Summer camp is the one time a year when most kids can get away from home to forge lifelong memories, make new friends, and have fun in the sun. Unfortunately for patients with pediatric Type 1 diabetes and their treatment care teams, summer camp could be a thought that brings about more stress than it does relief.
A juvenile diabetes association set out to solve this “summer camp dilemma” in 2003, and organized a summer camp for pre-teens with Type 1 diabetes. With a firm grasp on the threat of hypoglycemic episodes that would send kids straight to the ER, the group employed an “app-like” technology using a web portal for patients log their variety of daily treatment, dosage, blood glucose, and carbohydrate intake, that was then transmitted to the treating practitioners and care team. The data was then analyzed and adjustments were executed in timely with a simple call to camp.
During this two-week trial, this pioneering “app-like” technology worked brilliantly, but once the kids returned home, patients lacked any real motivation to continue its use. Patients felt like they were working for their doctors - instead of the other way around. Besides, being back home meant patients could resume their routine treatment regimen.
According to a Berg Insight report cited in a December eWeek article, in 2015, the number of remotely monitored patients totalled 4.9 million - an increase of 51% over the past decade - yet is projected to reach an estimated 36.1 million remotely monitored patients by 2020.
What should be at the top of the priority list for any developer with sights on creating an app that is widely adopted due to its ease of use and necessity?
Here’s our top 10 list of considerations every single developer should take into account in order to make the ‘perfect health app’ that engages patients.
1. Patients don’t want to feel like they’re doing work.
When asked, the patients said consistently that spending time to log data made them feel as if they were working for their doctors, not for themselves. They didn't feel they were getting anything directly out of the reporting, so they were less likely to use the technology.
2. Like consumers, patients need motivation!
To really sustain patient engagement, health apps must be reassuring, incentivizing, relevant, empowering, and collaborative. It must provide an immediate and systematic benefit to patients when they share information.
3. Physicians should be able to prescribe the app according to the patient’s treatment plan, specific situation, and objectives.
The healthcare practitioner should prescribe the app, which initiates the patient’s motivation. Then the healthcare practitioner should personalize the app according to the patient’s treatment plan, specific situation, and objectives. That way patients feel they have a reliable solution for their particular situation that conveys their physician’s guidance in conjunction with their needs.
4. Incentivize with real-time results.
Incentives, such as a real-time feedback loop, motivates patients to take a more active role in their disease management by providing active decision-making support.
5. Transform the app into a medical device
The app must deliver value on top of the treatment by transforming data into medical intelligence. Protocol-based clinical algorithms can deliver real-time recommendations to patients via an app that remains simple and easy for patients to use.
6. Medical apps should comply with regulations the same as a medication or medical device must.
In the case of diabetes, a 2015 study by Huckvale, et al., published in BMC Medicine, found that 67% of insulin calculator apps carried a risk of inappropriate output dose recommendations that violated basic clinical assumptions. This engenders the need to go through regulatory clearance, to ensure their safety and prove efficacy, in the same way a medication or medical device needs to.
7. Feed the growing need for FDA-compliant medical apps in a sea of unregulated tech.
Beginning in 2011, the U.S. Federal Trade Commission has routinely removed fraudulent medical apps from app stores. In fact, there are over 55,000 medical apps on the market, and only approximately 150 have been able to achieve FDA clearance.
8. Clinical trials reign supreme in demonstrating app efficacy as well as potential economic gains for payers.
Because they intend to support disease management, an app's potential claims should be supported by clinical evidence and validated by regulatory bodies.
9. Apps play a huge role in helping drugs reach their optimal clinical outcomes in the real world.
For insulin-treated patients who must calculate their insulin doses multiple times a day, the most useful decision support would come in the form of recommending insulin doses according to their treatment plan. Apps could deliver this real-time decision support by using “companion software.
Much like “companion diagnostics,” the term companion software is meant to convey that it is a companion to patients and their treatment.
10. Auto sharing is a must
A successful app can automatically share patient information with the practitioner to ensure a two-way dialogue that allows the practitioner to remotely monitor the patient and fuel further collaboration, supported by common metrics, terms, analysis, etc.
The next few years should see an explosion hit the market as medical technology expands, empowering patients to self-manage, self-monitor, and self-dose - beyond diabetes - to help patients manage many chronic diseases , from multiple sclerosis to psoriasis and from hemophilia to oncology, that severely impair quality of life.
Aptly named, Enclothed Cognition is the official Medelita blog for medical professionals interested in topics relevant to a discerning and inquisitive audience. Medelita was founded by a licensed clinician who felt strongly about the connection between focus, poise and appearance.
