The mobile moonshot

Though mobile phone apps have long been regarded as potential 'game changers' in healthcare, the journey has been slower than many digital gurus expected, with surprisingly few apps actually designed to bring value to patients. Is pharma getting the message right?

I first started tracking mobile apps that were being created by life science companies in 2010, when all the bleeding edge digital health gurus were cradling their iPhones like lattes whispering to each other how this was going to be a 'game changer'. Although the visible output we had seen up until that moment was meagre, we were all certain the collective industry was feverishly toiling away in its secret mobile app factory, from which countless life-changing innovative apps were about to explode. Of course we said that a few years earlier when we were getting drunk on the social media Kool-Aid, but this was different. This was Apple juice, and we had all humbly taken the oath in the Church of Jobs.

At that time I was also impressed with the work of my peer and now recently returned digital health pioneer Jonathan Richman, who had succeeded in building a loyal following by the simple act of aggregating a list of pharma's social media activities on his Dose of Digital blog. Yes, the blog was also filled with Richman's terrific analysis and observations, but it was that list that kept many of us in the orbit of his narrative.

The value we all derived from Richman's curation, combined with the heart-palpitating premonition that we were on the verge of a supernova explosion of mobile app creation, drove me to the decision to build a portal dedicated entirely to the task of tracking mobile apps created by life science companies. So in late 2011 I launched what was intended to be the most comprehensive directory possible.

However, though I believe I achieved my aim, initially it included what I thought was a shockingly small number of apps, at least compared to my expectations. Even if I were to have disregarded the technoratis' hype, it was impossible to ignore the industry's increasingly feverish focus on this channel in every trade magazine you picked up, or at every pharma conference you attended. There we all were doing the app conga dance while beating the drums of a mobile health revolution.

Yet the small number of existing apps, along with the low frequency of new ones being created hardly seemed worthy of a dedicated directory, let alone the sophisticated tracking and scraping tools I had built to keep the directory current. The rocket boosters were starting to shake and for a moment I thought I wasn't even going to even clear the Troposphere.

But just as I began to think that Jobs' social distortion field had warped all of our realities, things began to change. Slowly at first, but eventually picking up a head of steam – to the point where now we have blown past the moon and we're well on our way to Mars. And when you add 'wearables' to the rocket fuel, discovering entirely new galaxies is completely within the realm of possibility.

So, while the rate of growth has finally aligned with the initial spectacular promise of the mobile moonshot, there are many things that continue to surprise me as I look out of the window and observe.

Warp speed ahead

Today the directory has grown to contain over 6,000 apps, with 10-15 new apps being launched each week, up from one to two per week in 2011. Equally impressive is the fact that there are about 15-20 apps being revised or updated weekly, which is up from five to 10 in 2011.

An international mission

Almost 80 per cent of the apps in the directory in the first year were made by US companies, for US audiences. The rest of the non-US apps had been contributed by 25 other countries. Today, the picture looks very different. Only 35 per cent of apps are created for the US app store and the number of countries creating mobile apps has more than tripled.

Gravitational pull of market share

In the first year we saw a lot of experimentation where companies created apps for multiple devices, including iPhone, Android, Blackberry and Windows. Today, the app marketplace has clearly become a 'two-party' system comprising iOS and Android. Most US companies are creating apps for iOS devices and more often than not they're being developed to run on both the iPhone and iPad. But outside the US the app market is more fragmented, with many companies making both iPhone and Android versions of the same apps. This is not surprising, considering that there are many markets where Android devices have far larger penetration than Apple products.

Voyage of discovery

We have also seen a surprisingly large number of apps being created for internal audiences where previously most were made strictly for healthcare professionals. For example, there are dozens of apps available for company employees that offer content and functionality previously reserved for intranets, such as maps for navigating facilities, tools for engaging with credit unions, or news streams on company happenings. There has also been significant growth in apps focused on meetings and conferences, including apps for employee retreats or strategic planning sessions. Similarly, there has been an increase in the number of 'branded' apps, designed for patients taking specific products or for the physicians who prescribe them. Many of these apps require passwords or some form of verification/authentication, but not all. Most of the patient 'branded' apps focus on training in how to use a product, especially those requiring reconstitution and injections. Almost all of the branded physician apps are dosing calculators.

Houston, we have a problem

One of the more interesting changes observed is the number of people that are contributing comments and reviews regarding apps in either the iTunes or Google Play store. While there are many who share words of praise, complaints are equally abundant. Most of the complaints fall into three categories:

1. A user believes the app is missing important functionality to make it worth using;

2. A user is experiencing some kind of bug that is preventing the app from working as they think it should;

3. An update has been made to an app that is either causing some kind of issue, or has changed the functionality in an undesirable way.

Back to Earth

When all of the digital health geeks were excitedly pondering the future of mobile apps, I think most of us were thinking about how the app revolution would transform the way companies communicated with, and supported, patients. Yet, relative to the number of apps being created, aside from branded training apps, a remarkably small number of them actually focus on creating value for the patient.

In some ways, it's not unlike what we saw in the early 2000s when Pharma first dipped its toes into the Internet; many of the initiatives were branded with a focus on healthcare professionals. Few of those efforts went beyond putting the detail aid online. Since then, I think most of us would agree, the industry's use of the Internet has dramatically evolved to where we're now seeing companies invest significant resources into leveraging a wide range of digital channels to engage, educate, support, and build long-term relationships with patients and those who care for them.

Despite the similarity, or perhaps because we've already lived through this, it's surprising to me that so little of the current approach to digital has found its way into what is inarguably the most transformative communication device ever introduced into modern civilization: the mobile phone. It's the one device that keeps almost every human on earth always connected to everything that matters. So it begs the question: Why is this industry not leveraging this incredibly powerful connection point to do something that truly delivers care? Or, if this is simply history repeating itself, the more appropriate question might be: When are we getting started?

About the author:

Fabio Gratton is the founder of Alchemy Factory, a Southern California-based digital health incubator launched in 2013. He is also the CEO of Vocalize, a 'Voice of the Influencer' company that recently hatched Truvio, a mobile voice-response platform that enables healthcare organisations to get instant feedback from patient opinion leaders. Fabio is also the Innovation Catalyst of Sonic Health, a patient-focused digital health consultancy he co-founded in early 2014. When he is not incubating companies or developing products, he oversees Pocket.md, a curated directory of mobile apps created by life science companies, which he created in 2011.

Prior to Alchemy, Fabio co-founded Ignite Health, a digital marketing agency which was sold to inVentiv Health in 2007. At inVentiv he was Chief Innovation Officer for six years, where he created and operated a digital ideation division called Labs.

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