The patient engagement cage match: mobile vs. web vs. paper

Obesity is estimated by the World Health Organization to the be fifth leading cause of death and is associated with diabetes, cancer, and heart disease. In an attempt to scrutinize the effectiveness of popular patient-driven weight loss approaches, a group of researchers in the UK analyzed the results of a paper-based program, a web-based program, and a smartphone-based program. 


Study Design

A sample of 128 overweight volunteers were randomized to receive one of the three interventions. For six months the volunteers used either paper, the web, or a smartphone app to track and manage progress against weight loss goals. The only face-to-face component of the intervention was during the enrollment period and during brief follow-up sessions at 6 weeks and 6 months to take anthropometric measures and administer questions. In other words, live coaching was not part of the program. 





  Mobile Web Paper
% who continued to end of trial (6 months) 93% 55% 53%
Average days of adherence during trial 92 days 35 days 29 days
Average weight loss 10 lbs 2.9 lbs 6.4 lbs
Average fat loss 2.9 lbs 1.1 lbs 1.9 lbs


Bottom Line

Mobile won this match by a knockout. Upon reflection, this comes as no surprise. Mobile devices have become part of the way we go about the day-to-day management of our lives: getting directions, depositing checks, connecting with friends, etc. Why would health management not be mobile.  Here's a relevant excerpt from an article I co-authored with the Chief Medical Information Officer of WakeMed Health and Hospitals:


Consider this common scenario:


You have recently been discharged from the hospital and have made a follow-up appointment to see your primary care physician. You are now in the waiting room of that physician's office. It occurs to you that your PCP will want to see your care summary and discharge instructions. You're called into the exam room and your physician not only asks for these items, but also asks for a recent medication list and the results of the tests that were run.


If you didn't bring the paper records and you don't have access to the records via your smartphone, then you and your PCP will simply have to wing it. After all, only about 25% of doctors receive discharge summaries by the time patients make their first post-discharge visit. The rate doesn't rise to above 50% until after four weeks, affecting the quality of care in about a quarter of follow-up visits.


Meanwhile, 41% of patients are discharged with a pending test result and 66% of physicians are unaware of the results of the pending tests.  As well, at discharge, only 42% of patients are able to state their diagnosis, and 37% are able to state the purpose of all of their medications.


... How many patients carry laptops to the doctor's office? This is a usability problem with serious consequences.