With the number of Americans who own smartphones steadily increasing – recent research indicates that more than two-thirds of adults own some type of smartphone — the number of people using apps to help manage their healthcare is also increasing. Healthcare providers, practices, payers, and other stakeholders in the delivery of healthcare are also beginning to see apps as a means to better engage patients in their own care, while simultaneously improving outcomes and reducing costs.
Yet with all of the hype (and hope) around healthcare apps, there are some who question their value. Last year, The Commonwealth Fund conducted a study in which researchers reviewed more than 1,000 patient-facing apps designed for those with chronic conditions, including heart disease, COPD, substance abuse, mental health issues, asthma, and more. Of the apps the study reviewed, fewer than half were deemed potentially useful to patients in terms of engagement, quality, and safety.
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The Problem: Patient Engagement
The issue of low patient engagement with apps is one that’s getting attention across the board. Even at the esteemed Cleveland Clinic, apps are failing to get the patient buy-in required to generate real results. In fact, during an industry event, one Cleveland Clinic leader noted that the hospital has 22 different apps, each devoted to a single function. While individually, the apps can be useful (for example, a wayfinding app within the facility), overall such a disjointed effort only confuses and frustrates users, and is unlikely to reach levels of engagement that truly make a difference.
The question then becomes one not of whether patient-facing apps are a good idea, but how to develop a healthcare application management strategy and create apps that drive patient engagement and move patients forward in their healthcare goals. Given that nearly half of all health professionals have plans to use mobile apps with their patients by 2020, it’s important to think about those goals now and take steps to encourage meaningful engagement with your app.
Patient Activation and App Engagement
Researchers in the Commonwealth Fund study found that the potential engagement in an app was largely determined by a patient’s own level of activation in their healthcare. Patients who had low levels of activation — that is, they rely almost entirely on their doctors to make decisions for them and are less likely to comply with instructions or make changes to ensure wellness — are generally not all that engaged in apps either. These patients tend to use apps mainly for information, and to receive alerts or reminders about medication, appointments, and other tasks.
As patients become more activated in their care, engagement with apps also increases. In fact, the researchers found that apps that offer more interactive elements, such as competitions or gamification of health activities, peer support, and communication with their providers, are most appealing to activated patients, who are looking for more than basic reminders or tracking capabilities.
So what does this mean for healthcare app developers? It’s important for your app to meet patients where they are, and to offer features that are meaningful to them at their stage of activation. In other words, patients who aren’t already activated likely won’t respond to an app that gives them points when they work out or watch their salt intake — at least not right away.
On the other hand, patients who are already active in their care are likely to want more than a simple interface that only reminds them of appointments and prescription refills. As you develop your app, it’s important to carefully evaluate your audience and how you want them to engage with the tool, so you avoid creating something irrelevant or overwhelming.
You can do this by creating custom segments, based on your users’ in-app behaviors, preferences, context, and other factors. This allows you to target content and features to specific users, and create an experience that is meaningful and relevant to them.
Engagement Best Practices
Beyond considering patient activation levels, many of the best practices to increase healthcare app engagement are the same as those for any other app.
First Time User Experience Matters. The experience that a patient has when he or she first uses the app can be a powerful influence on their future use of the app. A bad experience on the first use can keep them from coming back, or even lead them to delete the app without a second try. Make it easy to login, provide simple navigation and explanations of features (and allow users to skip the introduction on subsequent uses), and basically roll out the red carpet for new users.
Seek Feedback. Use survey tools to get feedback from users on what they like and dislike about the app. Use this feedback to tweak your app, if needed.
Use Messaging. Your app should change and evolve over time. Use messaging, including push notifications and updates, to keep users informed and engaged. If your app is the same now as it was two years ago, you will undoubtedly see a decline in engagement. Conversely, fresh content and new, useful features can increase engagement.
Healthcare apps can be an important part of your patient engagement strategy, but only when patients respond to them. By focusing on engagement from the start, you can capture attention right out of the gate, and keep your patients on the road to activation.
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