ePharma Editor, Caroline Criado-Perez examines the current role mobile applications play in pharmaceuticals and healthcare, and the barriers to widespread adoption...
"I hate when they make you wait in the room. 'Cause it says 'Waiting Room.' There's no chance of not waiting. 'Cause they call it the waiting room, they're gonna use it. They've got it. It's all set up for you to wait. And you sit there, you know, and you've got your little magazine. You pretend you're reading it, but you're really looking at the other people. You know, you're thinking about them. Things like, 'I wonder what he's got. As soon as she goes, I'm getting her magazine.' And then, they finally call you and it's a very exciting moment. They finally call you, and you stand up and you kinda look around at the other people in the room. 'Well, I guess I've been chosen. I'll see you all later.'"
Wise words spoken by a wise Jerry Seinfeld. But might they be about to lose their universality? Will we look back on them as quaint reminders of a past where everyone was familiar with the interminable wait before you hear the magic words, "the doctor will see you now?"
Well, maybe. But before we reach that brave new world, there are a number of obstacles to be overcome, not least doctors themselves.
According to a recent report by PWC, 59% of mHealth users say it has replaced some visits to health practitioners. Patients see it as giving them easier access to care and greater control over their health. Which are surely good things?
Perhaps not if you’re a doctor: it is exactly this control that they object to, with 42% worrying that mHealth makes patients too independent. The upshot is that only 27% of doctors encourage patients to use mHealth applications, while 13% actively discourage it.
The reluctance of doctors to cede control to their patients is partly due to privacy concerns, but there are other reasons too. For example, Professor Chris Taylor claims in the report that "healthcare professionals don’t currently treat as credible any data that is being created [through lifestyle apps]." Unlike doctors, patients can’t be trusted. Even less honourably, a recent article in The Economist suggests that doctors are reluctant to embrace innovations such as mHealth because they see them as a threat to their prestige. PWC’s discovery that it is actually younger doctors who are most resistant to mHealth is therefore compelling: the implication is that younger, more vulnerable doctors are more likely to see themselves as threatened by mHealth.
But for all the naysaying, when doctors can really see the benefit of mHealth, they do support it. This was recently demonstrated by the popularity of the NHS Hack Day, which proved such a success that another one has been planned for September.
This event rubbishes the suggestion that doctors are implacably opposed to mHealth: a commentator at The Guardian regretted that most of the apps were geared towards doctors, rather than nurses or patients. If doctors are so against apps, why create so many for themselves?
And it’s not just grassroots stuff: the big players are getting involved too. Hot on the heels of the NHS clinical trials app, NICE has launched a BNF prescription drug app.
In fact, despite the apparent enthusiasm of patients, they may in fact end up being the real obstacles that mHealth has to conquer: it’s not a total love-in. Give patients a free app and they might play with it for a while, but like any new relationship, the novelty soon wears off: 67% of app-patient relationships break down after six months. Ask them to pay, and they’re nearly always unresponsive, with only a quarter of those questioned paying more than US$5 a month. This is particularly noticeable in developed countries, where patients are used to freeware and the open nature of the internet. With this attitude so firmly entrenched, app developers may find it hard to achieve a decent ROI.
But with demand for health services ever-increasing, the model of the physical patient in the physical waiting room seems like the camel’s back waiting for the final straw.
Something’s got to give. And there might just be an app for that.
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