By Clinical Informatics News Staff 

May 8, 2015 | Two months after announcing their first app built on Apple’s ResearchKit platform, LifeMap Solutions is sharing some of the earliest user-engagement findings from their Asthma Health app, a personalized tool that helps participants gain greater insight into their asthma, adhere to treatment plans, avoid triggers, and take charge of their health. The findings were published on the ResearchKit blog.

The Asthma Health app facilitates a research study designed by Yvonne Y-Feng Chan, Director of Personalized Medicine and Digital Health at the Institute for Genomics and Multiscale Biology, at Mount Sinai.

LifeMap CEO Corey Bridges told Clinical Informatics News that Apple approached Mount Sinai and a few other institutions for feedback and participation early in the process of developing the ResearchKit platform. Eric Schadt, Director of the Icahn Institute at Mount Sinai and a co-principal investigator on the study, already had a relationship with LifeMap to develop mobile health (mHealth) tools and applications, so he brought LifeMap on board.

The primary goal of the Asthma Health study is to gather data over six months on how effective it is for asthma sufferers to use mobile health solutions. The app provides basic feedback on the user’s physical environment, gives medication reminders, and asks questions: How well did you sleep? Has asthma interfered with your work this week? Have you used a rescue inhaler this week?

“It’s a very straightforward, basic app,” Bridges said, “but the study has never been performed before. Basically [it is] checking to see how useful it is for an asthma sufferer to utilize an mHealth solution.”

Recruitment for this type of study will present new challenges, but also new opportunities for clinical trials. After all, 700 million iPhones have been sold, said Rafhael Cedeno, CTO of LifeMap Solutions. That’s a huge pool of potential participants, although at this point ResearchKit apps are only open to US users.

Bridges says that recruitment for the Asthma Health app has gone exceedingly well. But LifeMap’s app does have a significant first-mover advantage. When Appleannounced ResearchKit on March 9, Asthma Health was one of only five apps profiled.

In the first few days, 3,500 people downloaded the app, and Bridges said 7,600 people are enrolled today.

But what does “enrolled” mean for an app freely available in the App Store? To join the study, users start by answering five questions confirming that they are over 18, are not pregnant, live in the United States, “have asthma as confirmed by a doctor,” and are taking some medication for their condition.

Those who are eligible are invited to complete an eConsent process within the app. The eConsent process consists of several screens of study particulars. Participants consent to about 15 minutes of interaction a week, and can choose to share their data with Mount Sinai and researchers worldwide, or limit it to Mount Sinai and its partners. At the end, participants answer a 3-question quiz, read (or scroll through) a longer consent document, and sign in an on-screen signature box to complete the consent process.

LifeMap reports that so far over half of the users who downloaded the app completed the e-consent process, and used the app the next day.

The app needs to be “sticky,” LifeMap believes, prompting daily interaction to keep users engaged. So far, usage data shows that users are very engaged and have a particularly high level of activity on Mondays after weekly automated reminders.

“It was our theory going into this that some people are going to be motivated by improving their health. Some segment of people would be motivated by contributing to general scientific asthma knowledge to help all asthma sufferers. It looks like that second motivation is actually quite strong,” said Bridges. “The user retention numbers, the user engagement numbers… show that people are, in fact, finding the app quite ‘sticky.’”

The research study behind Asthma Health will run for about a year, Cedeno said. The scientific findings will be published by researchers at Mount Sinai.

In the meantime, LifeMap plans to continue sharing its findings in terms of the best ways to create research apps and analyses of user behavior.

“These are general analytics and metrics around how apps are working. It’s really interesting, because we haven’t seen apps that were geared specifically for research,” said Cedeno.

Since its launch two months ago, LifeMap has continued to update and refine the app. “We wanted users to have a great user experience,” said Cedeno. “It’s not an app  just for researchers and collecting data, but the app is actually helping people with asthma better manage their condition and learn about their condition. I think the app is going to continue to have value even after the enrollment period is over. We haven’t fully decided exactly how we’re going to handle that transition.”

LifeMap is working on several new ResearchKit apps, in addition to their commercial products. Also in March, LifeMap released COPD Navigator on Apple’s HealthKit platform, a commercial app with a research component, also in conjunction with Mount Sinai.

Bridges stressed that LifeMap will continue sharing best practices in app development with the community.