Web-based vs App-Based – Telehealth Features Series

In this Telehealth Feature Series, we’re going to cover the long list of potential telehealth features available today.  As you’re considering your own approach to telehealth, we will provide you a look at all the possible features telehealth companies are offering on the market.  Plus, we’ll offer our insight into the nuances of each feature so you can select the right telehealth company or companies you use.  Not all telehealth is created equal, so taking the time to understand all the possible features and options is worth the effort.

The next feature we’re going to cover is Web-based vs App-Based.

Ironically the discussion of web-based vs app-based goes back a long ways and has a complex history.  Plus, it mirrors in some ways the previous discussions we’d have about client-server vs web based.  In most cases, the web-based application has won over the client-server based applications.  The only exception was in rural environments where they didn’t have quality high-speed internet.  Of course, there are also some legacy client server applications that have stuck around too, but once they’re replaced it will likely be with a web-based solutio.  The reality is that no one would build a new application that was client server which tells you something.  All new applications have been cloud based, but I digress a little.

This begs the question, which side is going to win when it comes to web-based vs app-based telehealth applications?  First, I think it is important to divide the discussion into patient vs clinician.  Each has a little different need.  Also, it’s worth noting that even those telehealth applications that are web-based should be optimized to work on mobile devices.  If they’re not, that’s a big issue for those doing telehealth.  However, most of the time this is not an issue and your telehealth solution will be optimized to work on mobile devices.

Patient Perspective

From a patient perspective, most people are suggesting that web-based telehealth is the way to go.  The main reason for this is that it’s a much harder onboarding process for a patient to have to download an app and then connect to the doctor in a telehealth visit.  Many telehealth companies are touting the ease of use they provide patients by just sending them a link which they can use to connect to their telehealth appointment.  No apps or other software to download.  Just click your unique link and you’re connected to your telehealth visit.

To be honest, it’s hard to argue against this kind of simplicity.  Even as a tech expert (or at least was one), I sometimes find the flow hard when someone wants me to download the app in order to connect with them on video.  Plus, you start running into account issues if you have multiple people using the device and other challenges when it comes to knowing if you’ve downloaded the right thing and are in the right place or if you need to do something else to connect.  If I have trouble sometimes, imagine my mother who will no doubt give up if she runs into trouble.  So, the single link connection to a webpage is a powerful feature for telehealth users.

While this is true, I think that the success of Zoom and Skype in telehealth are examples that have proven that an app or other software download can work as well.  It can be a little clunky sometimes and be a harder onboarding process, but it is doable.  Plus, many of these types of services offer both an app and a web based version now to address some of the usability and onboarding issues.

What’s a much harder lift is getting a patient to download a dedicated telehealth app to manage their telehealth experience.  I’m talking about a dedicated app on their mobile phone that goes beyond Zoom or Skype which many people have used before and is really only for the video connection.  There are some telehealth companies which have their very own app to be able to handle the full telehealth experience.

In some ways, one could argue that a dedicated telehealth app could provide a much better experience to you than a web based application.  It could provide push notification reminders to the patient.  You can collect all the patient paperwork and if the patient forgets to fill out some piece of the paperwork, then you could notify them of the need to complete it before the visit.  You can also integrate things like asynchronous messaging with the patient and patient payment.

While you could create an arguably better experience for the patient on a dedicated mobile app, it’s still a pretty high bar to be able to convince a patient to download a new app to their phone.  The exception I’ve seen for this is when the telehealth application is something that’s going to be used on an ongoing basis as part of ongoing care.

For example, there are a number of direct to consumer telehealth companies, often for very specific health issues, where it could make sense for a patient to download the app.  One example of this is the telehealth companies that provide birth control and other related services.  This is something that’s needed regularly and requires an ongoing connection to the patient in order to refill the patient’s birth control.  In this case, you can see where an app could make sense from a patient perspective.  They can easily do the telehealth visit every 3 months (or whatever the refill time frame might be) on their cell phone.  Plus, the app can remind them of this which is valuable to the patient.

Clinician Perspective

The clinician perspective is a little different than the patient.  In fact, I’ve heard from a lot of doctors that they wanted to find a telehealth solution that wasn’t app based.  Sure, as we mentioned above, they want to be able to use their mobile phone in a specific scenario or situation to do a telehealth visit, but it seems most clinicians would rather do a telehealth visit on an actual computer.

Why is this?  In most cases, the doctor wants to be able to do multiple things at once.  In fact, the ideal situation is having not just a workstation setup, but dual monitors.  This way a doctor can have the telehealth visit up on one screen while they have the patient’s record up on another screen.  Or they may have the video on one screen and they’ll document the patient visit on another which would include them receiving various clinical decision support alerts.

Unfortunately, multi-tasking on a mobile device with your telehealth application open is not nearly as easy.  Just imagine a doctor wanting to pull up a link to some patient education for a patient and then sending that link to the patient.  While possible on a mobile device, it’s so much easier on a desktop or laptop and even easier with dual monitors.

There are some places where a mobile based solution is a benefit to the doctor when doing telehealth.  One of those is when doing virtual rounding or telequarantine.  Then, it could make sense to have an app on the mobile device that allowed them to do their rounding in a safe, socially distant way.  Also, an app can be a nice compliment to a web based solution where the doctor might hold the live video visit on a workstation, but they’ll respond to asynchronous text messages on a mobile app.

Conclusion

On the patient side of things, I think some consumer telehealth companies are going to do well with an app based approach to telehealth.  However, it will definitely be an uphill climb for them to get patients to download and engage with the app regularly.  The good news is that if they’re successful, that will be a barrier to competitors.  However, on the more traditional telehealth visit with your doctor, I think most are going to edge towards the web-based telehealth with a unique link to join the video visit.

On the provider side, most are going to want the ability to multi-task which generally means a web based telehealth solution.  The only caveats are for situations where the clinician needs to be mobile or as we shift to more of a value based care telehealth solution where the care team provides ongoing care for a patient that includes telehealth as needed.

Be sure to check out our full list of telehealth features, our deep dive into each telehealth feature, and our list of telehealth companies.

About the author

John Lynn

John Lynn

John Lynn is the Founder of HealthcareScene.com, a network of leading Healthcare IT resources. The flagship blog, Healthcare IT Today, contains over 13,000 articles with over half of the articles written by John. These EMR and Healthcare IT related articles have been viewed over 20 million times.

John manages Healthcare IT Central, the leading career Health IT job board. He also organizes the first of its kind conference and community focused on healthcare marketing, Healthcare and IT Marketing Conference, and a healthcare IT conference, EXPO.health, focused on practical healthcare IT innovation. John is an advisor to multiple healthcare IT companies. John is highly involved in social media, and in addition to his blogs can be found on Twitter: @techguy.

2 Comments

  • As a software engineer, I’ve long wondered about the rationale for ‘apps’, when the company involved could (it seems to me) do the same thing on the web. Perhaps the rural bandwodth issue is a partial explanation.

    As a certified contrarian, I don’t own/need a smartphone (and don’t do social media). If I did, it would really annoy me if, to use a service, I had to deign to download an app; and I probably wouldn’t do it.

    Apps are often used by media so that desktop web content will be formatted properly on a small screen. But The Washington Times does this on the web by using ‘m’ instead of ‘www’. And now many web site forego the sidebars and wide dropdown menus so that their content is amenable to both desktop and smartphone.

    As to tele-visiting with my doctor… I won’t do it. I think schooling and medical checkups should be done in person. Virtual may be OK for some, but students and patients need a more personal approach, IMO.

    That said, there is still a need for telemedicine for non-contrarians, and the bugs definitely need to be worked out. ZOOM is out; maybe Google et al will develop web-based alternatives. I agree that all future work in this area should be web-based. And don’t forget the lowly telephone and texting — both realtime interactive; video is a bandwidth hog and certainly isn’t require for most situations.

    There’s an old line to the effect: “Just because you CAN do something doesn’t mean you SHOULD do it.”

  • Apps can provide a great experience. For example, my gmail on an app is better than a mobile optimized website. However, it requires you to want to use the app regularly for that to really matter.

    BTW, Google has come out with more guidelines that are shunning the “m” instead of “www” approach for what they call a responsive website. They did just delay their search engine ranking penalties for this since so many had done it the way you describe, but long story short, there are ways to do mobile nicely on the web.

    I’ve been impressed by how many visits have been done on the phone lately. Definitely underrated.

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