Revenue and market growth statistics about mobile medical apps are presented in the press almost daily. All of those in the industry, other stakeholders, and peripherally related businesses know that great strides have been made even in the last 12 months. However, smart phones and apps already play such a big role in the lives of medical students, physicians, nurses and others in healthcare that they are not willing to wait for the business sector to furnish the apps they desire and need. Many are developing their own apps. Here are some reasons why:
1. There is no readily available means of knowing which apps are safe, reliable, and useful. As discussed in a previous post, a certification program for medical apps is one way in which medical schools can know if apps are safe and reliable. Johns Hopkins University is evaluating the efficacy of some apps. Both of these programs are in their initial stages and are voluntary on the part of app developers, though in the future they will likely become quality benchmarks required de facto by the demand of users.
2. The apps are developed by clinicians and others out of real and specific needs. Many medical apps are developed by software engineers or businessmen who have a perceived expertise in medicine or who translate successes in other fields and attempt to apply them to medicine. Success is best achieved when development of a product addresses a real need or problem. I have seen over many years healthcare consultants who apply either abstract reasoning or cookie cutter initiatives to their clients. Apps developed in-house by clinicians and others address specific issues relevant to that institution. This not only addresses concerns in the development process along the whole cycle, but adds to the probability of adoption success
3. A wide range of resources are readily available. Medical schools have resources to develop medical apps including financial, IT, and clinical support. This is best seen in this presentation by the University of Michigan Medical School. Resources are even made available to medical students. There are many apps which have been developed by medical students. One of these, Symcat, has received significant attention. Medical schools do not have to wait for VC money to develop apps. They have trusted experts and they know their market. Most medical schools are also very tech oriented. For example, the University of Massachusetts Medical School requires students in their clinical years to access evidence-based clinical support tools via mobile devices. This type of indoctrination filters out to many aspects of the school and clinical environment
4. Reimbursement is not a prerequisite for development. Since these apps are developed to address an internal need, whether it be operational or clinical, and not necessarily as a profit-driven endeavor, reimbursement is not a prerequisite. Many developers as well as adopters are hesitant to jump on the medical app bandwagon until reimbursement for prescribing apps is established. Two things need to be said about this. One is that reimbursement may not ever happen for prescribing of medical apps. By the time it comes up for legislative consideration, bundled and outcomes-based payments may dominate the landscape. There may not ever be money in the budget of legislators to reimburse for this. Both physician advocacy groups and legislators might not see this as a service in demand enough to warrant suggesting reimbursement. Of course, reimbursement might come to pass and I can be wrong. One way of passing this type of financial stress test for medical apps is to have some really good, effective ones developed which increase efficiency and improve outcome (as all of these profess to do). This itself will lead to adoption, perhaps forcing the reimbursement issue
5. They are unique and complex healthcare institutions. Medical schools are the most complex of healthcare delivery institutions. Apps are applicable to operations, education (physicians, nurses, and other allied professionals), patient care, and communications with many affiliated institutions. Their challenges are significant. They might be vertical healthcare delivery systems which are payer, equipment supplier, and healthcare provider. Apps development in such an environment can serve as models for other smaller developers, demonstrating types of need and implementation successes.
Medical schools are often the places of clinical breakthroughs. I believe we will be witnessing digital health breakthroughs as well, specifically in the area of mobile medical apps.