"Health apps will be normal in 20 years time"- - but what do we do in the meantime?
The adoption of mobile health is a global phenomenon, not only in the United States.
"The mHealth app industry has created a lot of hype recently. The number of mHealth apps has surpassed the 100,000 mark, big players like Apple and Samsung have announced new enabling platforms, sensor-integrating mHealth business models have caught a lot of press coverage and investors are lining up to push money into the market."
Still, the number of solutions that are integrated into the daily routines of healthcare professionals and that are reimbursed by payer organizations is limited. So what is the actual status of the mHealth industry and where will it be in 5 years?
Mhealth is developing not only in clinical medicine but also in allied health and non-health industries.
Analysis reveals several suprises despite 'hype' about mobile health and other mobile apps.
"Today’s mHealth app publishers and Wannabes predominantly target chronically ill patients
(31%) and health and fitness-interested people (28%). As primary users, physicians are
targeted by 14% of app developers.
mHealth app publishers could be categorized into 6 main groups:
traditional healthcare players, helpers, mobile app specialists,
connectors, medical and fitness specialists. Out of these groups,
traditional healthcare players like Pharma and hospitals have the
longest way ahead of themselves to find their role in the mHealth
app ecosystem.
mHealth app publishers have released an average of 7 mHealth
apps. The majority (36%) have entered the market only recently (2013&2014). An mHealth
app publisher typically hires 3-10 (23%) or 11-100 (23%) employees.
The vast majority of mHealth app publishers (82%) generated less than 50,000 downloads
with their mHealth app portfolio last year, whereas the top 5% reached more than 500,000
downloads.
68% of mHealth app publishers make less than USD 10,000 or no revenue. The middle
income group, which makes between USD 50,000 and USD 1m, represents 17% of the
publishers. The top 5% makes more than USD 1m. The most relevant revenue stream is
linked to services which are offered via the apps."
The study
represents
around
10% of
mHealth
apps
The report also looks at the future trends, drivers and barriers of the mHealth
app market. This includes the changes in distribution channels, the preference
of app categories and mobile operating platforms, the impact of wearable and
other types of sensors and the target groups which offer the highest business
potential in the next 5 years.
See how experts from all around the world rate what impact mHealth apps
will have on healthcare costs and on how healthcare is going to be delivered in a 5-year time
span.
With 2,032 respondents from all over the world the fourth mHealth App Developer
Economics study is by far the largest of its kind.
Sponsorship options for 2015 research programme
available now. Get on front of the global mHealth app decision maker community
Infos at www.mHealthEconomics.com
The relatively late market entry of a large proportion of the mHealth app publishers is one of
the reasons why 50% of the publishers have by far released one or
two mHealth apps only. There are also mHealth app publishers with
more than 50 mHealth apps in their portfolio, but they represent
only around 5% of the total mHealth publisher base.
Today’s mHealth app publishers and Wannabes predominantly target
chronically ill patients (31%) and health and fitness-interested people
(28%). As primary users, physicians are targeted by 14% of app developers.
The “Other” category includes nurses (2%) and health insurers (2%) as well as still different,
but significantly smaller target groups.
Which mHealth platform ?
The preferred mobile operating platforms for mHealth app publishers today are Android
(83%) and iOS (81%). All other platforms are far behind. The importance of the second tier
platforms like WindowsPhone and HTML5 is significantly higher among Wannabes. 51% and
45% of future app publishers plan to release mHealth apps for WindowsPhone or HTML5.
In the much diversified landscape of mHealth app publishers, there are six groups which
stand out in terms of their goals and market approaches.
1. Traditional healthcare players: This group includes Pharma, hospitals, health
insurance and Med-tech companies, representing 3.4% of the total number of app
publishers. They usually belong to the mHealth app publishers with > 5,000
employees. Their primary objective is to raise brand awareness. They have published
the largest number of mHealth apps, but their average reach, in terms of downloads,
is far below the average. App publishers from this group are so far the least satisfied
with the achievements in the mHealth app market. The use of tools and APIs to
improve the efficiency of the app development process and app monitoring as well as
the value of the app is below its competitors.
2. App specialists: App specialists are small companies with typically 3-10 employees.
They have entered the mHealth app market to benefit from the revenue potential.
They have an app developer background and are familiar with the available
development tools. The medical experts’ share on board is the lowest of all the mHealth app category share
Chronically ill people
31%
Health and fitness
interested people
28%
Physicians
14%
Temporarily ill people
8%
Hospitals
7%
Others
12%
Source: reserch2guidance mHealth App Developer Economics survey 2014, n=2032
© research2guidance 2014 18
research2guidance’s mHealth App Developer Economics 2014
groups under consideration (40%). This group represents 14% of the total mHealth
app publisher community.
3. Helper: Helpers are companies or individuals with the primary motivation of
publishing mHealth apps in order to help others. Revenue generation is a minor
factor. In terms of goal achievement, Helpers outdo all the other groups and
sometimes even state to have over-achieved their goals. Helpers are typically small
companies of 3-10 employees. They represent 32% of the market. Their download
profile shows the highest share of companies (61%) which attracted less than 5,000
downloads last year.
4. Medical specialists: Medical specialists leverage their medical know-how to develop
mobile apps. Similar to the Helper group, Medical specialists have a large share of
members who publish apps to help others. Usually by now, they have partly reached
their goals. They have the highest share of companies that made more than USD 1m
with their mHealth app portfolio. They represent 20% of the market.
5. Fitness specialists: This group of app developers represents around 10% of the total
mHealth app developer community. They primarily develop fitness apps with a clear
objective to generate revenue. They connect more often to medical databases and
sensors and their use of app development tools is above average. The typical
company size is 11-100 employees.
6. Connecters: This group of mHealth app publishers represents 18% of the total
mHealth app developer community. Their strategy is to create value-rich apps by
enabling connection to other apps, sensors and databases. This group generates the
highest average revenue and has the highest achievement level of their goals.
All mHealth app developer groups have similar platform preferences with iOS being the
number one platform and Android the second ranked. Connectors and Medical Specialists
have the highest platform preference for iOS (62%). Fitness and App Specialists have the
highest share of companies which choose Android as their primary app platform (34% and
32%).
Established Healthcare Players have the highest share with a WindowsPhone preference
(13%).
Comments: Downloads and revenue in 2013; Download numbers refer to a) less than 5,000 downloads b) more than 1
million downloads in 2013 across all platforms; API usage includes APIs that provide access to medical info, personal health
data, medical devices and Health&Fitness tracking devices; Tool usage includes tools supporting app analytics, cross
platform development, storage, test, ads and social network integration
Source: reserch2guidance mHealth App Developer Economics survey 2014, n=2032
Establ.
Health
Players
Helpers Medical
Specialists
Connecters
App
Specialists
Fitness
Specialists
Brand
awareness
Revenue Help
people
Help
people Revenue Revenue
Goal of
apps
Downloads
(<5k/ >1m)
67%/
3.2%
25.7%/
7.8%
42.7%/
9.1%
51.4%/
5.1%
39.4%/
7.4%
39.0%/
8.9%
Revenues
(0/ >1m)
Goals
achieved
APIs usage low average average average high all
low average average high Very
heavy Tool usage high
13.5
7.4 10.7 7.5
11.3 11.3
# of
mHealth
apps
mainly
not
partly partly mainly
yes
mainly
yes
mainly
yes
# Ø
$
Percentage
of total %
3,4%
14,3% 20,2%
32,3%
10,2%
18,0%
57,6% 40,1%
100%
47,5% 43,7% 49,7%
Medical expert
in team ✚ Ø
Typical
company
size
5,000+ 3-10 3-10 3-10 11-100 11-100
53.1% /
7.7%
44.6% /
7.4%
58.6% /
6.3%
61.2% /
5.8%
60.1% /
6.4%
43.3% /
6.7%
© research2guidance 2014 20
research2guidance’s mHealth App Developer Economics 2014
It seems that traditional healthcare players put much effort into the mHealth app business,
but have not found the right strategy yet. If they did, it would accelerate the market’s
development, or as a survey participant puts it: “I feel if there were more corporate
involvement in these apps that more people could be reached out to.
Publishers, Who are the most successful >
Lessons from successful mHealth app publishers
Given the diverse set of goals mHealth app publishers pursue, success could be defined in
many ways.
The question is: What do mHealth app publishers who are economically
successful do differently as compared with those who are not?
Economically successful publishers are defined as companies which have generated more
than USD 1m revenue in 2013 (Millionaires). They are juxtaposed with Low Earners who
earned less than USD 10,000 and Zero Earners with no income generated in the last year.
There are six areas where Millionaires show significant deviations. These have been the
distinguishing factors based on the survey results:
1. The size of the mHealth app portfolio
2. The preferred revenue model
3. The number of years in the market
4. The current use intensity of tools
5. The current and planned usage of medical databases and devices (APIs)
6. The platform preference
Millionaires have a significantly higher share of app publishers with a considerable app
portfolio.
35% of Millionaires have released more than 20 mHealth apps. In contrast, Low &
Zero Earners focus on one or two apps.
The analysis also shows that within the group of Millionaires a single-app strategy is not the
preferred approach. A larger app portfolio offers relatively larger cross selling potential and
helps companies balance the risks in case of unsatisfactory performance of an individual
app. As a result, such a company can better care for the overall economic performance of its
mHealth app portfolio.
Millionaires have
Service
Sales as their
primary
source of revenue.
Low Earners
bet
on Paid
Downloads.
Millionaires also differ in their business model preference. As much
as 35% of Millionaires state that their top revenue source are Service
Sales. On the other hand, 31% of Low Earners state that their 1st
rank revenue source are Paid Downloads
The strongest mobile health developers are already involved in other SAAS or HIT applications and the mHealth apps are only a portion or additon to their business line.
In fact, Millionaires have been involved in mHealth app publishing for 3.9 years on average,
whereas Low & Zero Earners for 2.4 and 2.2 years respectively.
Millionaires also make more use of tools to support development,
performance monitoring and monetization of their apps. These tools
include Ad Network (e.g. Admob, inMobi, Apple), Analytics (e.g.
Flurry, Distimo, Localytics), Cross Platform (e.g. Marmalade, Unity,
Adobe AIR), Performance (e.g. Crashlytics, Testflight, Hockeyapp),
Social Network (e.g. Facebook, Twitter) and Storage tools (e.g.
Dropbox, Box, Google Drive).
The gaps in use levels are getting even more noticeable with regards to the way publishers
connect/plan to connect to medical databases, devices and apps via APIs.
There are four groups of APIs that companies make use of at a different level:
Medical info APIs: APIs that provide access to general health information databases
for e.g. drug, food, disease, device information (MyNetDiary Food Search, FatSecret)
Personal health data APIs: APIs that provide access to personal health databases e.g.
calorie intake, steps, weight, blood pressure (MyFitnessPal, Withings)
Medical device APIs: APIs that provide access to a medical device of a third-party
vendor e.g. glucometer, blood pressure monitor (Accu Check, Freestyle, Withings)
Health & fitness tracking device APIs: APIs that provide access to health tracking
devices of a third-party vendor e.g. heart rate monitoring belts, step tracking
bracelets, scales (Fitbit, iHealth)
Sections of the report include:
API development
This development will lead to an explosion of health and fitness data collected by an
increasing number of app and sensor users.
Three different categories of vital parameters are captured today.
1. Health & fitness tracking data: The majority of today’s metrics are activity and
weight information like steps, kg/pounds and calories. The Connected Elite focuses
on these measures.
2. Patient monitoring data: The second category of vital signs belongs to apps which
support the continuous management of a chronic condition. Apps which support this
group of use cases allow for storage of a much broader range of different metrics
such as vital signs, blood pressure, blood oxygen, blood glucose and brain waves, but
have a substantially lower app user adoption.
3. Medical examination data: The third category of vital signs is related to medical
examinations. Patients/doctors capture the data with the help of an app or a sensor
on a case-by-case basis. The number of different vital signs which fall into this
category is much more extensive than those of the first two groups, but user
adoption is much lower. Examples of vital signs and examinations in this group are
respiratory rate, lung air volume, ECG, EEG, blood tests, color tests, urine tests and
ultrasound imaging.
The first group has the highest number of users who actively track vital signs and the lowest
number of parameters. In contrast, the third group has the lowest number of users and the
highest number of collected parameters.
Outlook: What will be in 5 years time
Before looking ahead what will happen in the next 5 years, it is worthwhile to look back to
where the market started 5 years ago.
In 2009 smartphones are just starting to play a role in the global mobile phones market. Only
13 % of all handsets shipped in Q1 2009 are smartphones. The vast majority of mobile
phones that are purchased in this quarter are simple feature phones such as Nokia’s 63
series handsets. The most dominant mobile operating
system for smartphones at that time
is Symbian with an almost 50% market share (shipments). iPad is to be launched only one
year later.
Today Google and Apple dominate the operating systems market for mobile phones. The
formerly leading market player Nokia and its operating system Symbian have been sold or
disappeared altogether from the market. Smartphone shipments are projected to reach USD
1.2bn2
in 2014. This means that smartphones have become the global, No.1 connected
device and, in addition, tablets are sold even more than laptops.
The app market is developing with exceptional speed - 15 times faster than the growth rate
of stationary internet users.
What does this mean for the mHealth app market and its potential impact on the delivery of
healthcare in 2019? First of all, with a few exceptions in developing regions (e.g. some in
Africa), almost everybody in the world will have a device which could be targeted with an
mHealth solution.
The likelihood that soon doctors and patients will meet in the doctor’s office to talk about
apps which could support medical treatments is very high, given
the high penetration rate of smartphones and tablets among
doctors and the interest app users/patients show in mHealth
apps3
.
It also means that not only will new players such as sensor
vendors or mHealth data aggregators enter the healthcare
market, but also that they will become the dominant participants.
Traditional healthcare players need to understand what impact
e.g. health API and data aggregators will have on their business
models. A clear understanding of the growing connected mHealth
app market is indispensible for those traditional healthcare
players who do not wish to be left out from the new ecosystem.
Finally, even though there are and will be good arguments that mHealth apps will not have a
big impact on the way healthcare is delivered given the high resistance by traditional
healthcare players, consumers will set the pace and the market will need to follow.
On the other hand, the majority of app developers who concentrate on mHealth have not
had a successful market entry yet. The hesitant activities of traditional payers like health
insurers and companies, still slows down the overall development of the market. It will take
a while until mHealth apps become as widely used as a thermometer or as a survey
participants envisions it: “In 20 years, mHealth apps will be the normal way of managing
health” Survey Participant.
During the past five years the annual HIT hype is about mHealth. The reality is it hasn't happened yet.
