The interview partners
Prof. Dr. Patrick Da-Cruz is Professor of Business Administration and Healthcare Management at the Faculty of Healthcare Management at Neu-Ulm University of Applied Sciences (HNU) and Academic Director of the MBA program Leadership and Management in Healthcare.
Before joining HNU, Mr. Da-Cruz worked for renowned strategy consultancies in the pharmaceutical/healthcare sector and in management positions in healthcare companies in Germany and abroad.
Dr. Felix Holl is a postdoctoral researcher and deputy head of the DigiHealth Institute at HNU. In 2023, he completed his PhD as Dr. rer. biol. hum. at Ludwig-Maximilians-University. He has a background in medical informatics and completed a Master in Global Health Sciences at the University of California, San Francisco as a Fulbright Scholar. Additionally, he completed a postgraduate program in Public Health at UMIT in Austria. His research focuses on the evaluation of medical informatics projects and the use of informatics in global health. He is a member of the editorial boards of Sage Digital Health and BMC Digital Health and chair of the Global Health Informatics working group of the American Medical Informatics Association. Dr. Holl has many years of experience in the emergency services and is a part-time consultant for Health Information Systems for the German Red Cross International Relief. He is also a lecturer in the “Digitalization and AI in Healthcare” continuing education program at HNU.
What role do mobile health applications currently play in practice?
Dr. Felix Holl: Mobile health applications are playing an increasingly important role in practice. Since 2019, the Digital Healthcare Act has given all people with statutory health insurance in Germany the legal right to be prescribed a digital health application (DiGA) by their doctor. These so-called “apps on prescription” can help patients to better manage their health - be it through digital therapy support, monitoring of chronic diseases or preventive measures.
In addition to DiGAs, there are many other mobile health applications that are aimed not only at patients but also at healthcare professionals. These range from telemedicine platforms and digital decision support systems to mobile solutions for data collection and analysis in clinical research.
In practice, however, it is clear that the widespread use of mobile health applications is still accompanied by several challenges. These include issues of data security, interoperability with existing IT systems and actual use by patients and medical staff.
Which methods are suitable for measuring patient benefit?
Dr. Felix Holl: Evaluating patient benefit is essential to demonstrate the added value of mobile health applications so that patients benefit from the applications and the healthcare system only pays for applications that have a benefit.
There are various methods for this:
- Clinical studies and randomized controlled trials (RCTs): These are considered the gold standard for providing scientifically sound evidence of the effectiveness of an application. They enable a comparison between user groups and a control group in order to measure the specific influence of the app on the patient's state of health. However, they are expensive and take a long time. By the time the results are available, the application may already be outdated or updated.
- Real-world evidence (RWE) and health services research: In addition to RCTs, methodologically robust observational studies that analyze the application in real-life health care settings are playing an increasingly important role. Routine data, usage statistics or digital health data are used to gain insights into the long-term benefits.
- User analyses and engagement data: Usage behavior within the app (e.g. length of stay, regular use, interaction with functions) can provide conclusions about how well the application is accepted and whether it will be used in the long term.
In your opinion, what factors are most important to ensure a high level of acceptance among users, and how can these be measured?
Dr. Felix Holl: The acceptance of mobile health applications depends on several factors:
- Ease of use and intuitive operation: a simple, accessible layout and an appealing design are crucial for users to use the app in the long term.
- Evidence-based effectiveness: Patients and doctors are more likely to accept an application if its effectiveness has been proven by studies. This can be proven by clinical evaluation studies.
- Data protection and security: Trust in the protection of personal data is essential, especially in the healthcare sector. To increase acceptance, applications must comply with the highest data protection standards (e.g. GDPR compliance).
- Integration into existing care structures: Applications must be able to be seamlessly integrated into everyday care. Interfaces to electronic patient records or medical practice software are crucial here.
- Long-term benefits for users: An app should offer real added value, be it through an improvement in health status or relief in everyday life. This can be verified through long-term analyses and qualitative user studies.
What trends and developments do you see in the field of mobile health in the coming years?
Dr. Felix Holl: The mobile health landscape is evolving rapidly. Some key trends are:
- Artificial intelligence (AI) in personalized medicine: AI-supported algorithms enable individual adaptation of therapies and preventive measures based on large amounts of data.
- Interoperability and seamless integration into healthcare systems: In the future, it will be crucial that mobile health applications are better connected with existing IT infrastructures (e.g. electronic patient records).
- Wearable technology and continuous monitoring: Linking health apps with wearables (e.g. smartwatches, blood glucose sensors) will further improve personalized healthcare.
- Regulatory development and new reimbursement models: Regulatory frameworks will continue to develop in Germany and internationally in order to bring innovations into care more quickly.
- Hybrid care models: The combination of digital solutions and personal care will continue to gain in importance, e.g. in the form of blended care approaches in psychotherapy.
What contribution can evaluations make to integrating innovative technologies into healthcare more quickly and in a more targeted manner?
Dr. Felix Holl: Evaluations are an essential part of integrating innovative technologies into healthcare not only faster, but also in a safe and evidence-based way. They make it possible to identify both opportunities and potential risks at an early stage.
- Early benefit assessment and iterative improvement: Agile evaluation approaches, such as pilot studies or user feedback analyses, allow applications to be optimized at an early stage of development.
- Proof of efficacy for reimbursement: Healthcare systems and health insurance companies are increasingly demanding evidence-based proof of benefit. Evaluations help to create a scientific basis for reimbursement.
- Long-term accompanying research on care integration: Evaluations should not only examine short-term benefits, but also long-term effects on healthcare. Registry studies and long-term cohorts play an important role here.
- Acceptance and user-centricity: Evaluation processes can help to better understand user needs and ensure that digital health applications are truly practical and helpful.
Solid evidence-based evaluation can make healthcare not only more innovative, but also more effective and patient-centered.
Thank you very much for the interview!
The content and statements presented in the interviews reflect the perspective of the interviewees and do not necessarily reflect the position of the editorial team.
