This past month, WellDoc announced their BlueStar mobile health (mHealth) offering, labeled as a “mobile integrated therapy,” which is the first patient-centered medical product cleared by the FDA for use by adults with type 2 diabetes (http://www.welldoc.com/Products-and-Services.aspx). BlueStar, a powerful mHealth app, supports patients through smart blood glucose testing, healthy diet and exercise choices, medication adherence, and quality standards of care such as A1c tests, foot exams, and blood pressure and lipid levels. The app provides real-time motivational, behavioral, and educational coaching to help patients self-manage their diabetes treatment plan. Additionally, BlueStar provides the patients’ physicians with clinical decision support. What makes this different than most health apps that are in the market is that it requires a prescription from a licensed healthcare provider—and it is being reimbursed by some private health plans.
So, there are thousands of health apps out there—how does the WellDoc BlueStar solution stand out from the rest? Here are five reasons that this app differs from other options you can go and download from iTunes.
1) Proven Results: Data show that BlueStar actually affects outcomes
According to WellDoc, “The combination of patient behavioral mobile coaching with blood glucose data, lifestyle behaviors, and patient self-management data, individually analyzed and presented with evidence-based guidelines to providers substantially reduced glycated hemoglobin levels over 1 year.” What is important here is that clinical trials show positive results over a 12-month period. Based on a 2011 Consumer Health survey, 26 percent of mobile apps are downloaded and used only once, and of the people who confirm use of those apps, 74 percent drop out by the 10th use. (http://www.consumer-health.com/press/2008/NewsReleaseSmartPhoneApps.php)
Clinical trials show that the WellDoc solutions have proven outcomes (which very few apps can claim), which continue to engage and affect users long past the average app. (http://www.welldoc.com/LinkClick.aspx?fileticket=bC3Kcw-y5Sg%3d&tabid=61)
2) A Pathway for Payments: Opens the door for physicians to be reimbursed
A hurdle for mHealth, and other technologies like EHR, has been around the challenge of doctors getting reimbursed by health plans for their time and effort. Because BlueStar works basically like a standard pill prescription, there is now an incentive for providers to prescribe the app—beyond the obvious reason of improving health outcomes for patients. This could help provide further incentives around adoption and interest in the HCP community to recommend and use applications and mHealth solutions that assist in improving patient outcomes.
3) Keeping it Simple: Uses the familiar process of going to a pharmacy
To get and pay for the BlueStar solution, patients just follow the current Rx process of adjudication through a pharmacy. So, there is nothing new for either HCPs or patients to have to figure out—they just do the same routine. Taking it one step further to ensure that patients get the most out of the BlueStar solution, WellDoc will actually schedule time with a patient to train them on how to use the app properly. This level of service seems even better than getting handed a bottle of pills with typically minimal instructions at a counter.
4) mHealth is Going Mainstream: Timing is better, with greater adoption and comfort around mHealth technology
Personal technology, and more specifically, mobile devices for health management, are becoming more accepted and common. Here are a few facts that help support the possibility of acceptance:
- A recent survey reports that 90 percent of patients surveyed would accept the offer of a mobile app, while only 66 percent of respondents would accept prescription medicine from their doctor. So the appetite is there—what has been missing is a solution that has sticking power and keeps people engaged beyond a few months.
- The Millennial audience segment: Recent data show that Millennials are engaged with their smartphones every hour in the day, and use fitness and health apps twice as much as other age groups. This level of attention—along with a well-designed experience that will keep people engaged and interested—will make a difference in general acceptance and utilization of apps like BlueStar.
- In another recent US survey commissioned by Royal Philips Electronics, a quarter of Americans surveyed said they trust symptom checker websites, symptom checker mobile apps, or home-based vital sign monitors as much as they do their doctors. This indicates a level of trust around the technology used to manage their health, and is a behavioral shift from simply researching health information online before going to a doctor.
5) Plays Nice With Others: BlueStar is multi-screen and works across devices
The WellDoc BlueStar app is accessible on a smartphone, feature phone, tablet, or computer. By not limiting the experience and the method of engagement to only one kind of device, it is practical, and fits with a variety of users. This is important, as many users still use a variety of screens, and some screen sizes are better for certain tasks than others. On top of that, it is also capable of periodically sending data to a physician via an automatic e-mail or fax, further extending the app’s impact beyond just the device, and potentially directly with healthcare providers. You may say, and probably correctly, that doctors don’t readily engage with products like this, but then again, they may be more willing if they can get reimbursed for the action.
Even with all these advantages, there are still a few outstanding challenges that WellDoc will need to carefully monitor if the BlueStar app is to reach its full potential.
1) How will the app integrate into EHR platforms?
One of the biggest challenges in mHealth is what to do with all the data being collected. There is a lot of information that could be useful, but its clinical or medical relevance is an ongoing debate, where some argue that what these health apps collect does not really belong in EHR at all, but is truly supplemental information. As it stands today, there really is no place to put this information in a patient’s CCD file, so this debate will continue on for the time being. But since BlueStar is a prescription, could it somehow be listed in the medications section of a CCD? Does that lend itself to better overall tracking against a person’s health outcomes? We will see.
2) Is the cost worth it, even with reimbursement?
The cost to patients, even after reimbursement, has yet to be really disclosed, even though WellDoc indicates it is less or at least comparable to other alternative diabetes management options. They also claim that it saves money each month. In the end, what is the true cost/benefit for this solution, when is the right to time prescribe it, and for which patients would it work best?
3) BlueStar is not accepted across the board…yet
As of today, the BlueStar solution is not covered by all healthcare plans, and is not covered under Medicare and Medicaid. WellDoc has chosen to start in the commercial space and has plans to seek coverage across the board, but until that happens, this mHealth offering is only available for a certain segment of the population. Time will tell if WellDoc is able to get broad coverage for this innovative app.
Overall, the fact that there is a new type of offering that is challenging the current mobile health landscape is definitely a step in the right direction. Solutions such as the BlueStar app are the start of what will hopefully become a better and more comprehensive way of managing health conditions, bringing us one step closer to the day when health plans and providers routinely adopt and support mobile health solutions. It will be very interesting to track the success (or failure) of BlueStar moving forward!
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