Monday, May 9, 2011

Smartphones for Health? A survey

Last month, Consumer Health Information Corporation released the results of a survey of 395 smartphone consumers. It was a good first effort to dig into a very murky, but important question: how will folks use their smartphones to manage their own health? 

They reported a number of findings:

  • 74% of smartphone apps are abandoned by the user before they use it 10 times.
  • Most health apps do not comply with public health guidelines.
  • In spite of these failings, most consumers were willing to pay a few dollars for the app.
  • Respondents preferred text messages over other methods of getting health reminders.
This last finding is a bit problematic. Apparently the survey included only electronic methods of communication (phone calls, e-mails, app messages, etc.). However, none of these methods has ever been shown to improve health outcomes or lower costs. On the other hand, personalized first class mail is quite effective and has been proven in large scale clinical trials to change patient behavior for the better.

I guess that's what happens when you survey cell phone users on Facebook - they tell you they like using cell phones! But whether health apps will truly change our health awaits a more rigorous evaluation, including a large randomized clinical trial.

Friday, May 6, 2011

Patient Portals and Equity

Mita Goel, David Baker and the good folks at Northwestern University report in the Journal of General Internal Medicine about use of the patient portal in their large, academic practice in Chicago. Of 7,088 patients invited to open an account on the portal, 69% enrolled. However, older patients and minority patients were significantly less likely to use the technology.

Once they were enrolled, race and ehtnicity didn't seem to be associated with how the patients used the portal. However, younger patients were less likely to initiate a request for refill or advice, perhaps because they have fewer medical issues. Likewise, men used the system less than women, reflecting the general tendnecy for women to seek health care more often than men.

The good news for engaging patients and exchanging health information is that over 2/3 of patients in this large, complex population took the opportunity to enroll. Patients want to connect. The bad news is that it might not help resolve the racial and ethnic divides that continue to bedevil health care and American society - it might even make them worse.

Goel M, Brown T, Williams A, Hasnain-Wynia R, Thompson J, Baker D. Disparities in Enrollment and Use of an Electronic Patient Portal. Journal of General Internal Medicine 2011; Online first at