Going native with healthcare apps: stepping back from the
By Chris Watson, Product Manager at Exco InTouch
31 October 2014
The use of health apps to monitor patients' progress and to help
them self-regulate their condition has been growing dramatically
across the globe. With this in mind, there has been much debate of
late about how to deliver public-facing healthcare apps across
different operating platforms (iOS - Apple, Android or Windows8) to
provide the best user experience.
There has been a huge demand in the healthcare industry for
electronic clinical outcomes assessment (eCOA) providers to deliver
user friendly solutions that patients find easy to use and
accessible. Alongside this demand, there has been a lot of
discussion recently on the growing use and popularity of native apps
in the clinical industry. At present there are three different ways
to present healthcare apps, all of which can come with an icon on
the devices’home screen, but which fundamentally have different
- Native apps: downloadable software which is
coded to run directly on the devices’operating system. The
versatility of native apps means that they can be used without
requiring a mobile or internet connection and can interface
directly with the devices’inbuilt functionality (camera,
Bluetooth, microphone etc.).
- Web apps: downloadable mobile websites that
look and feel like native apps, normally built using HTML5
technology to utilize the devices’web browsers. Whilst they
boast interactive functionality (as opposed to just capturing
information), they are unable to readily access many of the
devices’inbuilt functions. These apps consist of a HTML5 core
which is embedded or wrapped”into a code base, which appears to
the phone as being native code.
- Mobile websites: websites which are
accessible on a mobile device and which have been optimized for
use on a mobile phone or a tablet. Mobile websites by nature
provide web-based controls to users on their own devices,
storing the website URL on devices’home screens as an icon and
generally providing information or facilitating the capture
information from the user. However, they have limited
Currently the most common approach when developing healthcare
apps is to use HTML5, which wraps a web app into mobile operating
controls. HTML5 web apps are prevalent because the technology
facilitates speed to market, as there is one fundamental build which
is then embedded into a code base that enables them to run on
different mobile operating systems.
However, as HTML5 is a web-based language, it does not enable the
layout of the screens to be optimized for the devices’ screen size,
or enable the incorporation of natural button configurations.
Therefore, whilst HTML5 web apps may look like native apps at login,
once inside they often adopt a web look and feel.
In contrast, native apps provide a consistent look and feel
across all screens and devices' types and can be developed to
deliver clinical and healthcare programs in a timely, cost effective
manner across all platforms, without the need to compromise on the
Native apps enable the display to be optimized to the user
demographics, so as to control how the screens are presented by
automatically adapting to the users’controlled accessibility
settings within the devices. This is especially crucial when dealing
with patients of advancing years or those with disabilities.
In addition, native apps are ideal if a study is being carried
out in geographies where mobile connectivity may be unreliable. In
this case, a native app should store data locally in an encrypted
form until a connection is made to enable secure data transfer.
Native apps will have enough capacity on the device to ensure
eCOA data can always be stored when necessary and will have the
mechanisms in place to ensure that the data is securely deleted once
the data has been sent. This applies particularly in a Bring Your
Own Device (BYOD) setting, which is becoming more popular due to
patients’familiarity with their own devices, which in turn
translates into increased engagement.
Furthermore, alongside the collection of primary outcomes data,
native apps can also facilitate the measurement of secondary
outcomes data through the active integration of medical device data
(such as Vitalograph asma1-bt and MyGlucoHealth) and the passive
integration with lifestyle devices (such as FitBit and the Withings
devices) which are becoming increasingly popular tools for use in
As experts in electronic data capture, Exco InTouch use their
experience to deliver solutions which are designed to be fully
compatible with a broad range of home monitoring devices, providing
a simple interface for medical device reading for the end users.
Pressure to be first to market has seen many business and
organization consider native apps as costly, timely and unwieldy.
Detractors say that it is easier to develop a web app because there
is no need to produce multiple app versions to operate on different
platforms and their operating systems, such as iOS, Android and
Windows8 Mobile. Nothing could be further from the truth when it
comes to healthcare.
Apps for healthcare
For healthcare organizations, a native app will enable them to
select their preferred delivery model, offering the flexibility to
either provision appropriate devices for the study population, or to
enable BYOD in both clinical and commercial health programs. This is
enabled, for example, by Exco InTouch’s proprietary mDNA technology,
which provides sponsors and payers the robust reassurance of
protecting Personally Identifiable Information (PII) and maintaining
data security even when using patients’ own devices.
At the heart of the native vs web app debate is an issue of
selection. Going native does not rule out mobile web (native can
utilize mobile web). What HTML5 does with a web app is a compromise
— a halfway house that may be quicker and cheaper in the short term,
but not for longer studies. The increasing popularity of native apps
means they will become more prevalently used in future. There
remains a functionality cliff with HTML5, and sooner or later it
will become apparent. Would you rather develop an app twice — or do
it right the first time?