The role of mHealth and digitisation in diabetes care

Martin Gerber, global head of innovation at Ascensia Diabetes Care, writes about the use of digital health technology in helping treating diabetes patients.

The number of mobile health (mHealth) apps continues to soar year on year, with more than 300,000 currently available on iOS and Android compared with the approximately 165,000 available in 2015.

Digital tools such as apps are becoming increasingly important for the 463 million people across the globe with diabetes, helping many to manage their condition. But as mHealth becomes more established in healthcare and as adoption is accelerated by the ongoing COVID-19 pandemic, we need to consider how to optimise its impact for all.

mHealth and diabetes care

Most people with diabetes (PWDs) only see their healthcare professional (HCP) for a few hours each year, making the majority of care self-management. It’s therefore no surprise that there are approximately 2,000 apps in the US alone related to supporting people with diabetes. Crucially, in the absence of regular facetime with HCPs, some of these apps enable PWDs to monitor their diabetes management, identify patterns and trends, and share data with their HCPs when they need more input.

These mHealth apps play a key role in self-management and there is evidence to show they really do work. For example, we found in a study from 2018 that using Ascensia’s Contour Diabetes app for over 180 days was associated with a reduced frequency of both hypoglycaemic and hyperglycaemic events.  

Furthermore, apps can provide vital support in driving long-term behavior change in areas such as nutrition, activity and sleep that not only improve diabetes but also its related comorbidities. This is where digital health solutions have great potential to offer holistic approaches that deliver sustainable, optimal health outcomes.  

Creating a holistic ecosystem

It is key to keep in mind that mHealth apps cannot be used in isolation – they must be employed as part of a holistic healthcare ecosystem.

Digital health is about connecting the dots between different devices, conditions and treatments as well as between patients and HCPs. As a result, partnerships and collaborations play a crucial role. From digital health start-ups to healthcare providers, organisations need to ensure that their devices and systems integrate together if they are to improve the quality of life for those that depend on them.

As an example, for PWDs this could include enabling data integration from multiple sources such as CGMs, ECGs, and other wearables into the same app or digital solution. From this, treatments and management advice can be tailored to the bespoke needs of the patient.

A data driven society

In today’s society, data drives many of the biggest discoveries and healthcare is no exception. Huge advances in technology are now arming HCPs and patients with vast amounts of data and it’s becoming apparent that this is leading to better health insights.

The future of diabetes management, for example, is more than just devices and medications. Collecting and analysing data to provide actionable, personalised management recommendations is critical to improving the health and lives of PWDs. Yet less than 1% of mHealth apps related to diabetes in the US have more than 50,000 monthly active users (MAUs), and less that 10% of mHealth apps across the board have exceeded this level either.

The challenges for developers offering mHealth apps remain unchanged: how to engage, re-engage, and retain regular users.

From app recruitment to retention

Some fundamental barriers to app usage are harder to address than others. Around the world many people don’t have access to the necessary technology, such as smartphones and laptops. This is further compounded by digital and health literacy issues that create a serious barrier to virtual diabetes care.

It is imperative for apps to retain those who do have access as they can improve a person’s engagement in their care. In a study we found that engagement with diabetes self-management increased over time, as demonstrated by frequency of blood glucose testing after 180 days of app use versus 30 days. In other words, long-term use of a mHealth app seems to facilitate higher engagement by people with chronic conditions and, in turn, this can lead to better self-management. 

The user journey is generally the most influential factor when considering how best to retain and engage users. Apps must fit into the lifestyles of those managing chronic conditions and listening to users is paramount in establishing what features matter. This is where user centred design and frequent usability studies become critical to the development process.

In healthcare, needs vary from person to person, through gender, age and socioeconomic situation. A truly personalised user experience goes beyond medicine in order to drive engagement, and ultimately improve quality of life.

For the health ecosystem to really thrive, we need to increase access to mHealth and enable better collaboration that can optimise digitisation. We are starting to see this in abundance in diabetes care and we are very excited to see this transformation stretch above and beyond diabetes management.