Digital solutions for multiple chronic conditions management: What are the strategies to develop a successful one-stop shop app for the complete patient care?

Millions of patients worldwide suffer from more than one chronic condition and struggle with the necessity to use several narrowly focused apps to manage their health. Creating a successful app-based solution to provide complete patient care is one of the key challenges for digital health developers today. Although some of them attempt to deal with several conditions simultaneously from the very beginning, becoming an established player within single disease management and expanding into other diseases later seems to be the prevalent and more effective strategy.

 

The main goal of developers of mobile apps for chronic conditions prevention and management is to achieve a reduction of the associated healthcare costs for these patients by decreasing risks of hospitalization and emergence of various disease complications. These digital health solutions empower users to manage their health on their own by introducing relevant lifestyle improvements and changing behavioral patterns, as well as enabling healthcare professionals to adjust treatment and monitor their at-risk population.

It is scientifically proven that the factors contributing to the development of some of the chronic conditions are strongly interconnected, which means that there is a high probability of one patient having to deal with more than one chronic disease at the same time. It means that there is a demand for a universal one-stop shop solution allowing to take care of all the patient’s needs, rather than covering only one of their conditions.

Nowadays, a typical disease management solution in the mobile app market is designed with only one key condition in mind. There are only a few companies offering more complex care and providing an app with functions suitable for several conditions. However, expanding into multiple chronic conditions seems to be a promising vector of development, with some of the prominent disease management players keeping introducing new elements of their care ecosystems, and with other digital healthcare companies having this expansion on their roadmaps. In particular, Erez Raphael, CEO at one of the top digital diabetes management care companies – DarioHealth, in his interview with Research2Guidance, confirmed his team’s intention to incorporate other chronic conditions into their existing platform.

A closer look at the market demonstrated which strategies are being deployed to introduce one-stop shop mobile application for multiple chronic conditions management, in what way it can be beneficial for its developers and what are the challenges they are facing.

Two main strategies to introduce a single app for multiple conditions
To identify the ways how digital healthcare companies enter the sector of multiple conditions management, we are going to look closer at the example of diabetes, obesity, cardiovascular diseases and hypertension. Patient bases of these four conditions overlap since they have several common behavioral factors contributing to the risk of disease occurrence and complications. Those are, namely, unhealthy diet, lifestyle lacking an adequate amount of physical activity and excessive alcohol consumption.

Digital-solutions-for-multiple-chronic-conditions-management

The four conditions vary significantly both in terms of number of patients suffering worldwide and associated digital health market potential. As revealed in the Research2Guidance mHealth App Developer Economics study 2017, hypertension and cardiovascular disease have the largest patients base (1.1b and 1b respectively) and provide the lowest monetization prospects at the same time. Obesity is a moderately widespread condition with 600m sufferers and moderate market potential. As for the diabetes care market, it is the most developed and advanced of all four. Despite the lowest number of sufferers of only 424M, it has the largest base of patients engaged in the digital care programs and the highest associated revenues.

Generally, there are two ways of entering the market for multiple chronic conditions management: by deploying “all-at-once” or “one-by-one” strategies. The strategy choice would heavily depend on the type and sophistication level of the solution offered, company’s resources and potential competitive advantage. As the evidence shows, usually there is a correlation between the kind of entry strategy chosen and the final digital product’s quality.

“All-at-once” strategy: In the case of “all-at-once” strategy deployment developers start from the middle of the ecosystem by targeting several conditions from the very beginning. They perform the product development, initial launch and distribution with the wider audience in mind.

As a rule, digital offerings developed in an “all-at-once” way tend to be more generic: publishers’ aspiration to make their apps more universal and fit the needs of patients with various diseases result in simplistic logbook-type mobile applications. They would allow tracking and aggregating a wide range of symptoms and health datapoints but in some cases they may have a limited medical device connectivity and lack of diseases-specific details. Moreover, “all-at-once” approach limits the possibilities of remote coaching and monitoring services integration, creating obstacles for successful app monetization. In addition, such solutions struggle to gain visibility among very similar and hardly distinguishable apps and rarely achieve substantial number of downloads and active users. On average, their monthly downloads number does not exceed 100 (per single iOS or Android app).

Yet, some companies manage to develop a comprehensive mobile solution for multiple conditions management. For instance, Tactio Health offers a connected mobile app to support chronic conditions management for obesity, hypertension, diabetes, atherosclerosis, COPD and CHF, while syncing the collected health data with their telehealth platform to enable HCPs to monitor their patient population and provide coaching.

“One-by-one” strategy: The second way one-stop shop solutions for multiple chronic diseases management emerge in the market is through a gradual expansion from one disease to others. For the conditions under discussion, the most popular and strategically advantageous entry points are diabetes care and obesity. These segments are more established in terms of disease management standards and demonstrated outcomes of mHealth interventions.

The “one-by-one” strategy is widely popular among prominent mobile healthcare market players and the year 2018 has been very fruitful in this regard. For example:

  • Livongo Health, one of the leading digital management and coaching platforms for pre-diabetes and diabetes in the US, introduced integration of hypertension into their care ecosystem after slightly more than 3 years after the platform’s launch in September 2014.
  • Omada Health, digital behavioral change program specializing in weight loss and obesity-related chronic conditions prevention, announced new coaching programs for Type 2 Diabetes and Hypertension self-management in June 2018.
  • Welldoc, the company behind Bluestar digital diabetes management solution, also enriched their offering with hypertension and weight loss features. The company plans to launch hypertension management system as an independent solution later in 2018.
  • Hello Heart, in contrast, started with cardiovascular diseases, heart rate and hypertension management, adding diabetes management and activity tracking to its mobile app in May 2018.

 

Benefits and challenges of publishing one-stop shop solution
These are the six main reasons why the development of a mobile app and a platform to address several chronic conditions is so attractive for mHealth companies:

  1. Complete care. In contrast to taking care of only one dimension of a patient’s health, such an application allows to replace all the other apps and become the ultimate health management solution.
  2. Enhanced outcomes. Taking care of a wider range of common interconnected risk factors for various chronic conditions can enhance the user’s improvements.
  3. Higher usage. One-stop shop app incorporates more functions and replaces other solutions, resulting in higher frequency of usage and the time spent within the app.
  4. Wider userbase. By including several conditions and offering flexible chronic conditions management formats, publishers are targeting a wider audience.
  5. Increased B2B partnerships monetization. When a company already has an established potential userbase within B2B partnerships, expanding into additional diseases can allow to easily reach another layer of population.
  6. Similar elements of disease management. Since some chronic diseases are similar in terms of underlying factors and key condition management elements, solutions can be relatively easily adapted to fit the needs of other patients.

 

On the other hand, development of such universal application may be linked to some challenges as well:

  1. Functionality overload. User retention rates for chronic conditions management apps demonstrate high dependence on the app’s interface. Users prefer easy and intuitive solutions, not requiring large number of data inputs. It means that adding more functions and logging options creates a risk of overloading the mobile application and making it too cumbersome and time consuming to use.
  2. Quality loss. While developing a single solution for multiple use cases, it is easy to overlook some of the minor yet imperative elements in individual chronic condition’s care. Even when not overlooked, some of the app features have to be excluded in order to make the final solution usable for its potential audience.

 

As can be observed from the digital health market developments, the highest quality of app-based solutions for multiple chronic conditions management is usually reached by the companies with established reputation and successful product for a single disease. Starting from a narrower field with higher market potential and moving into additional conditions allows to make the most out of the potential benefits of one-stop shop app introduction, while being more equipped to deal with the associated challenges.

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