgery or hospital

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©Ruder Finn 2012

Introducing the panel…

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Institute of Digital Healthcare

Institute of Digital Healthcare

Christopher JamesChristopher JamesProfessor of Healthcare Technology & Director of IDHProfessor of Healthcare Technology & Director of IDH

the

the

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Emerging model of Emerging model of HealthcareHealthcareOld model of

care: Focus on acute

conditions, reactive management

Hospital centred, disjointed episodes

Doctor dependent Patient as passive

recipient; self care infrequent

Use of ICT rare

New model: Focus on long term

conditions, prevention & continuing care

Integrated with people’s lives in homes & communities

Team based, shared record

Patient as partner; self care encouraged & supported

Dependent on ICT & devices

the challenges we face

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The Institute of Digital The Institute of Digital HealthcareHealthcareA world-class £4M 5-year funded

partnership between the NHS, WMG, WMS and other relevant organisations

Aims: to improve people’s health and wellbeing through the use of innovative digital technologies and methodologies

We do this through high quality research, education and training capabilities

who are we?

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The Institute of Digital The Institute of Digital HealthcareHealthcarewhat do we do?

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Iterative Process

Intervention Framework

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Mobile Health Technology:A Clinician’s Perspective

Dr. Tom [email protected]

Associate Professor and Honorary Consultant EndocrinologistUniversity of Warwick and UHCW NHS Trust

The Future of Mobile HealthcareLondon, 27th November 2012

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Outline of presentation

• My background

• General remarks regarding clinical applicability of m-health

• The case for obesity

• The Human Metabolism Research Unit

• Concluding remarks

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My Background

Newcastle University 1995-1998 (MBBS)SpR Endo 2001-2004

EdinburghSHO General Medicine1999-2001 (MRCP)

Carlisle and MiddlesbroughJunior House Officer1998-1999

Cambridge University 1992-1995 (MA Hons)

Oxford University (OCDEM)2004-2007 DPhil2007-2010 SpR Endo and Locum Consultant

University of WarwickUHCW NHS Trust2010-presentAssociate Professor Honorary ConsultantEndocrinology, Obesity,Metabolism, Diabetes

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General remarks regarding clinical applicability of m-Health

• Broad applicability: administration (appointments), direct and continuous monitoring of health/disease parameters, ‘alarms/alerts’, interaction with health care professionals, reminders, disease prevention

• Confidentiality is key!

• Ubiquity of usage of mobile devices and apps

• Avoidance of acute admission in chronic disorders (eg. diabetes-related)

• Ease of use/application is essential

• Communication improved

• Remote clinics (eg. thyroid disorders; remote communities)

• Adjunctive rather than replacement

• Facilitate many aspects of traditional healthcare

• Paramedic application (communication with A&E)

• Financial implications for NHS are substantial

• Health of the nation

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The Case for ObesityThe global obesity epidemic: trends in children

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The Case for ObesityPortion sizes and activity

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Forest plot of the association between short duration of sleep (≤5 hrs) and obesity in studies carried out in adults

Adults who sleep less than 5 hours per night have a 60%

increase in the risk for obesity compared to adults who sleep

more

Adults who sleep less than 5 hours per night have a 60%

increase in the risk for obesity compared to adults who sleep

moreCappuccio et al. SLEEP 2008

The Case for ObesityThe Link Between Sleep Deprivation and Obesity

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The Case for ObesityThe effect of cold exposure on brown fat activationin an obese man

A sugar-cube volume of brown fat can burn off up to 4Kg white fat in a year if stimulated

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The Human Metabolism Research Unit

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Concluding remarks

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Developing the Diabetes UK Tracker AppOwen Booth| November 2012

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1. Let’s develop an app!

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“We need to do an app because…”

● Everyone’s doing them● Mobile is really important● Something something fundraising● Er…

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Let’s start again…

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How can we find out what our audience wants?

Diabetes UK Facebook page Snapshot: June 2012

● Page likes 39,388 ● Total reach 46,381 ● Number of times DUK posts shared 682 ● Number of comments on DUK posts 667 ● Number of likes on DUK posts 2,818

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What are they talking about?

Diabetes UK Facebook page comments

● 27% comments about Blood Glucose levels● 26% people seeking medical information● 18% concerned supporters● 10% external links● 8% complaints about diabetes● 6% general conversation● 5% people seeking nutritional advice

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Will they talk to us?

● We used Facebook, Twitter and forums to ask our (potential) users about how they manage their condition…

● … and to source 15 face-to-face interviewees● Then we fed the initial insights back to the community for

comments● … and got 200+ responses

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What we found out

Key insights about our audience

● They don’t tell the truth to their doctors● They think family and friends don't understand● They like to share information with their ‘inner circle’● They often keep notebooks to monitor their condition● …including their emotional state

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User goals

“I want…”

● Something that helps me self-manage, even on bad days● Something that’s easy to share with others● To be able to communicate about the daily impact of my

condition● To participate in the development of my own healthcare

plan● A better relationship with my health care professional

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Using the Diabetes UK Tracker app

● Log and track blood glucose, insulin, carbohydrates, calories, weight and ketones

● View data in day and week graphs to spot trends● Track feelings - and see whether this affects levels● Share entries with friends or healthcare professionals● Save specific records as 'talking points‘

Recognise patterns and use them as reminders in healthcare appointments.

Get the most out of appointments by setting an agenda of concerns.

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Results

● 25,000 downloads in first year● 22,000 updates downloaded – suggests ongoing use● Extensive user feedback guiding continuing development● Third Sector Excellence Awards 2012: Use of Digital

Media – Winner

● Unintended consequence: strong response from younger audience, who are often unengaged with their condition

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Next steps

● Other operating systems● Desktop version● Interest from other charities● Ability to take BG measurements straight from meter?● HCP involvement…???

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©Ruder Finn 2012

Thank you

For further information about digital health contact Emma SindenHead| Healthcare Technology PracticeRuder Finn UK+44 (0) 7734 905583 [email protected]