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John de Souza is president of the consumer health division of Aptus Health and the former president and CEO of mHealth app vendor MedHelp, which was acquired last year by Aptus, formerly Physicians Interactive. Aptus provides mHealth apps and online and consumer digital health services and clinical resources and software for healthcare.
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De Souza, who is originally from Ethiopia, has spent much of his career working with mobile health apps, wearable health devices and patient engagement strategies. In this interview with SearchHealthIT, he discussed the benefits and design of health apps, digital health services and wearable health devices and using technology to get patients involved in their healthcare.
This is the second part of a two-part Q&A.
According to research cited by your company, 80% of consumers would use digital health services to manage their healthcare, but only 23% do so today. How can the health IT industry move that number upward?
John de Souza: People want to use it. When we look at what is currently offered by a lot of health insurance companies or providers, the apps are not as compelling as they should be. Initially when people were developing these apps the approach was people need the information, they need help, so they'll use whatever we provide to them. But I think the mindset has to be more consumer-oriented because we need to get people to use [them]. The benefit of providing a compelling app is very large. It's worth the effort to build it. Part of the reason some of the apps are currently not as compelling is people reinvent the wheel. They develop an app and it's from scratch every time. They're mostly leveraging things that are out there already. If you're trying to build a thing like community, it's a chicken and egg thing. How do you get the first people on so the new people don't feel like as if they're all alone?
And the last thing, which is really critical, is if you want to build a compelling app you need to commit to doing frequent releases, so you take all the information you get from users and populate it in the new versions. If your release cycle gets too long, even every other month, that's too long to be able to effectively incorporate that information and deliver it in a compelling app.
To cite one more statistic that your company uses, 66% of Americans would use mHealth and digital health services to manage their healthcare, so what are vendors, providers and payers doing right in making that happen? And what are they doing wrong or not doing at all?
De Souza: I'll give you an experience I had not long ago. I went to a hospital, and as I was going they told me to log into [their system] immediately. The nurse told me don't log in from your phone, log in from your desktop, it works better, it's not optimized for the phone. So I went home to log in and they said within 48 hours we'll get back to you once your account has been created. If you think about 48 hours for an account to be created … you can get stuff delivered by Amazon in an hour, so it should take less than 48 hours to create an account. I think that's an example of what they do right and what they do wrong. I think they realize the importance of providing people with access, mobile access. I think some of what's happening is sometimes these organizations just go through a checkbox and check "OK, we've provided it if people want to have access." But in order for this to be successful it can't just be a checkbox, it has to be something they're committed to, and committed to delivering real value. As soon as they do that it becomes sort of centraI. I think it's gone beyond "mobile first." It's all about mobile when it comes to patient engagement.
What kind of gap is there between patients' involvement with their own care and health and their enthusiasm for digital health services and communication channels and physicians' embrace of all this technology?
De Souza: We're in a time when people have developed more awareness of their own health and they're willing to engage and you see a lot more people tracking their own health. In terms of mobile health apps, there's a lot more that we need to do. This applies to a lot of chronic conditions as well and developing apps for a lot more conditions. There are really good apps out there, but it has to expand. When people look at their own health they don't want a set of disconnected apps. What we've spent a lot of time doing is looking at what's the most effective way to connect the data at the back end. Finally, with wearables we're starting to get good penetration. But wearable devices need to do a lot more.
Part of the hindrance to that is [many] people producing these devices are very scared of what the FDA regulation is. We still get a lot of these health devices that are out there and being marketed for entertainment purposes. I think things will advance once it's clear in the regulatory environment what you can do and what you can't do and how do you deliver value to the consumer. From [physicians' and patients'] perspectives, it's still hard to share the data back with your physician. A lot of apps produce reports that you can email to physicians but I think we need to do more in terms of bringing that data back to the physicians and also have the physicians trained in what to do once they have the data. Right now [many] of them have not been trained in that. That part of it is one we need to do more work on. Part of it is training physicians to make better use of the data, and part of it is developing mechanisms to share it better.
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