Only 7 % of mHealth app portfolios have more than 50,000 monthly active users – Best mHealth user retention concepts

User retention for digital healthcare solutions is still a major issue. Only 7% of digital health app portfolios count more than 50,000 active users. Connecting to a HCP is seen as the most effective retention approach by digital health market players.  

New data from mHealth Developer Economics research reveals that user retention for digital health solutions is still a challenge for the majority of the digital health app publishers.


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62% of digital health app publishers report digital solutions with less than 1,000 monthly active users (MAUs). These healthcare apps are not meeting the needs and expectations of the users, nor the market potential. For example, more than 1 billion people in the world suffer from chronic respiratory diseases, yet far less than 1% of the addressable target group use mobile health apps.

Another 21% of the digital health market players report less than 10,000 MAUs. (An active user is defined as an app user who has used the app at least once a month.) These publishers also have a long way to go for their digital solutions to become daily companion for their targeted patient.

A closer look at the mobile health market shows that some progress has been made. 7% of mobile health solutions were able to reach substantial market penetration and their publishers report more than 50,000 monthly active users. Companies in this group mainly publish solutions for running, exercise, diabetes, women’s health or weight loss.

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User retention: Which concepts work best for mHealth apps?

mHealth publishers know that to become a daily companion, mobile health apps must be individualized, easy to work with and offer real value to their users. Having a good share of active users offers them more business opportunities.

To drive MAUs, re-engage and retain users, these mHealth app publishers use a variety of approaches that range from reminders, personalized feedback, digital coaching and interactions with doctors, relevant educational content and dashboards. Some of these features provide the simplest and most effective means to user retention, others are not seen valuable by mHealth app publishers.

The two parameters that digital solutions publishers need to look at when evaluating different features for increasing MAUs numbers are: the impact that feature is having on MAUs and the level of difficulty when implementing.

Generally, there are 4 user retention categories that will have a different impact on driving MAUs. Let’s take a closer look at them:

1.Higher Impact & Easy Implementation

Dashboards are seen by the majority of the mHealth experts (60%) as the simplest and most effective feature to implement in driving behavior change and re-engaging with users, followed by personal reminders (49%).

2.Higher Impact & Harder Implementation

Allowing the user to directly interact with doctors – e.g., sharing weekly test results and receiving feedback via the app, is seen as the approach that has the highest impact on behavior change and user retention but is the most difficult to implement.

Companies like ONE DROP add another layer to the HCP / coaching connection. The company drives user retention based on a daily curriculum. The program supports daily interactions between the HCP / coaching and the user. (To learn more about digital coaching services, read “What are the six success factors of best in class digital enabled health coaching services?”)

3.Lower Impact & Harder Implementation

Gamification has a lower impact on user retention in Healthcare. Currently, 28% of mHealth app publishers include gamification approaches into their apps. Leadership boards or badges might increase user retention for fitness apps but are difficult to integrate within most other medical condition apps. Few exceptions exist: The MySugr monster feature has most likely contributed to the success of the app.

Offering financial incentives to support habit changes and increase user engagement with an app is another approach. Direct financial rewards and / or reducing deductibles within health plans are being offered, for example, in return for staying active, like going to the gym or executing a step challenge. However, the current impact of financial incentives is perceived to be limited and difficult to implement by most of the mHealth market players. Therefore, only 20% of mHealth app publishers are using financial incentives within their app portfolio.

4.Lower Impact & Easy Implementation

Social monitoring, e.g. sharing blood pressure results on social networks, is something that might work in other app categories as well as for app promotion, but it is considerably seen as having little impact on user retention according to 20% of mHealth app publishers.

Despite the low popularity among app publishers, peer groups (the managed or non-managed) have shown initial success in driving app usage. The ability to exchange directly with peers is creating incentives for mobile health app usage and for revisiting the app.

For example, OnePath (the UK based behavior change app service) is placing all the users into groups of around 20 peers letting them exchange tips, obtain information or just cheer each other, thus encouraging user engagement.

Mobile health apps can play an invaluable role in assisting people to manage their medical conditions. The share of the monthly active users and their engagement with the app are critical for driving revenue. Today, adding “personal touch” via coaching, services, peer group chatting, or remote HCP monitoring seems to be the preferred user retention approach by the mHealth market players.

Thank you for reading it. Your feedback and comments are highly welcomed.

To learn more about developing and monetizing mobile health apps:

– Download numbers of mHealth apps
– Monthly active user numbers
– Best marketing channels for healthcare apps
– Best business model and business model with highest revenues
– Costs for development and marketing for an mHealth apps
– Development time

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