8 lessons Apple is learning from 8 mobile health apps

Open your phone and say Ahh

Open your phone and say agh
Credit: Stephen Sauer for ITworld

There's an app for...what? Asthma? Epilepsy? Autism?

After first telling folks nearly six years ago that "there's an app for that," Apple is now working with big name university medical schools and development partners on apps for eight different maladies. Many thousands of iPhone users have already downloaded these apps from Apple's App Store. Meanwhile, Apple and its prestigious partners are learning valuable lessons about the types of features iPhone owners will happily use in the interests of getting healthier.

[ Related: ResearchKit at 6 months: 100,000 people now using medical apps ]

Apple and its university colleagues released the first set of these medical apps -- for asthma, Parkinson's disease, diabetes, breast cancer, and heart disease -- in March of 2015, following on in mid-October with new apps for autism, epilepsy, and a potentially deadly form of skin cancer known as melanoma.

Built on ResearchKit

All of these apps are built on Apple's ResearchKit, an "open source development framework" that lets software developers create disorder-specific apps that work with the iPhone's HealthKit and hardware sensors aboard the phone.

In the Parkinson's disease app, known as mPower, patients can use the iPhone's sensors to take a series of interactive tests for measuring and tracking their memory, speech, motor, and gait/balance skills.

With the Autism & Beyond (A&B) app, parents use the iPhone's camera to shoot videos -- snapped with the kids held in their laps -- that can help with early screening for autism.

Autism & Beyond app Autism & Beyond

"Although ResearchKit is not without its limitations, Apple is to be commended. There's never been anything like ResearchKit before, and it has the potential to change existing ecospheres. Apple's ResearchKit partners are trailblazers, and you can be sure that they're getting back to Apple with some of the lessons they're learning,” said Pam Baker, an industry analyst and consultant, in an interview with ITworld.

Here are eight such lessons Apple and its research partners are learning from the eight apps.

Lesson One: Successful mHealth apps are ‘sticky’ and ‘engaging’

“Asthma Health needed to be as ‘sticky’ as other popular apps in order to generate the required amount of study data,” Corey Bridges, CEO of software development firm  ) LifeMap Solutions, said in a blog post on Apple’s ResearchKit site back in May.

“It’s one thing to get users to download your app, but for your app to succeed, you need users to return to the app the day after they install it, then after one week, one month, etc.,” Bridges told ITworld.

“Social networks and games generally have higher retention rates than business or health apps. Based, we believe, on our use of compelling features, good design, and timely reminders, we’ve been able to keep users coming back to Asthma Health,” Bridges said. When users of the app are sent reminders each Monday, usage spikes.

Successful mHealth apps will need to continually engage participants, concurred Brian Bot, principal scientist at Sage Bionetworks, co-developer of the mPower app with the University of Rochester. In mPower, tasks where patients are asked to engage in an activity tend to be the best received and most often completed.

“Not surprisingly, saying ‘aaaaaaah’ into a phone for ten seconds or trying to tap as fast as you can carries much less friction than completing a 20-question survey,” Bot told ITworld in an email.

Lesson Two: Apps should run on Android, too

ResearchKit’s main limitation is that the first crop of apps runs only on Apple hardware, according to Baker. Moreover, some researchers maintain that the data from the ResearchKit apps is skewed, since iPhone users tend to be younger and much more affluent than the overall US population.

Five of the ResearchKit applications are open source, an advantage designed to allow ports to Andoid as well as integration with existing devices such as medical monitoring systems.

Apple is reportedly trying to encourage Android ports by developers.

“We are actively interested in [Android ports] ourselves,” said LifeMap’s Bridges. “We haven’t revealed our schedule, though.”

Yet, although these ports are possible, they’re not a proverbial piece of cake, some partners say.

“The difficulty will be reconciling the differences between sensors such as accelerometers, gyroscopes, microphones and cameras (on various Android phones),” according to Bot. But “there are efforts moving forward among the Android community,” he added.

Lesson Three: mHealth apps offer unprecedented geographic reach

“More than 50,000 people downloaded our app," recalled Dr. Yvonne Chan, director of digital health and personalized medicine at Icahn School of Medicine, in a summary of preliminary results for the Asthma Health app. Of those 50,000 downloads, 8,800 people “met our strict eligibility criteria to join the study (asthma diagnosed by a physician, on prescription meds for asthma, USA resident, 18 or older),” according to Chan.

“We broke the geographic barrier that typically limits traditional research to the local area of the university/medical center. For our study, 87% of participants live outside of NY and NJ!”

This kind of reach could also come into play for scenarios involving remote diagnosis by medical specialists based in far off locations.

Lesson Four: Some apps need to speak multiple languages

Various other analyst firms, many of them based overseas, have pointed to rapid future growth in regions like Latin America and Asia-Pacific. They cite factors such as rising penetration of mobile devices and increasing awareness that remote monitoring of chronic illnesses can help to cut re-hospitalization and other healthcare costs.

The international market opportunity can’t have escaped notice from Apple, which is teaming with Duke University on an autism app created in three languages: English, Spanish and Chinese.

The English version hit Apple’s App Store in October. The Spanish version is slated for availability within the next month, with the Chinese version set to follow shortly afterward, according to Guillermo Sapiro, professor of electrical and computer engineering at Duke.

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