Study produced by Apadmi Enterprise, a leading mobile application and technology developer | September 2016

How can mobile application technology change the way patients engage with healthcare organisations?

Hello and welcome to ApadmiEnterprise’s mobile healthcare report.My name is Matt Hunt and I’m the CEO of Apadmi Enterprise, a leading mobile application and technology developer. We work with businesses of all sizes, to help them transform the way they work through the innovative use of mobile and smart technology.

Many businesses are realising the

power of mobile technology, how it can

transform the way the organisation

works and also the way it can

engage with its customers. Termed

‘enterprise apps’, the market is growing

considerably and Gartner* predicts

that demand for enterprise mobile apps

will outstrip available development

capacity five to one by the end of 2017.

I have been involved in mobile

application development for over 15

years and I have experienced first hand

the evolving trends in both technology

and the applications of technology.

Mobile apps were initially driven

by consumers who discovered the

appeal of news apps, email, messaging,

Facebook, Twitter and mobile gaming.

Fast forward to today, and businesses

are slowly catching up and starting

to see the potential power of mobile

application technology. It is no longer

the reserve of the consumer. Take the

health sector, for example. Mobile

applications are starting to change

the way patients engage with health

professionals and how care is being

delivered and received.

We have been engaging with the NHS

for over a year now on a joint project to

develop a mobile application solution

that improves the way specialist

nurses can collect and manage patient

information. The ultimate goal is to free

up the nurses to allow them to spend

more time focusing on the patients

and their families. This has given us a

strong insight in to delivering mobile

application technology within healthcare

and opened up our eyes to the potential

improvements that can be made.

With this in mind, we have conducted a

patient study and developed this report

to give healthcare professionals valuable

insight into what patients want and

expect from mobile technology in the

healthcare sector.

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Matt HuntCEO, Apadmi Enterprise

*Gartner, June 2015

Executive summaryOur study highlighted the key areas where patients feel mobile application

technology can improve the way hospitals communicate and engage with them.

Below are the key findings:

At present there are a number

of concerns with how hospitals

communicate and engage with

their patients. The biggest bugbear

that patients have with hospitals

is around the lack of information

available about parking.

59%

Other bugbears point to a lack of

technology and communication that

could help to improve processes, for

example when referral times are too

long between seeing a GP and getting

a hospital appointment.

36%

Also patients said there was a lack of

communication between the different

departments in a hospital (29%), and

patients think it’s annoying that they

have to recite their medical history to different members of staff (23%).

Another flaw in communication and

technology efforts between hospitals

and patients is that patients don’t feel

they receive regular enough updates

when they are in hospital (17%).

55%of patients admit they have never used

mobile app technology to engage with the

NHS ahead of, or during a hospital visit.

89%

However, a staggering

89% of people stated

they would use a mobile

app if it improved the

NHS service and made

their experience with

the hospital better.

A quarter of those that have actually

used mobile technology in hospitals

have used it to receive general hospital information, for example

25% finding out where a

hospital is located

20% managing their

appointment

Patients would favour

mobile apps that helped

them to manage their hospital appointment.

76% 76%

Being able to easily

access their own

healthcare records is

another top function

that patients feel that

mobile apps could serve.

Healthcare organisations need to consider

other barriers to adoption, such as data

privacy issues, which ranked the top concern

(69%), security issues (64%) and the fact

that 75% of patients prefer face-to-face

communication over engaging with an app.

Patient empowerment

is also key and 43% of

patients would want

hospitals to invest in mobile

app technology that helps

them to manage their own illness/condition.43%

When it comes to what patients do not want from a healthcare app, a third

of people said they would not feel comfortable discussing sexual health issues

on an app, and a fifth would not be happy reviewing gynaecological issues.

one third one fifthwould not feel comfortable

discussing sexual health issueswould not be happy reviewing gynaecological issues

In 2014, the NHS set out its five year

vision to help improve patient care

stating that it will put money into new

choices for its workforce, and improve

health technology – so that patients’

experience of working together with

the NHS is much better. Then in

February this year, the government

announced its latest drive to digitalise

the NHS. The aim is to move towards

So with smartphones, connected

medical accessories and apps starting

to be utilised by the healthcare industry,

we wanted to undertake research to find

out how patients feel about the mobile

technology currently being used in the

healthcare industry. This includes how

healthcare organisations communicate

with patients, and what patients would

like to see in the future.

The research was conducted with

1,000 NHS patients and looked into

the experience they currently have

when using mobile technology to

engage with hospitals. It also explored

the mobile technology that patients

would be happy to engage with if it made

their experience with hospitals better,

whether opinions on this technology

varies by different demographics, and

the ways that mobile technology could

improve the relationships between a

hospital and its patients.

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a ‘paperless’ healthcare service that

improves processes and transparency

for both patients and NHS staff, as well

as boost the use of technology to make

patients’ lives more convenient.

More recently, Jeremy Hunt has

unveiled a number of pledges to help the

public access healthcare online. One of

the plans is for the 111 service to deliver

Specifically, we wanted to look at how mobile technology can improve engagement with patients in hospitals.

Digitalising the NHSits services via smartphones so patients

can key in their symptoms and receive

instant advice from professionals.

There have already been numerous

studies that highlight how technology

within the healthcare industry will help

to improve patient outcomes, and the

efficiency and effectiveness of the way

organisations within the sector operate.

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How well do hospitals engage with their patients?First of all, we wanted to find out what patients’ biggest bugbears are with hospitals to discover where improvements could potentially be made with the use of mobile technology.

Having to wait longer than expected is

one of the biggest gripes for patients.

The majority (59%) said they felt

annoyed when they had to wait longer

than expected for an appointment

because hospital staff were running late.

46% also disliked the waiting times to

actually book a hospital appointment,

and a fifth thought it took too long

to be discharged by the hospital.

36% also said referral times between

seeing their GP and getting a hospital

appointment were frustrating.

Poor communication was also cited as

another bugbear for patients. 29% said

a lack of communication between the

different hospital departments was a

problem, a quarter said they tended

to have different consultants every

time they visited a hospital, making

for an inconsistent visit, and 23% said

a concern was having to recite their

medical history to different members

of staff. In addition, 17% said they did

not receive enough updates when they

or a relative were in hospital.

59% waiting longer than expected

46% waiting times to book an appointment

36% referral times too long

29% lack of communication between departments

25% different consultants every visit

23% reciting medical history to staff

20% taking too long to be discharged

17% not receiving enough updates

Common patient frustrations

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We also wanted to find out whether

patients are currently using mobile

technology to engage with hospitals.

Over half (55%) said they have never

used mobile app technology ahead

of, or during an NHS hospital visit.

When the patients who have used

mobile technology to engage with the

NHS in the past were asked to rate their

experience, 11% said it was very good,

23% said good, 12% said it was average,

4% admitted it was poor and could be

improved, and only 1% claimed it was

very poor and could be improved greatly.

And it seems the older generation are

among the less likely to have utilised

healthcare mobile tech. The research

found that 61% of people aged 65+

have never used mobile app technology

around a hospital visit, and 63% of 55-

64 year olds have not either.

Of the 45% that have used mobile app technology ahead of, or during an NHS hospital visit;

25%

said they used it to receive general

hospital information, for example,

finding out where the hospital is located

have used mobile tech to

manage their appointment

have used it to manage

their prescriptions

to update personal information to manage their own illness

7%

have accessed their health

records via a mobile app

have had a virtual consultancy

What this shows is that mobile app technology is still in its infancy in hospitals and much more can be done to improve patient outcomes and participation.

20% 12%

12% 12%

3%

1%very poor

4%poor

12%average

23%good

11%very good

What do patients want?So what exactly do patients want from

healthcare providers in terms of mobile

application technology? Would they

want to use this type of tech to have

a better engagement experience with

their local hospitals?

The good news is that 89% of people

said they would use a mobile app if it

improved the healthcare service and

made their experience with the hospital

better. They would also be more likely to

use an app if it was free of charge.

Healthcare is definitely behind in

comparison to other industries that are

already using apps to improve processes

such as making payments, or tracking

deliveries. But patients already experience

the benefit of this type of technology and

naturally expect to be able to have a

similar experience in healthcare.

As such many patients would want

an app that helps them to better

manage their healthcare and improve

communication between themselves

and healthcare professionals. However

in terms of functionality, they are not

looking for cutting edge requirements –

they would just like the basics.

The overwhelming majority of

patients (76%) would want a mobile

app that helped them to manage

hospital appointments – be that

booking an appointment, cancelling an

appointment, receiving notifications

from the hospital regarding an

appointment being cancelled or

changed, or confirming an appointment.

66% would use a mobile app if it

provided general hospital information,

such as finding out where a hospital

is located, or information regarding

parking, for instance, and 60% would

be happy to update their personal

information using one. But education

and information just scratch the surface

of what mobile health can achieve.

Managing prescriptions was a more

elaborate function that rated highly with

patients. Over half (55%) said they would

use an app to purchase a prescription,

order a repeat prescription, or even

receive notifications about picking up

their prescription.

45% would want to use an app to easily

access their healthcare records and

it’s been widely deliberated that using

mobile tech to provide greater patient

access to medical information could

dramatically improve health outcomes,

as it allows people to make better

decisions about their health.

Technology that empowers patients

with regards to their own healthcare

is also another key consideration. 43%

of respondents said they would want to

use an app that helped them to manage

their own illness - such as tracking their

medications, or keeping a food diary,

for instance.

76%manage hospital appointments

66%general hospital information

55%purchase a prescription

45%access healthcare records

60%update personal information

43%manage own illness

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Despite wanting to communicate better

with hospitals, some patients may

feel uncomfortable discussing certain

healthcare issues. Therefore we wanted

to find out if there were any healthcare

conditions that they would not feel

comfortable discussing via technology.

The results can be found below:

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Bearing these results in mind, health

providers will need to consider how they

engage with patients on more sensitive

issues, such as sexual and mental

health, and whether an app would be

appropriate for these matters.

Sexual health issues (e.g. reproductive

problems, contraception, STIs)

Mental health issues (e.g. depression,

bipolar)

Gynaecological (e.g. issues to do with

uterus)

Muscular/skeletal problems (e.g.

bones, joints, muscles)

Chronic health problems (e.g. diabetes,

cancer)

Gastroenterological issues (e.g.

digestive, intestinal, IBS, IBD)

Common health issues (e.g. cough,

cold, or the flu)

Vascular/circulatory problems (e.g.

issues affecting the heart)

Allergies (e.g. hayfever, food

intolerances etc.)

Dermatological issues (e.g. skin

problems, rashes)

Travel health issues (e.g. travel

vaccinations, tropical diseases)

33% Sexualhealth issues

24% Mentalhealth issues

20% Gynaecological

20% Muscular/skeletal problems

15% Chronichealth problems

13% Gastroenterological issues

10% Vascular/circulatory problems

8% Allergies

8% Travelhealth issues

8% Dermatological issues

11% Commonhealth issues

What do hospitals need to bear in mind when adopting new technology?Whilst there are a lot of benefits associated with adopting mobile technology in

the healthcare sector, it is also important to consider some of the key barriers and

challenges preventing its adoption. So we asked patients what their key concerns

are around mobile technology in the healthcare sector.

They expressed concern about where

their healthcare and personal data

would go if it was available via mobile

app technology, who would be able to

access it, and whether the healthcare

organisation would ever sell it.

Security was the second highest concern

amongst users. Tech and data security

within the healthcare sector is of vast

importance, especially if vital and

confidential data of millions of patients

is made available on mobile for people

to access. In addition, if patients are able

The main concern amongst patients was that of data privacy (69%).

to use mobile technology to update or

store their own personal health data this

could also raise many security concerns.

As with most things on the Internet,

there is always the risk that mobile

technologies could be hacked, so

it’s important that this is a key

consideration before a mobile strategy

is implemented. There is a mounting

need to address the security concerns

amongst patients and healthcare

providers to ensure better safety and

security measures are in place.

Just over 1 in 3 patients (35%)

surveyed were concerned that the

technology may vary from hospital to

hospital, making for an inconsistent

experience, while a quarter stated they

would still prefer to talk to someone

face-to face about their healthcare,

rather than using a device.

13% were concerned that they might

not have the skills to be able to use

the technology effectively. This is

because some patients, especially the

elderly, might find it difficult to use

mobile technology. Some patients

may be hesitant in understanding new

technology and worry about getting

it wrong. This could greatly hinder

the adoption rate; so healthcare

organisations need to consider this when

creating a mobile first healthcare agenda.

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What lessons can be drawn from these findings?As highlighted by our research, the

majority of patients would be keen

to utilise mobile app technology that

improves engagement between them

and healthcare professionals. However,

organisations need to address patients’

concerns around sensitive information,

data and security to ensure that they

are offering a consistent solution that

patients would want to use.

Below we’ve put together a few insights that healthcare organisations should consider when it comes to developing mobile app technology:

Embrace strategic thinkingMobile app technology could really

mark a fundamental movement in

the healthcare industry. However, it’s

important that these apps have staying

power, so healthcare organisations

must ensure they do not jump on the

technology bandwagon just for the sake

of it, or because they are seen to be

doing the right thing. An investment in

technology requires all stakeholders

involved to embrace strategic thinking

and consider the purpose of such

technology within their organisation.

What will the deployment of the

technology achieve in the long-term?

What are its objectives? It’s important

to take a phased approach and define a

realistic and manageable development

roadmap. Often, even large

organisations benefit from external

expert consultancy to help stakeholders

adopt a strategic approach and ask all

the right questions before heading down

the development journey.

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Consider the needs of both patients and employeesWith the deployment of any mobile app

technology, it’s important to consider

the needs of your users - whether

that’s the patients or your healthcare

staff. Historically, many organisations

have been guilty of neglecting an app’s

design considerations.

However, to get the best out of the

technology and ensure it is widely

adopted and embraced by both patients

and employees over the long-term, the

app must be engaging, intuitive and

boast excellent user experience.

It can be very easy to over complicate

things when pushing the boundaries

of what’s possible but it’s vital to keep

in mind that your project can only

be successful if users are happy with

the end result – so put people first to

ensure a great user experience.

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Identify the correct technology and understand the full pictureSelecting the correct technology to

support your plans for within your

organisation can be a minefield. There

is a plethora of choice and plenty

of opinions on each, which often

provokes passionate debate within

the industry. Be sure to assess the

technology approach at the beginning,

taking advice from those with proven

experience working with the software

if needed. It’s important to review here

and not assume thinking native, hybrid,

cross platform or HTML5 is only the tip

of the iceberg.

It is likely that any app you develop

will integrate into an existing business

system and if not, will require one

building from scratch. In the case of

the former, it may be the case that

your system already provides a mature

environment for mobile integration.

However, the more likely scenario is

that some level of work will be required

to get the system to a state where it

supports mobility and delivers the end

points to allow the implementation

of mobility features. Understanding

this will help teams understand the

scope of the project and address all

the areas and key dependencies for a

fully comprehensive and connected

technology infrastructure.

Develop in the right wayMuch of this will come down to

the skills and experience of your

development team, whether that be

internal or external. In either case it

is imperative to ensure they adhere

to development best practices and

embrace the testing/quality assurance

process throughout, not just at the end.

This way, you’ll ensure your technology

gets a big tick mark for quality, doesn’t

deviate away from the intended plan

set at the beginning, and avoids costly

errors which are often only uncovered

at the end. If your intentions are to

select an external team to help you

develop your solution, ensure you

have done your due diligence – what is

their development experience? Do they

fully understand your requirements

and what is their delivery plan? For

large healthcare organisations it may

well be a mix of internal and external

teams working on your project.

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If this is the case, ensure roles and responsibilities are clearly defined and collaborative working is encouraged.

Consider security and data policiesWhat’s more, any healthcare

organisation should demonstrate it

is doing all it can to withstand the

growing threat of data theft. Mobiles

are inherently unsecure devices – they

fall out of pockets, are left in taxis and

get stolen. The implications of this are

that the device is an unsecure part

of the security chain and additional

requirements must be placed on

any mobile application dealing with

sensitive information.

It’s also important to communicate

the data and security policies

surrounding the technology to show

that all reasonable care has been

taken to prevent inappropriate access,

modification or manipulation of data

from taking place.

Technical and administrative safeguards should be put in place to ensure the mobile app technology and data is secure.

ConclusionMobile technology has huge potential to

transform the way healthcare is provided

and accessed in the UK - and across the

world. New apps and services will allow

healthcare professionals to better serve

their patients, as well as enable people to

be more proactive in managing their own

health and well-being.

This represents a huge step forward in the sector and with the ‘paperless’

scheme firmly cemented on our public

health service’s agenda, it’s now up to

health organisations to embrace and

encourage innovation to improve the

way care can be accessed and delivered.

When it comes to hospitals, there

is a clear need to improve patient engagement and communication, and

our research highlights that focus needs

to be around providing regular updates

so patients feel informed during the

entire visit, as well as offering greater

access to patient information so they

feel empowered to manage their

own health too. Clear and prompt communication is key and this is where

mobile app technology could come in to

help alleviate current frustrations.

But while it’s clear that mobile app

adoption in hospitals is still in its

infancy, our research demonstrates that

there is a strong demand from patients

for this kind of tech to be implemented.

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There is no better time for healthcare providers to seize the opportunities of mobile app technology.

However, with all new developments the

path to a mobile future in healthcare

won’t come without its difficulties, so

much consideration needs to be taken

to guarantee its success. To really make

mobile health a reality, focus needs

to be on the quality of the tech that is

developed and deployed. The industry

needs to create robust, secure, useful

and engaging apps that really make

a difference; otherwise they risk low

adoption rates and exasperated users.

Organisations will undoubtedly

need help managing utilisation,

streamlining processes and handling

the vast amounts of data that will

be stored or generated. But it seems

there is no better time for healthcare

organisations to seize the opportunities

of mobile app technology to take

advantage of greater efficiencies and

better patient outcomes.

For more information on the solutions that Apadmi Enterprise can offer, please visit our website - www.apadmi.com