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mHealth Myths part 1

OK I thought it was time to share some of my deeply-held beliefs about mHealth, based on the school of hard knocks experience I’ve had so far. I’m going to do a series of blogs on what I call ‘Myths and Realities of mHealth’ – and for the first part I’m taking on one of the biggest misconceptions in the world of mHealth – the myth that ‘mHealth is all about apps’. And by apps I mean those little self-contained pieces of code that you download from an app store like iTunes, Google Play or Windows store. 

I can already hear the howls of anguish from you and furious retorts – ‘how can you ignore the 97,000 health-related apps available on the app stores?’  Well let me explain why apps alone are not the answer:

  1. Most apps get downloaded then discarded
    mHealth appstore

    97,000 health apps and counting

  2. You can’t control the app environment easily, so you don’t know which version users are seeing
  3. It usually operates in isolation with a single user only
  4. You’re creating a dependency on a device type that limits access to your solution – and limiting yourself to the 20% of mobile users who have smartphones

 I would even suggest that most apps were created either as a hobby or by organisations (such as pharma companies or hospitals) looking to salve their conscience a little and showing their board they were doing something with mHealth. 

There is a view that apps are cheap to create and necessary in case of network unavailability. A single low-function app may be cheap in the first instance, but when you factor in the lifetime cost of maintenance, updates and doing that for multiple phone platforms, it isn’t cheap anymore.

And as for network availability, most apps are simply gateways to internet services anyway, and a better design approach would be to build a mobile internet service using something like HTML5 so you can still collect data if out of network coverage – I was involved in projects in remote parts of Africa using exactly this approach. 

So if apps are the myth what is the reality? I would say it is provision of services. What does that imply?

  1. Continuity and commitment to support the users over a long period – and if you are serious about mHealth then this is a basic requirement
  2. A proper design for data and process flows, so that the data goes somewhere and is used for real action – by HCPs, patients or carers
  3. Application logic delivered from a server – via mobile internet or SMS – so you know that users are working with the most up to date version

 There will always be instances where an offline app can do a job (a dosage calculator would be fine, as long as you work out how to make sure it gets updated), but it’s the service design that matters not simply launching another app into a very crowded sky. 

So enough provocation for one week – what do you think? Please feel free to challenge me or contact me.

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