Seeking Patient Engagement, Payer Curates Mobile Apps

Aetna is rounding out its mobile strategy by selecting more than 20 Web-based healthcare applications for its own CarePass wellness app, which pulls data from various sources and presents visualizations of progress toward goals.

Most patients think of their health insurance company as a source of never-ending paperwork and denied claims. Aetna, through technology, is working to bust that stereotype.

The insurer's latest move is to effectively become a curator of mobile and Web-based healthcare apps, rounding out the company's mobile strategy, which already includes iTriage, the popular mobile phone app the company acquired last year.

Aetna CEO Mark Bertolini spearheaded the development of a wellness app called CarePass to make buying healthcare as convenient as going to a store, scanning a bar code, finding the best price online, and having it shipped to his home.

By the way, this practice, known as "showrooming," drives retailers crazy. Likewise, some doctors will be a bit agitated by Aetna's new app, for it draws together the new crop of wellness apps, but doesn't yet advance interoperability of those apps with electronic medical records.

But if healthcare providers are going to engage patients, they have to assume different roles: curator, coach, cheerleader, and concierge. CarePass pulls data out of different wellness apps and visualizes consumers' progress towards a goal, and so doing aspires to solidify Aetna's brand in new ways.

The 20-plus apps Aetna has picked touch more than 100 million consumers today. Some of the numbers for each app are staggering. MapMyFitness has 30 million users. RunKeeper has 25 million. Aetna's scrambling to get in front of a parade already under way.

Each of these apps already has its own community, its own social network, and its own structure of peer support. Aetna pulled in another virtuous cycle by incorporating consumer-entered data from healthy eating apps such as FatSecret or Lose It! CarePass then generates custom discounts in local supermarkets, powered by Zipongo, yet another app tapped for CarePass prominence.

If CarePass is the Aetna wellness app, iTriage remains its health app—the place Aetna sends its members (or non-members) for symptom checking and doctor referrals. But starting later this year, the lines between the two will start to blur. At that point, CarePass will begin to connect with some of the mobile apps that strive to help people manage, and remember to take, their medications, says Aetna vice president Martha Wofford, who heads the CarePass initiative.

"It's obviously a difficult space," Wofford says. "I don't think any of the solutions are super-strong yet, but again it's an important part of the whole process for many consumers."

There's still a lot of friction in the digital practice of wellness. People generally can't be bothered with entering their calories or food choices. Passive devices such as FitBit (supported by CarePass) take over some of the work. The most important new device in the home is probably the Withings scale (also supported by CarePass) which captures that all-important regular weight reading and uploads it to the Withings servers and from there on to Aetna.

But once you wander into medication adherence and the like, you're entering the FDA's territory. That's why we'll be hearing more and more about the connection between devices, apps, and patient safety. Just recently, it was noted that Apple continues to crack down on medication dosage apps listed in its App Store.

So Aetna, other insurance companies, and providers aren't the only ones trying to curate health apps—app vendors are getting into the act as well.

At some point, however, CarePass, iTriage, and consumer wellness devices start to become part of a complete healthcare picture, but without some of the traditional guidelines that the FDA has imposed upon medical devices. Part of the challenge is that various transient readings from devices can be indicators of more serious conditions, and yet there are no guidelines that the apps being fed data by these devices aren't summarizing or averaging such data. If such summarizing or averaging does occur, telltale signs of undetected disease might be missed.

Wofford realizes the challenges ahead, and in fact, notes that CarePass comes with a set of disclaimers about not allowing it to act as a substitute for a doctor's care.

"What we'll implement is the ability to a consumer to at a summary level to share information back with their doctor, to say, look, you told me to get in a healthier lifestyle, and here's the data to show it," Wofford says. "That's fine, but as we get into more clinical uses of data into the workflow, that's where I think you end up crossing that line into more of the FDA space. We'll have decisions to make in the future about how far do you go."

At the moment, Aetna is more focused on empowering consumers to bring their data together to track and trend that information. But caring for a condition is clearly the next step. "I think you're right about understanding that there's a continuum here, where we currently are, versus what the opportunities are."

One thing that Aetna cannot do is curate more than a few dozen apps, which leaves another 40,000 or so mobile health apps outside their reach or recommendation. As far as assurance that the few dozen apps are good apps, Wofford admits that popularity is one determinant. Startup apps such as Zipongo may slip in as well, but they must have a national footprint to play in CarePass, she adds.

To promote CarePass, Aetna just launched a Web site, whatsyourhealthy.com, which it is promoting on TV and other media, even billboards. Wofford won't give specific numbers, but it's clear Aetna hopes to reach many of the 100 million consumers I mentioned earlier.

All around the Internet, opportunities beckon to providers and payers. It remains to be seen just how successful traditionally dominant healthcare players will fare. But these are platform plays, so don't bet against the big players. Healthcare will be the same kind of one-stop shopping, or impulse experience as showrooming has become in retail stores. Expect the unexpected.