Mobile Technology: What s in Demand Now? Marsha K. Millonig, BPharm, MBA Catalyst Enterprises, LLC
What will we learn today? Mobile Technology: What s in Demand Now Marsha Millonig, R.Ph., M.B.A., President, Catalyst Enterprises ACPE #: 207-999- 13-032- L04- P AcGvity Type: Knowledge- Based 1. Describe the growth in the health- related mobile technology market 2. List several pharmacy- related mobile technology applicakons and their use 3. Understand trends in the consumer/pakent- oriented health applicakons market 4. Explain the status of FDA- regulakon of mobile device health care applicakons
Disclosures Marsha Millonig is receiving an honorarium for this presentakon. She declares no other conflicts of interest or financial interest in any product or service menkoned in this program, including grants, employment, giws, and stock holdings. The conflict of interest was resolved by peer review of the slide content. ASAP s and NCPA s educakon staff declares no conflicts of interest or financial interest in any product or service menkoned in this program, including grants, employment, giws, and stock holdings.
Mobile Health Market Rapid adopkon of smart phones has boosted demand for health apps Smartphone global shipments have been greater than PC shipments since4q2010 Mobile devices are increasingly the prism through which pakents, families and clinicians view and manage aspects of their health Convergence of technologies that enable remote pakent monitoring, telehealth, online medical collaborakons, cloud compukng and coordinated pakent care
Mobile Health Market
Mobile Health Market For mobile health apps: Expected to grow 39% annually From $1.2 billion in 2011 To nearly $12 billion in 2018 More than 40,000 available with some eskmates much higher Number of health apps quadrupled between 2010-2012
Asymco eskmates more than 30 million apps are downloaded each day in the world
Mobile Health Market The U.S. is the largest market for mobile health technology at $660 million followed by Europe at $420 million and Asia at $120 million SoWware and services represent 80% of the global market with hardware comprising 12% and network and conneckvity, 8%
Pharmacy Mobile Apps Drug informakon and clinical decision support Point- of- sale to support business and clinical operakons PaKent directed for medicakon adherence
Drug InformaKon Plethora of journals and associakon- publicakon related apps Some free, some subscripkon Examples: Epocrates Micromedix Lexi- Comp Pharmacist s Leder AHFS Drug InformaKon APhA Drug InfoLine OTC Guide App (Pharmacy Times)
Clinical Decision Support/Resource Examples: Medscape WebMD PubMed FDA Mobile News Redi- Reader Sigler Drug Cards Google Translate
Pharmacy Business Support Mobile POS terminals Check out purchases Capture signatures HIPAA acknowledgement Scan cards for payment Prints receipts
Pharmacy Business Support Delivery tracking applicakons Pulls informakon from the pharmacy system to servers accessible by mobile devices that drivers carry Delivery confirmakon Signature tracking Status reporkng to pakents Many seings using
Pharmacy Clinical Support Either directly through pharmacy sowware or in partnership with vendors Refill ordering, scanning barcode with phone Hospital discharge counseling at bedside Adherence messaging through pakent s preferred channel Example: Prescribed Wellness s One Million More media campaign for flu shots
Pharmacy Clinical Support
Pharmacy Clinical Support itriage: appointment booking app JiffPad: providers can record short videos, voice notes, FAQs for pakent review awer visits
MedicaKon Adherence GW Conference 2011 on study showing mobile apps can help remind pakents Examples:
MedicaKon Adherence Drug company created: Care4Today Numerous disease- specific, eg. Sanofi s ib- GStar Other examples: HealthPrize Pillboxie MediRemind Dosecast
MedicaKon Adherence MoKonPHR Health Record Medsy Rxmind Me MedCoach PillStaKon
Consumerism... 85% of U.S. adults own cell phones, of those 53% are smart phones 31% of cell phone owners use the phone to look for health informakon and 17% used it to look for health advice Smartphone owners: 52% gather health informakon with device While 80% of cell phone owners use them for texkng, health texkng is only 9% Pew Mobile Health Report 2012
Consumerism 19% of smartphone owners have at least one health app on their phone Women, those under 50 years, beder educakon with incomes over $75,000 are more likely to have downloaded a health app Younger adults, minorikes, and those in parkcular need of health informakon lead the way As do caregivers, those with chronic condikons, faced a medical crisis or change in health status
Popular Apps Exercise, diet and weight 38% of health app users track their exercise 31% monitor their diet 12% manage their weight
Types of Health Apps All health app users (n=254) Exercise, fitness, pedometer or heart rate monitoring 38% Diet, food, calorie counter Weight Period or menstrual cycle Blood pressure WebMD Pregnancy Blood sugar or diabetes MedicaKon management (tracking, alerts, etc) Mood Sleep Other 31 Types of Health Apps 12 % *Less of health than 1% app of users respondents who use apps to track Source: Pew Internet/CHCF Health Survey, August 7- September 6, 2012. N=3,014 adults ages 18+. Interviews were con 7 5 4 3 2 2 * * 14
Health App Types Opened ended menkons:.health insurance, brain trainer, allergy alert, hypnosis, MD encyclopedia, medical handbook, drugs, specific pharmacies, condikons, first aid, anatomy, symptom app, comparing prescripkon.
Top Health Apps 2012 Most popular in the Google Playstore and Apple App store: MyFitness Pal Counter & Diet Tracker WebMD SleepCycleAlarmClock MapMyRun GPS Running Fitness Buddy
Other Top- Reported Apps ANDROID CardioTrainer Pro Carlorie Counter Pro UlKmate Weight Watcher Diary Endomondo Sports Tracker JEFIT Pro iphone MyFitness Pal Lose It! WebMD Weight Watchers Mobile itriage
Future Trends Mobile pakent monitoring Mobile health games using gamificakon technology FDA regulakon
Mobile Health Monitoring
Mobile Health Monitoring
Mobile Health Monitoring Leads to meekng Meaningful Use goals Keeps pakents from readmission Reduces costs Improves quality
WellDoc Diabetes Manager Two insurance companies will reimburse pakents for using the app PaKent coaching applicakon for educakonal, behavioral or mokvakon messaging FDA- Cleared PrescripKon- based Our core system architecture of a PaGent Coach, Expert System, and Decision Support Tools can be used to support almost any condikon.
InteracKon & Gaming Gaming more common Social networks common GamificaKon of apps considered future to engage new generakon Games for improving health outcomes
Why? Game mechanics influence behavior Games can saksfy some fundamental desires: Reward CompeKKon Status Achievement Altruism
Layering Technology With electronic medical records already implemented at Kaiser, we can now think about layering gaming technologies like scenario- modeling, real- Kme analykcs, and decision support to increase produckvity and engage clinicians more effeckvely. Dr. Yan Chow, Kaiser Director of InnovaKon and Advanced Technology
Example Packy and Marlon 1994 Main character with diabetes Gamer manages glucose monitoring, insulin use and food seleckon for 4 days Study found those who used increased communicakon about diabetes, gained knowledge, increased appropriate self- care behaviors Their ER and urgent care visits decreased 77%
Notable Health Games Disease Management Telcare: diabetes first, cross- plaworm social community Cellnovo: mobile- connected patch pump, touch- screen controller, glucose meter and ackvity tracking in real Kme
Notable Health Games MedicaKon Adherence Proteus: networked in- and on- body sensor technologies capture/correlate health behaviors and physiologic responses HealthPrize: combines financial incenkves, educakon, reminders and fun Pilljogger: mokvakon engine using surprise, discovery, secure recordkeeping with pharmacies, companies, employers and plans sponsoring pakent
Notable Health Games Life and Self- Improvement Mindbloom: tree metaphor to represent different life branches and making small, meaningful changes Livn.it: mobile habit network helps users master posikve, sustainable daily habits Meyouhealth: promotes everyday well being encouraging small ackon to create change Zamzee: online reward program for teens powered by their physical ackvity Basis: wrist- worn, connected health and heart rate monitor
Notable Health Games Brain games Dakim Brain Fitness: definikons, famous people, picture puzzles, decoder and others proven in clinical trials Lumosity: Playing Koi, Familiar faces, by the rules..subscripkon based
Notable Health Games Corporate Health and Wellness Keas: posikve reinforcement, shared affinity, team dynamics, newsfeed and fun Vive coach: fun challenges of all shapes and sizes fostering healthy culture Hea!thrageous: personalized advice to reach health goals Redbrick Health: gaming, networking, financial rewards
But..raises the queskon, do they work? We realized this could be a medium for mischief. James Prunty, FTC Only two government cases against health- app developers in 2011 acne related.
FDA RegulaKon FDA proposed in July 2011 to oversee mobile medical apps that: - Are used as an accessory to an FDA- regulated medical device. For example, an app could enable a health care professional to view medical images on an ipad and make a diagnosis; - Transform a mobile plaworm into a regulated medical device. For example, an app that turns a smartphone into an electrocardiography, or ECG, machine to detect abnormal heart rhythms or determine if a pakent is experiencing a heart adack. - Defines a mobile plaworm as a commercial off- the- shelf compukng plaworm with or without wireless conneckvity that is handheld. Rules have not been finalized to date
Expected Results Increased cost to developers Must submit premarket nokficakon or 510(k) for $2,500 Medical Device Manufacturer s Assn reports average cost to bring a low to moderate risk product through 510(k) was $31 million and carried a 31 month approval Kme
FDA RegulaKon 75 apps approved to date Beginning late 90s Difficult to ferret out from FDA Web site New report: $295
ATT Top 5 IT Trends for 2013 A shiw from stand- alone "unsponsored" apps to meaningful "sponsored" mhealth solugons supported and pushed by insurance companies, healthcare providers, employers, or other insktukons will result in higher pakent adopkon and engagement. Hospitals and other healthcare insgtugons including payers will begin to move more and more healthcare data into the cloud, with data analykcs to beder manage healthcare costs by finding and addressing pakent needs earlier. Remote pagent monitoring will move from pilots to large- scale adopgon as more hospitals adopt the accountable care organizakon model to reduce hospital readmission costs associated with chronic condikons.
ATT Top 5 IT Trends for 2013 Integrated mhealth applicagons will be created that can connect with other devices, apps and data for more holiskc healthcare, where informakon is safely shared across plaworms regardless of the vendor. Upswing on telehealth to bridge the significant gap between physician resources and pagent demand.
Resources to Stay Abreast MobiHealthNews.com imedicalapps.com Medgadget.com MedicalSmartphones.com Palmdoc.net
Or, is it That s an APP!
Thanks for Having Me! mmillonig@catalystenterprises.net 651-905- 9002