Mobile Health Applications: 2012 Study

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I am pleased to present the Verasoni Worldwide’s AhHa! Insights Mobile Health Applications: 2012 Study.  The study is a snapshot of what people are doing with healthcare related mobile applications, what platforms they are using and it also examines the popularity of healthcare application downloads by categories and specific applications themselves.

There is no shortage to the aspirations of the Mobile Health Applications market (mHealth) in the United States and around the world. Healthcare players from life sciences companies, pharmaceuticals, hospitals, insurers and beyond are scrambling to make sense of the opportunities that 4G mobile applications can deliver for their business enterprise and for improving patient health.  They have already been experimenting with other digital platforms such as web and social media, yet mHealth carries a disruptive rumbling in a marketplace that is searching to capitalize on the promise of even more data through hyper-mobile inter-connectivity.

As with many industries, innovation is key in healthcare, not simply on the clinical and pharmaceutical side, but in the seemingly sleepy, yet ever-important areas such as patient access and compliance. After all, patient behavior – how people use these healthcare applications – is key to the success of mHealth applications. We define success as raising awareness or improvement of a person’s particular health condition.

I hope you enjoy our report and find it relevant and insightful.  As with our other research projects, blogs and reports, we welcome your feedback.

Abe Kasbo
CEO
Verasoni Worldwide

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Executive Summary

About the Verasoni Worldwide AhHa! Insights 2012 Mobile Health Applications Study:

Media and technology move at an exponential and extraordinary pace.  The subsequent rapid adoption of devices and platforms also happens at a swift tempo leaving healthcare providers, including life sciences companies, pharmaceuticals, hospitals, physicians and dentists, and healthcare professionals to wonder how to use these platforms, which platforms to choose and what type of investment in applications would make solid business sense.

People today have unparalleled access to healthcare information via the web, and that number will surely continue to increase due to the mobile web, with the proliferation of smart phones and tablets.  Indeed, mobility is driving growth in healthcare applications and delivering unprecedented access to healthcare information and tools to people who want to be engaged in both their healthcare and well-being. This presents a unique set of challenges for those healthcare enterprises hoping to capitalize on mobile health or mHealth opportunities.

This study looks at the behavior of people and what applications they are downloading with respect to health, wellness and medical mobile applications. In looking at download data, it appears that adoption of mHealth is growing at a furious pace.  The rapid rise of  mHealth does require healthcare enterprises to develop a more nimble entrepreneurial mindset relative to the digital world. Yet, we caution, as far as we have come in “connected healthcare,” the market is still at its infancy, much like the web of the early 1990s.

Since the mHealth app world is massive, this study looked at the top 150 mobile health applications downloaded.  We defined “top 150” by the number of downloads.  We looked at the top 150 on two platforms, Android and iOS (iPhone only) for a total of 300 applications downloaded in the United States only. The factor of inclusion was the number of downloads specifically for the iPhone and Android devices.

According to the Pew Internet & American Life Project (Half of Adult Cell Phone Owners Have Apps on Their Phone, November 2, 2011), of adults who download apps to a cell phone, “11% of all adult cell phone users” have reported downloading “an app that helps them manage their health.”  We thought it would be useful, through this study, to look at what types of apps are being downloaded to gain a better understanding of how people may be using these apps and the types of health related issues apps are being used for.

Study Scope & Limitations

This study is a snapshot in time and looked at the total number of mHealth applications downloaded through March 31, 2012.  The study reviewed available data from Xyologic, iTunes and Google Play.  However, data was primarily sourced from Xyologic, because, in our opinion, it offered a more comprehensive data set relative to the parameters of this particular study.  It is important to note that this study and its sponsors by no means endorse or have been paid by Xyologic.

We looked at health related mobile applications categorized under “Medical” and “Health and Fitness” for both Android and the iPhone. Because there are thousands of applications, we decided to focus on the top 150 Android and the top 150 iPhone mHealth applications downloaded in the United States only.

Data acquisition was done within a period of two weeks, to better provide a consistent comparison among download numbers. We approached our study as any user who may actively search for health related apps.  Searches were conducted by search term “top [health/medical] apps,” since this wording yielded more top ranking applications than other attempted searches, including “top ranking [health/medical] apps,” “best [health/ medical] apps,” “[health/medical] apps by download,” among others.

Although Xyologic tells the total number of downloads of applications across sectors including healthcare, we could not obtain the top 150 apps across all sectors in order to compare the top 150 healthcare app downloads against the total universe. Nonetheless, we have been able to obtain the total app download number which we think gives us some perspective on how mobile health apps are faring with respect to downloads.

While some iOS applications may work on the iPad, we specifically studied downloaded mHealth application data for the iPhone only. This study looked at the top 150 healthcare apps within the totals across the aforementioned platforms (a total of 300 apps – 150 for the iPhone and 150 for Android).

Data Sources

This study relied on data from Xyologic.com.

Xyologic as a Source and Its Limitations

Xyologic.com was used as a primary source for download information and although they do not publish their formula for determining application download rank, it is closely tied to the number of downloads per month, price and the publisher’s other successful applications.

We focused primarily on the number of downloads as a factor for inclusion, including:

  1. Number of (US only) downloads since an application was released
  2. Category (e.g. exercise, nutrition, reference, etc.)
  3. Subcategory when applicable
  4. Cost if any
  5. iPhone and/or Android Market

In correspondence about the origin of its statistics, Xyologic.com told us: “We daily scrub Google’s and Apple’s app stores, most of the information is obtained this way. Download numbers are statistically estimated from the public app store’s data and our private database of real download values.”

General Limitations

Within the app categories, there was some overlap. The following categories included apps that overlapped:

1.“Reference” and “Medication”
2.“Sleep and Meditation” and “Mystical”
3.“Weight Loss” and “Nutrition”
4. “Tools and Instruments” and “Medical History, Tracker”
5. “Tools and Instruments” and “Reference”
6. “Reference” and “Emergency”

Key Findings

1. Medical applications, such as Emergency, Medication and especially Reference, were downloaded more by Android users than by iPhone users.  There were also a greater number of such applications available for Android. Reference applications, for example, were downloaded ten times more by Android consumers than by iPhone consumers.

2. Android consumers were more likely than iPhone consumers to download a Weight Loss application in March, but total download numbers showed the reverse. (See “Category Total Downloads.”)

3. There were more top Sleep and Meditation applications available to iPhone consumers than Android’s, (See “Number of Apps by Category”).

4. When total download numbers are considered, (“Category Total Downloads”) Weight Loss and Exercise comprise 60%. When removed from consideration, the following are the top six categories, in order:

a. Women’s Health
b. Sleep and Meditation
c. Pregnancy
d. Tools and Instruments
e. Reference
f. Emergency

5. Top grossing applications for both Android and iPhone were Exercise, Weight Loss, Sleep and Meditation and Women’s Health. However, the Android market’s top grossing applications were, in order, Reference, Exercise, Weight Loss, Tools and Instruments and Sleep and Meditation.

6. Downloads for paid applications were 7 times higher for iPhone applications than for Android applications.

 

MHealth Apps on the iPhone Dominate Android

The top 150 mHealth apps on iPhone far outpaced downloads of the top 150 mHealth apps on Android.

 

Chart 1: Top 150 mHealth Applications By Platform. N=300

 

Platforms and Low Acquisition of Device Costs Driving Growth

Be it Android, Apple (iOS: iPhone & iPad), or Google Play the potent proliferation of these devices have become the springboard to the growth of mHealth applications market.  Healthcare, already high on the list of search categories in the United States, will surely translate to mobile web applications.  But the question remains, how?  According to the Pew Research Center’s most recent study, “Nearly half (46%) of American adults are smartphone owners as of February 2012, an increase of 11 percentage points over the 35% of Americans who owned a smartphone” in May of 2011. The Pew study seems to corroborate the trend found in Nielsen’s Q3, 2011 study which showed that feature phones held a 57% market share, while smartphone penetration was at 43%.

We surmise that the lower cost of smartphones and tablets will naturally spur growth in the sale of these platforms and provide more fertile ground for growth of the mobile applications market including healthcare related applications.

The promise of the 4G era will take our new interconnectedness beyond just the social aspect and mobility will ultimately lead the way.  According to the Deloitte Research Open Mobile Survey 2011-2012, the healthcare sector is “thought to be the most promising new mobile growth channel…Seventy-eight percent (of study respondents) stated that the healthcare/life sciences sector held the most potential.”

Robust Downloads of Healthcare Applications

While “Angry Birds” it is not, mHealth mobile applications, as a genre, appear to be downloaded at a furious pace. Like the rest of the applications landscape there are “free” apps and “paid” apps in the mHealth space.

Weight Loss Is the Heavy:  Weight Loss Apps Dominate By Far

We found of the top 150 apps across iPhone and Android platforms, mHealth applications related to weight loss and exercise far outpaced other healthcare applications.  Of the top five apps for iPhone and Android, “Lose It” and “Calorie Counter & Diet” combined for over 24 million downloads (12,400,000 and 11,700,000 respectively).  The top 5 is rounded by “Pregnancy Tracker” at just over 2.5 million downloads, a running app “IMAPMYRUN” at 2.4 million downloads and “Period Tracker Lite” at just over 2.2 million downloads.

Chart 2: Top Five Downloaded mHealth Apps: iPhone & Android

 

For the iPhone, weight loss continues to dominate with “Lose It” with almost 12.5 million downloads as the number one downloaded app in the Top 150 followed by “Calorie Counter & Diet Tracker” at almost 12 million downloads. “Pregnancy Tracker” follows in third place with just over 2.5 million downloads, closely followed by “IMAPMYRUN” at 2.4 million downloads, and rounding out the Top 5 most downloaded mHealth apps is “Period Tracker Lite” with just over 2.2 million downloads.

Chart 3: Top Five iPhone mHealth Apps: n = 150

Of the top 5 Android apps, three of the top five are weight loss related apps led by “Calorie Counter MyFitnessPal” at 8.5 million downloads, “Calorie Counter – FastSecret” at just over 4.3 million downloads and “Alarm Clock Plus” at just over 3.6 million downloads (we included this app as part of the healthcare genre because we considered it a sleep related application). These are followed by “Instant Heart Rate” at just over 3 million downloads and “Noom Weight Loss Coach” which rounds out the top 5 with 2.8 million downloads.

Chart 4: Top Five Android mHealth Apps: n = 150

Exercise Leads in Category

Exercise is the leading category across both iPhone and Android.  Exercise is ahead by almost three to one.  Exercise leads the field with 102 apps or 34% of the top 150 apps on both iPhone and Android. Exercise is followed by reference (34 or 11%), Weight Loss (31 or 10%), Sleep and Meditation (26 or 9%), Women’s Health (21 or 7%), Tools and Instruments (19 or 6%), Medication (15 or 5%), Pregnancy (14 or 5%), while ‘Other” which encompasses disparate and various health applications comes in at 38 or 13%.

Chart 5: Number of mHealth Apps By Category: iPhone & Android. N = 300

Chart 6: Percentage of mHealth Apps by Category: iPhone& Android. N = 300

Healthcare App Categories by Platform: iPhone

Exercise is the leading app category for iPhones by a wide margin. The number of exercise apps is three times the next nearest category, Sleep and Meditation. There are 58 apps in the “Exercise” category making up 39% of the top 150 apps followed by “Sleep & Meditation” apps at 16 or 11%.  “Weight Loss” apps represent 9% of the total with 14 apps, followed by “Women’s Health” apps with 11 or 7% and “Pregnancy” (9 or 6%).  “Nutrition” and “Tools and Instruments” were found to have 8 apps out the total, each respectively representing 5%, followed closely by “Medication” with 7, also at 5%, while 19 or 13% of various healthcare apps in the top 150 are placed in the category of “Other” on the iOS platform.

Chart 7: Number of iPhone mHealth Apps by Category: n = 150

 

Chart 8: Percentage of iPhone mHealth Apps by Category: n = 150

 

 

Healthcare App Categories by Platform: Android

Not unexpectedly, on the Android Market, “Exercise” leads the way with 44 apps taking a 29% share of the top of 150 healthcare apps through March 31, 2012. It is followed by “Reference” with 28 or 19%, then by “Weight Loss” with 17 apps or 11%, then “Tools & Instruments” at 11 or 7%. We found 10 “Sleep & Meditation” and “Women’s Health” apps respectively with each taking a 7% share of the top 150 apps on the Android market, followed by “Medication” with 8 or 5%.  We found 22 various apps that we were unable to categorize with a coherent medical or healthcare related label, similar to what we discovered for iPhone.

Chart 9: Number of Android Apps by Category. N = 150

Chart 10: Percentage of Android Apps by Category. N = 150

Weight Loss is the Heavy: Category Dominates Total Number of Downloads on iPhone & Android

With almost 50 million downloads through March 31, 2012, “Weight Loss” apps clearly dominate the field outpacing the next category by almost 2 to 1.  “Exercise” follows “Weight Loss” with almost 26.5 million (21%) downloads, followed by “Women’s Health” at almost 10.5 million (8%) downloads.  We found just over 8.1 million (6%) “Sleep and Meditation” apps were downloaded while just under 7.5 million (6%) “Pregnancy” apps were downloaded during the same timeframe. Just over 6 million (5%) healthcare or medical “Tools and Instruments” were downloaded, while approximately 18.3 million (14%) “Other” healthcare apps within the top 150 apps were downloaded.

Chart 11: Number of Downloads by Category: iPhone & Android

Chart 12: Percentage of Downloads By Category: iPhone & Android

Weight Loss Category is Tops on iPhone

The category “Weight Loss” leads the way on iPhone with almost 31.5 million downloads which accounts for 46% of the top 150 healthcare apps downloaded from iPhone, nearly three times as many as the next category, “Exercise” which followed with almost 11 million or 16%.  “Women’s Heath” tracks third on iPhone with over 7.3 or 11% million while “Pregnancy” followed at almost 5 million downloads or 7%. Almost 4.5 million “Sleep & Meditation” apps were downloaded, or 7% of the total healthcare apps downloaded.  Just over 8.5 million healthcare apps fell into the “Other” category.

Chart 13: Number of iPhone Downloads By Category

Chart 14: Number of iPhone Downloads By Category

Weight Loss Is Tops on Android Too

It appears that “Weight Loss” as a category doesn’t have that much more day light between it and the following category “Exercise” relative to its peer on iPhone.  “Weight Loss” apps were downloaded just over 18.5 million times or 31% of the total number of apps downloaded in the top 150 healthcare apps.  It is closely followed by “Exercise” at almost 15.5 million downloads or 26%.  Healthcare or medical “Tools & Instruments” were downloaded just over 4.7 million (8%) times, while “Reference” and “Sleep & Meditation” were downloaded just over 4.3 million (7%) and 3.7 million (6%)  times respectively.  “Emergency” healthcare apps were downloaded just over 3.1 million times and represent 5% of the total number of downloads in the top 150 healthcare applications on the Android market, while “Women’s Health” applications were downloaded  just over 3 million (5%)  times and just over  6.1 million (10%) applications were downloaded that fell into the “Other” category.

Chart 15: Number of Android Downloads by Category

Chart 16: Percentage of Android Downloads by Category

The Business of Free and Paid mHealth Apps

There are free and paid apps in the “apposphere” and the same, of course, holds true for mHealth applications.  Of the top 150 mHealth apps across iPhone and Android, we found that people indeed paid for healthcare apps.  Prices range from $.99 to $7.99 in the top 150 mHealth apps.  The top five paid apps across iPhone and Android closely mirror the top five in the total universe studies. Naturally, “Exercise” led the way with just under 2.2 million paid downloads, a narrow lead over “Sleep & Meditation” with just over 2.1 million paid downloads, followed by “Weight Loss” with just under 1.8 million paid downloads, with “Women’s Health” trailing with just under 1 million paid downloads while “Other” representing a multitude of paid mHealth apps were downloaded just under 2 million times.

Chart 17: Paid App Downloads by Category, Android & iPhone

Paid Apps by Platform

On iPhone, just over 2 million “Sleep and Meditation” applications were paid for, followed by “Exercise” at just over 1.8 million and “Weight Loss” with almost 1.6 million.  “Women’s Health” paid apps were downloaded just over 800,000 times.  There were just over 1.6 million downloads for “Other,” representing a variety of health apps.   It is interesting to note that downloads for paid applications were 7 times higher for iPhone applications than for Android applications.

Chart 18: Paid iPhone App Downloads by Category

Paid apps on the Android devices were downloaded much less than for iPhone. Since we wanted to cover as many categories as possible, we looked at eight categories instead of five.  “Exercise” leads the way with just under 350,000 with “Weight Loss” a distant second at just over 200,000 paid downloads.  “Tools and Instruments” paid apps were downloaded just over 111,000 times, followed closely by “Sleep and Meditation” at just under 110,000 times.  A significant drop off from there to about 66,000 paid downloads for “Reference” with “Women’s Health” following at 57,600, “Emergency” at almost 50,000 followed by a compilation of paid mHealth apps that we categorized under “Other” with almost 90,000 downloads.

Chart 19: Paid Android App Downloads by Category

What We Know. What We Don’t Know.

It is important to note that companies like Nike and others are leading the way with connected gadgets like the FuelBand that allow users to wear a wrist band and measure how active a user may be during the day and delivers that data through a Nike FuelBand app. According to Wired.com (January 20, 2012), the real value in FuelBand could be in “helping you manage and track activities over time to achieve fitness and weight-loss goals.” How people respond to the feedback they receive from the app and what they do about it is, of course, unknown.  Mayo Clinic has developed an app for the iPad that allows patients to learn about recovery after heart surgery, access their plan of care and ask questions about their progress. This information is then transferred through the app to the patient’s healthcare team for monitoring and response.

We know that the mobile market will continue to grow and by every measure it is anticipated to surpass the desktop market.  We also know that healthcare applications are being downloaded at a brisk pace, though in this study we only looked at the top 150 healthcare applications across two platforms (iPhone and Android).  What we don’t know is how and if these mHealth apps are being used and to what extent. We don’t know if these applications are having a positive impact on the user’s healthcare as and if intended by the app itself.

Conclusion

Weight loss and exercise dominate the top 150 mHealth apps across  iPhone and Android.  Free apps dominate relative to paid applications, but since we do not have access to usage information it is not possible to determine if paid apps are used more than free apps or vice versa.  What is clear is that there is no shortage of consumer healthcare applications.  Yet,  download data is insufficient to determine whether people are actually using each app for its intended purpose and actually receiving a health benefit.

As mobile devices and networks continue to grow, it is reasonable to state that consumers will drive the mHealth market. Further, as mHealth continues to be adopted, it could present new ways of reaching consumers / patients via the app market, though we are still uncertain what impact any of these mHealth apps are having on improving the health status of those using them because there is no significant data available to us at this time that addresses the subject, and certainly, it’s very early in the game.

This exercise has also shed light on the fact that the most downloaded mHealth apps are not those that allow people to monitor their heart rate and send it to their cardiologists within seconds.  The most popular downloaded apps are weight and exercise related.  Our findings here seem to ring true with experts in the field like Francis Collins whose said in her article “The Real Promise of Mobile Health Apps” in American Scientific (July 10, 2012), that the most popular mHealth apps downloaded “pale next to the potential mHealth to aid in medical research and health care.”

As we have stated earlier, we believe that we are still early in the mobile health applications game.  The potential for mHealth will be encumbered only by our imagination and our ability to be compliant with the requirements of the technology and processes of the various mHealth applications.  At the risk of overstating the obvious, more data and research is needed about how people are using mHealth applications, because ultimately, the technology is already there. This begs the question, will we adjust our behavior as people and patients to allow the technology to do its intended job?

Acknowledgements
Abe Kasbo, Research Director
Rachel McLaughlin, Research Associate
Christine Falco, Editor
Sasha Idriss, Associate Editor
Edith Moczarska, Graphic Designer