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Going beyond killer apps: building a better mHealth evidence base
  1. David Peiris1,
  2. J Jaime Miranda2,3,
  3. David C Mohr4
  1. 1 Office of the Chief Scientist, The George Institute for Global Health, UNSW Sydney, Camperdown, New South Wales, Australia
  2. 2 CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru
  3. 3 School of Medicine, Universidad Peruana Cayetano Heredia, Lima, Peru
  4. 4 Center for Behavioral Intervention Technologies, Northwestern University, Chicago, Illinois, USA
  1. Correspondence to Professor David Peiris; dpeiris{at}

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mHealth relates to the provision of health-related services via a mobile device. It comprises multidimensional elements including provider, patient and administrative applications. Applications include consumer education and behaviour change, wearable sensors and point-of-care diagnostics, disease and population registries, electronic health records, decision support, provider tools (communication, workflow management, professional education) and healthcare management (human resources, financial monitoring, supply chain logistics).1

Although mHealth has potential to strengthen health systems worldwide, the evidence base is immature, and consequently, the opportunities to advance knowledge remain limited.2 3 Mobile devices and apps have become essential tools for disruptive change in many industries, but thus far, this has not happened in healthcare. Here, we discuss five interrelated reasons as to why mHealth has underdelivered and highlight challenges and opportunities for mHealth researchers.

The myth of the ‘killer app’

Disruptors often rely on a ‘killer app’—a highly popular application that users will consider indispensable for their needs. At last count, there were nearly 260 000 health apps on the market,4 but most downloads are never opened and consistent use is extremely rare. Further, these apps are often disease siloed, focus mainly on behaviour change, gloss over privacy issues and are not integrated into any overarching healthcare structure. Such apps struggle to achieve large-scale adoption because of their failure to address the needs of diverse stakeholders.5 Most apps are consumer facing, whereas healthcare systems tend to be provider facing. This important distinction may explain why the ‘killer app’ approach is not the correct mindset. The diversity of users and the inability to address their varied problems results …

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