new report from Research and Markets. Most of that revenue will come not from software downloads, but from mobile health device sales and services, the report says.
Based partly on a survey of 324 "opinion leaders," the report also estimates that about 50% of mobile phone and tablet users will have downloaded mobile health -- mHealth -- apps within five years. In contrast, 11% of cell phone users and 19% of smartphone users had mHealth apps on their devices in 2012, according to a Pew Internet survey.
The Research and Markets study predicts that smartphone user penetration will be the main driver for mHealth apps uptake and that "buyers will continue to drive the market." Applications will enter traditional health distribution channels; second-generation apps will focus on chronic diseases; and mHealth business models will broaden, the report states.
[ Not all health conditions are covered by mobile apps. Read Mobile Health Apps Neglect Poor Countries. ]
The report divides the development of the mHealth market into three phases. Having gone through the initial trial phase, the market has now entered the commercialization stage. This is characterized by "a massive increase of offered solutions, the creation of new business models and the concentration on private, health-interested people, patients and corporations as major target groups," said the report.
The third phase, in which mHealth apps will become part of doctors' treatment plans, is mainly being held back by "missing regulations," the report says. This is a reference to the long-delayed final rule of the Food and Drug Administration (FDA) on the use of mHealth apps as medical devices. Some observers view the absence of the FDA regulations, expected to arrive this fall, as a deterrent to investment in apps designed for people with chronic diseases.
There are other major obstacles, however, to the integration of mHealth apps with mainstream healthcare. One is the difficulty of integrating monitoring data with the clinical workflow and electronic health records. Another is the current lack of payment to doctors for viewing this data.
The report hypothesizes that in the next phase of the market, "health insurers will become the main payer, especially for the more advanced mHealth solutions (2d generation mHealth applications)." Today, however, most health plans are not even paying for home monitoring, let alone the use of mobile apps in treatment. Three large self-insured employers recently agreed to cover WellDoc's diabetes management app as a prescription benefit, but that's the exception so far.
John Moore, founder and CEO of Chilmark Research, which has also studied the mobile health market, told InformationWeek Healthcare that the transition to new reimbursement methods might reshape physicians' attitudes about mobile health. "We're moving to a capitated care model where providers are taking financial risk, and with that we're seeing a number of provider organizations begin to monitor patients outside of the exam room. But it's very preliminary—it's all pilots. There have been no broad rollouts of any of this stuff," he said.
Even if Research and Markets' forecast about downloads of mHealth apps turns out to be accurate, Moore said, most of those apps will continue to be medical reference and fitness/wellness programs. "The vast majority will not be integrated [with physician treatment plans]," he said.
However, he admitted, the crystal ball is blurry at this point. One factor that could change the equation, he noted, is the proposed Meaningful Use Stage 3 criteria. Among other things, those would require that EHRs accept patient-generated data, including biometric data on weight, blood pressure, and blood glucose.
How about the workflow issue? "Maybe the data will go into a cloud-based system that will convert it for EHRs to digest," he suggested. But doctors might still be reluctant to view the data unless they were convinced it would help them provide better care without increasing their liability.
Meanwhile, he pointed out, lots of companies are coming with new app-related monitoring devices to "surf the wave" set in motion by Nike and other fitness firms. Already, he said, some firms are selling their devices with free applications and coupling those with other apps you have to pay for. For example, a fitness app might be combined with a weight-loss program that is using the same data.
"What we haven't found yet is when is there a convergence between consumer needs for health and wellness activities and when providers will use it in the context of care delivery and monitoring a patient over time," Moore said.