Not all mobile health is created equal

Samyukta Mullangi — October 20, 2015

We at Wellframe were reminded of this truism with the publication of this NYTimes article this week, which cited a recent British Medical Journal report questioning the efficacy and use of health apps for generally healthy people. The argument basically boiled down to this: while everyone agrees that there is no data to show that mHealth apps have caused overt harm, there is also little evidence to suggest that they cause any good. In fact, the article continued, there is the real possibility that apps designed to track vital signs, sleep levels, sex, food intake, exercise activity, and otherwise continuously monitor our day-to-day lives do little more than stoke unneeded anxiety among the “worried well.”

Of course, this article and report were about the use of mHealth apps for generally healthy folk, while Wellframe is a mobile platform with a patient-facing mobile application designed primarily to support chronic disease management., We at Wellframe still agree with the overall conclusion of the article; apps or websites or journals, or any other medium that enables individuals to track their progress by achieving incremental goals over time all fall short when held separate from a therapeutic relationship with a care manager. Feeling like your progress is being monitored by someone you trust is more powerful than the brief rush experienced from simple tracking.

The folks over at Stickk.com understand this idea very well. Stickk is a company that harnesses insights from behavioral economics to try and change behavior around overeating, smoking, spending and other bad habits that people are desperate to break. Their clever insight involves having people sign ‘pre-commitment contracts’ for specific goals and pledge a certain amount of money towards achieving them. Users can also name referees – friends who monitor their progress and cheer them on. Stickk’s data suggests that when users sign contracts without wagering any money or naming a referee, their success rate typically hovers at about 29%, but when they have skin in the game, it shoots up to 79-80%. While Stickk’s platform is mostly about understanding peoples’ deep-rooted sense of loss aversion, it is telling that assigning oneself a support group seems to be an equally important contributor to success.

This is why at Wellframe, we have positioned our mobile platform as we did; while patients must go through their daily checklist and indicate that they have completed each action item, this interaction is done in the context of a care manager who monitors this activity on the other end. Moreover, our technology offers many more touchpoints between patient and care manager, facilitating a real therapeutic relationship- in this case, one that exists on a mobile health platform.  Indeed, patients report to us that this is what makes the difference with them, and what has been the leading contributor to our engagement rates of 50% to 90% with our patients – record rates when compared to industry benchmarks.

Also, the BMJ report juxtaposed the opposing views of two doctors, one who advocated for mHealth apps and one who disagreed with their use. The endorser recommended that physicians become more involved in educating the public on which apps to use and which health details to track, adding that scientific data to support their claims will always lag behind. If doctors wait for this data before making recommendations, they lose the opportunity to advise patients on which tools to use and to ultimately shape the industry.

Here at Wellframe, we are one step ahead . As we piloted our product to different types of hospital populations, we made sure to conduct randomized clinical trials to produce the kind of robust data that patients, and consequently, their physicians would appreciate. You can read more about our methods and outcomes here. We’re building an evidence-based solution, which is a work in progress. Stay tuned here.

Samyukta Mullangi

Samyukta Mullangi

Marketing and brand strategy consultant

Samyukta is currently pursuing a joint MD-MBA degree at Harvard with a focus on healthcare strategy and delivery system innovation.