Talking about health apps turns out to be a complex health communication issue, wrapped in another complex health communication issue. If you talk about, manage, or develop health apps, this episode is for you. You’ll get a quick glance at the field; why health literacy matters; and three things you can do to stay on top of things.
Hi. This is Ten Minutes to Better Patient Communication. I’m Dr. Anne Marie Liebel.
Today’s episode is about health apps. When physicians talk with me about apps, those conversations tend to fall into two categories. No, not ‘glee’ and ‘horror.’ Maybe you’ll recognize these. Either your patients are coming to you, talking/asking questions about various apps, or your organization uses a specific app, and you are talking to patients about that app.
Talking about health apps turns out to be a complex health communication issue, as you’ll learn in this episode. So if you find yourself talking apps, or if you have responsibility for an app or you develop apps, and you’re concerned about reaching all patients, this one’s for you.
We’ll start by taking a quick glance at the field. Though consumer facing med tech can include patient portals, wearables, devices, and websites, it’s apps, delivered through smart phones, that have been getting the buzz lately. One industry insider, Cynthia Burghard, and she is a research director with IDC Health Insights, points out that “Regardless of what one’s age is, no one goes anywhere without a mobile phone.”
Now ‘mHealth’ is the term used for mobile health, which is a subset of the larger digital health world. Depending on what definition of mHealth you use, the numbers of apps vary. A recent statistic shows that in the Apple App Store alone, in the first quarter of 2018 there were nearly 48,000 mHealth apps. Other surveys show larger numbers. Links in show notes.
Another industry survey shows 66 out of 100 of the largest hospital systems make their own apps. According to a recent Medical Group Management Association poll, 2/3 of healthcare organizations capitalize on our love of smart phones, and use text messages, mainly for appointment reminders.
Why do people use health apps? It’s not news that most apps provide information. So patients often use health apps the same way they would use, say, a reference book or maybe a website. But according to another industry report, patients use health apps to share and receive info from doctors, to comparison shop, to locate providers, to track their own data and for reminders or even to journal.
Instagram, move over: 69% of mobile health users think that tracking their health and fitness on their smartphone is more important than using that phone for social networking or online shopping, according to the NASEM Health Literacy and Consumer-Facing Technology Workshop. Again links in show notes.
Here’s Where health literacy comes into it. All those reason people use apps? They all involve literacy. That’s a lot of health literacy going on!
Health literacy is also an appropriate concern here, Because digital health tools cross social groups. Here are some statistics that may surprise you:
Sixty percent of seniors are somewhat or very likely to turn to online communities for health information, and are becoming more technically savvy on their smartphones. (NASEM workshop on Health Literacy and Consumer-Facing Technology).
Minorities are more likely to use their smartphone to access health information and track their health. Health-focused apps are more likely to be downloaded by African Americans and Hispanics than the white non-Hispanic population this is from an Earlier survey by the IOM (Designing Health Literate Mobile Apps)
But there are some problems.
Unfortunately, most developers are not providers. Also, the design of many health apps can reflect a bit of a gap. One mHealth industry newsletter cites a data brief on the usability of apps where researchers found that “most mHealth apps have low design quality.”
Adding to this trouble, most of the health information and patient education out there—like that provided in the apps–is still being written in a way that is inaccessible to most Americans.
So if you’re a provider, you can be stuck in the middle. On the one hand there’s the health information that’s isn’t as accessible as we’d like it to be, on an app that might be of questionable design quality. And then there’s your patient who is trying to make sense of it all and take more control of their health.
What you can do? Here are 3 things you can do when you next talk about an app with a patient:
- Assume nothing.
Take a look at that health information people are accessing on their app. Attending to the quality and nature of health information provided through the app is one means of supporting patients’ autonomous health decisions.
Yes the federal government and many professional organizations have made recommendations and providing Advice and guidance on how health information should be communicated. The problem remains that these are not always being followed. Is the information clear, is it accessible, is it actionable?
- Take small steps.
You’ve heard me say this before: start where your patient is. How well does this app fit with what your patient already knows and is already doing? Think about this in terms of tech in general, i.e. how do they use other apps, trackers, things like that. And also consider it in terms of how your patient is already managing their condition. The key here is to take small steps, adding gradually on to what they already know and can do. If your organization is rolling out its own app, make sure you know who’s responsible for guiding patients through the use of the app.
- Stay curious!
Whatever you think of the app, as long as the information is accurate, try to keep an open mind. From your patient’s perspective, is this app or device helping them live a better life? That’s as compelling reason as any to keep going.
The AHRQ makes some persuasive points to those who develop and purchase health IT: the increasing cultural and linguistic diversity of US population means developers who pay attention to health literacy will be broadening their potential audience.
They also argue that everyone benefits when health literacy concerns are included in development. They say “Higher literacy user groups also benefit from making health IT accessible to limited-literacy populations.” (p.1)
If you’re concerned about, or responsible for an app or even website in your organization, I can help. HCP has resources available to help you create or modify your health information content with health literacy in mind. It’s a framework that lets you meet or even exceed recommendations from federal agencies, so you know you’re producing health information that engages all patients.
Ready to get started? Contact me at healthcommunicationpartners.com. This has been 10 Minutes to Better Patient Communication. I’m Dr. Anne Marie Liebel. Thanks for listening!