The Top Chinese Mobile Health Apps: A Systematic Investigation – PMC

mHealth Initiatives

Through the oestrus map and mHealth initiative analyses (Figure 4), we establish that among the nigh common mHealth initiatives were telemedicine, appointment making, and medical educational activity. Telemedicine can broadly be defined equally the use of telecommunications technologies to provide medical information and services [23]. The use of telemedicine to diagnose and prescribe medication has yet to be legalized in Communist china. This implies that the actual service delivered in telemedicine was limited to full general medical inquiries, with limited medical deportment involved. Appointment making reflects a phenomenon beyond Mainland china of patients lacking admission to clinicians [7,ix].

Here, nosotros discuss the role and background of hospital appointment making. In 2009, the Chinese Ministry building of Health required all public hospitals of level three [24] or college to let date-making services and prohibited partnering with third-party agencies to profit from these services [25]. In recent years, for a given public hospital, bachelor appointment dates have been provided straight on the hospital’s appointment-making system, public (municipal or provincial) third-political party systems, or private tertiary parties such as apps. (Of note, in the Peking Union Medical College Hospital in detail, the ratio of cocky-distributed to public third-party distribution is 7 to iii.) These apps obtain a number of appointments past signing agreements with hospitals or with individual doctors. Apps solve the problem of difficult admission by (ane) aggregating hospital date availabilities on their platform, thus preventing patients from waiting at fully booked hospitals or (2) partnering with individual doctors to provide consultations on personal complimentary time.

Apps focused on medical education and scholarly articles targeted 2 key demands in the Chinese health intendance marketplace: access to reliable information, and clinicians’ need to publish peer reviewed articles. The proliferation of discussion forums and unregulated “medical” manufactures on the Internet and apps makes reliable information a rare commodity. The abundance of medical education apps appears to target this need.

On the other mitt, a clinician’south professional advancement is dependent on many factors, of which publishing peer reviewed articles is crucial [21,26]. The availability of apps to provide manufactures and aid with the writing process can be an endeavor to supply this demand. These apps provide writing resources such equally editing and actual writing, and provide access to scholarly manufactures. This access is often through a Chinese translation or a summary of the original article (about often in English).

Disease- and Specialty-Specific Apps

We examined the distribution of diseases and medical specialties in the mHealth industry through a heat map plotted against medical initiative. When examining the frequency of apps on a disease ground, we adamant diabetes to be the most common, followed by hypertension and hepatitis. This is consistent with epidemiological surveys pointing to these diseases as the most prevalent in Mainland Cathay. According to a report from the Chinese Heart for Illness Control, the prevalence of hypertension amid Chinese adults was 33.5% (amounting to roughly 330 million hypertension patients) [27]. A recent study showed the prevalence of type 2 diabetes at 11.6% of the population (amounting to nearly xc one thousand thousand diabetes patients) [28]. Since mHealth apps for these diseases focused almost exclusively on illness monitoring and recording, market forces driven by pharmaceutical drug sales may not be the primal cistron for app providers. Rather, it may be the distribution of monitoring devices. Diabetes is monitored by glucometers and single-utilize dispensable test strips, versus repeated-use blood pressure level machines for hypertension. The market place opportunity for diabetes in mHealth is believed to be greater than that for hypertension due to the nature of disease direction and monitoring, despite hypertension having nigh triple the patient volume.

Unlike many developed countries in the globe, in Communist china hepatitis B is endemic. Approximately 1-third of worldwide cases are in Mainland Red china [29]. A study noted 120 1000000 carriers of hepatitis B virus in Red china and 30 1000000 patients who are chronically infected [30]. The beingness of apps targeting hepatitis is consistent with the illness’s endemic nature in Mainland china.

The heat map of medical specialty by health initiative provided more information nigh the industry equally a whole. By far the most heavily targeted specialty, or lack thereof, is general medicine. The apps here mainly focused on appointment making and telemedicine. The telemedicine services offered were frequently a “lite” version of medical history taking, since patients were provided with general answers and so encouraged to seek specific guidance through in-app appointments. Thus, despite telemedicine and appointment making having lexical and implicit differences, Chinese mHealth apps providing telemedicine services were more synonymous than they appeared based on the to a higher place analysis. This finding reinforces the difficulty of accessing care.

Another pop surface area was pharmacology. The apps in pharmacology provided patients with admission to online or offline pharmacies and provided clinicians with pocket drug references. Pharmacology-related apps aimed to provide convenience for patients who crave drug refills and cannot repeatedly travel to community pharmacies or hospitals. Community pharmacies oftentimes do not deport a full repertoire of prescription drugs, and the current state insurance policy covers in-hospital prescriptions for fourteen days for able-bodied patients and upwards to 30 days for disabled patients. On the other hand, pharmacology apps targeting clinicians, pharmacists, and other HCPs provided references for dosing, interactions, and alternative drugs. The incorporation of pharmacology apps into HCPs’ daily exercise appears to exist a mainstay in China and many other countries [31,32].

Web App

Accessing an app from different media can allow users to experience the app differently and can serve dissimilar purposes. The apps in this study focused on mobile phones. However, about 1-third of the apps besides had a Web-based version. The main difference between the Spider web app and mobile app was the ability for users to view historical data organized in reports or graphs in the Web-based version. It has been reported that data visualization and context awareness could enhance an app’south utility [33].

Target User and Payment

An app’s target user tin can provide information about market place opportunities and underlying market forces facing app developers. Our analysis showed that app developers preferred targeting the not-HCP user, mayhap due to easier user acquisition and a larger potential user base. The HCP-oriented apps mainly provided services through medical education or scholarly articles. Few focused on medical care delivery or integration into hospital intendance. This can be explained by financial compensation related to publication requirements [21,26]. A physician’s compensation is directly tied to his or her position in a hospital hierarchy. Among many factors, publication quotas are mandatory evaluation metrics in many hospitals. We believe that this demand on physicians compliments an app developers’ need to grow and retain a steady user base. In that location were 10 apps with both an HCP and a non-HCP version available. These apps all allowed communication between the two parties.

Almost apps in Communist china were complimentary for users to download and use. All apps surveyed from the Android app stores were complimentary. Chinese users are likely accustomed to using costless apps.

Security

We examined the lack of information security from two perspectives: market forces and regime regulations. About all apps failed to mention on their website or user understanding course about securing the users’ data. This tin imply gross negligence from the programmer or use of the data for other purposes. The latter is likely the underlying motive considering, as noted past notable industry agencies, data tin can be knowingly or unknowingly sold to marketers for fiscal gains [34].

We besides considered data security from a policy perspective. Nosotros examined policies pertaining to medical apps by reviewing documents from the People’s Republic of China Country Council’s official website [35] dated between 2013 and 2015. The search was limited to “Net,” “Net plus wellness intendance,” and “Net plus medicine.” All results were read and screened by a Chinese Wellness Intendance Policy analyst (author LD) for relevance. Among the more than three grand policies and documents available, no straight laws governing medical apps, let lonely mHealth security, were establish, and only xi official releases were identified that tin can direct or indirectly affect the operation of medical apps (Table two).

The scope of mHealth apps can cross into many industries. Documents mentioning mHealth targeted industries such as it, manufacturing, health care, commerce, and intellectual property. The fact that many policies, across various industries, mention mHealth suggests that the Chinese authorities recognizes the future potential of the industry but has all the same to dictate a articulate stance on how to regulate this relatively new manufacture. The lack of specific policies toward mHealth may be due to the difficulty in pinpointing which industry it lies in.