The United States is on the brink of a catastrophic shortage of doctors. It is forecasted that by 2032, there will be a shortfall of 46,900 to 121,900 physicians.
This doesn’t account for other healthcare disciplines such as mental health professionals. It is estimated that there are approximately 30 psychologists per 100,000 people and 15 psychiatrists per 100,000 people.
What do these alarming statistics have to do with telehealth apps, you ask?
Telehealth holds the promise of mitigating the impact of this lack of supply of healthcare professionals and diminished access to healthcare services. It opens doors for new possibilities where healthcare providers can extend their coverage and make a more meaningful impact on the population with immediate results.
In this blog, we’ll cover everything you need to know about how to develop a telemedicine app.
1. Telemedicine Trends
The COVID-19 pandemic has already transferred the healthcare services landscape in a way that neither iPhone nor Web 2.0 nor consumer wearables have managed to do in the last two decades.
Doctors and patients alike, affected by the quarantine, embrace telemedicine as the technology that keeps them busy and healthy. Virtual care is no longer the privilege of millennials — the virus has encouraged everybody to up their tech-savvy game.
Let’s look at some of the trends shaping the telemedicine industry today.
According to Mordor Intelligence, the telemedicine market will surpass $66 billion globally by 2021. That’s a healthy 32 percent growth rate compared to 2019. And there are no signs of stopping, with telehealth reaching $175.5b by 2026.
CB Insights reports record levels of financings in telehealth in Q1 2020. With patients increasingly turning to online doctor visits, telemedicine funding soared nearly 300% compared to Q4’19.
Telemedicine is inclusive
Underserved communities, seniors with chronic diseases, and other vulnerable groups of population along with tech-savvy younger people — a vast population is going to adopt and rely on telemedicine.
That means the companies working telemedicine solutions would need to sort out another layer of complexity. How do you create a telemedicine app that is equally well understood and navigated by different target audiences?
Telehealth is rapidly expanding beyond e-consulting with a physician. As patients are getting accustomed to the new technology, there appears the need to cover the whole spectrum of healthcare services. That brings to life new, niche telemedicine products, such as teledermatology apps, telenursing apps, telepsychiatry, and other types of virtual care apps.
Better insurance coverage
Insurance companies and federal health care programs are stepping up to cover care administered by means of telehealth apps. For instance, Medicare already covers some types of telemedicine services and remote patient monitoring. Note that you can build a telemedicine platform integrated with insurance services.
Remote patient monitoring
Remote patient monitoring (RPM), as a distinct subset of telehealth, is garnering wider adoption as providers seek to push back patient readmission rates. RPM apps have proven their effectiveness in helping doctors watch patients’ recovery or illness progression while they stay at home.
Artificial intelligence is a change agent. Applied to patient healthcare data, the technology can assist medical personnel by making predictions about patients’ well-being. That results in timely and accurate treatment plans.
Benefits of telemedicine apps
Why would you build a telemedicine app? Training a new doctor can take up to 18 years. And one of the benefits of telemedicine is that it eliminates this waiting period for patients in communities with limited access to healthcare professionals by linking them to other physicians from all over the country, on-demand.
Let’s look at some other benefits telemedicine has to offer for patients and care providers.
- On-demand access to healthcare specialists
- Authorized permission to message the doctor
- No need to travel to a clinic
- Lower cost of service
- Ease of use (accessible on any device)
- Freedom to collaborate with remote colleagues on patient cases
- Access to home-care and discharged patients
- Ability to treat more patients simultaneously
- Integration with EHR and other clinical systems
- Fewer cancellations and missed appointments
Top 3 successful telehealth apps
Market Cap: $12.2b
Founded in 2002, Teladoc is one of the two publicly traded telemedicine companies in the US (the other one is SmileDirectClub, a teledentistry company). The company provides patients with easy-to-use mobile apps for iOS and Android and offers its telehealth platform as a white-label solution.
The Teladoc notable features include:
- Scheduling a meeting
- Mobile payments
- Video and audio calls
- Integration with Healthkit and Google Fit
- Medical history
Doctor On Demand
Funds raised: $160m
Doctor on Demand is a telemedicine app that connects patients with a variety of healthcare professionals. Similar to Teladoc, the company offers its customers apps on both mobile platforms. Patients can schedule a video appointment from their phones and tablets.
- Upfront pricing
- Medication management
- Push notifications
- Video calls
- Healthkit and Google Fit
Funds raised: $124m
MDLIVE is a telehealth service company that was founded in 2009 in Sunrise, Florida. MDLIVE is a serious player in the telemedicine space, especially after it partnered with Walgreen’s to step up its meds prescription options.
- ePrescribe integration
- Video calls
- Health records
- Instant messaging
- Mobile payments
2. Telehealth Challenges
Despite shocking stats for telemedicine apps adoption (on track to top 200 million e-visits this year vs. expected 36 million), there are still some challenges in telemedicine app development that developers and healthcare providers have to overcome to ensure sustainable growth of the technology.
Some communities are composed of people who don’t have a perfect command of English.
That can negatively impact their access to quality healthcare services. It’s not because care providers are inefficient, but because patients are unable to communicate their conditions and symptoms accurately as a result of the language barrier.
Technology now exists to translate communication in real-time so both the doctor and the patient can understand each other in their own native language.
This would drastically improve each patient’s safety and safeguard against misdiagnoses, wrong prescriptions, and mismanagement.
Do you need to be HIPAA compliant?
Yes. As with every covered entity, you’re going to be handling Protected Health Information. You’ll need to be HIPAA compliant at all stages.
Why not just use Skype instead of a Telehealth app?
Skype has not signed a BAA and does not require the encryption of protected health information. As such, it is not HIPAA Compliant.
A hacker can potentially listen in and steal PHI, causing severe damage to your organization. We do not recommend the use of Skype in place of a secure telehealth app.
3. What Functions Do You Need and What Tools Can You Use?
In order for your app to deliver complete telehealth services, you need to have the following basic features on your telemedicine app. Depending on whether you start with a minimal viable product (MVP) or continue building a full-fledged telemedicine app, there will be different features in your app.
MVP feature set
An MVP version of a telemedicine app needs to provide users with bare-bones features, just enough to turn virtual care into reality. Let’s briefly review this essential functionality.
Secure Video Calling
This is the most important service of the app. Patients and providers need to see and talk to each other in real-time. Visual cues make a big difference in identifying signs of illness. The video needs to be of high quality with low latency.
Providers and patients must have the ability to send rich messages to each other to exchange information before, during, and after a call. This is a useful tool for healthcare providers to give written instructions and reach their patients when not able to call.
Also, patients can write information that can’t be easily understood during a call due to differences in pronunciation or interruptions in network connectivity.
If you are building an app for neurology, you will need a secure repository for patient information, medical history, labs, and imaging. This will also handle user authentication.
An appointment tool or patient scheduling tool so people can book appointments with their chosen provider.
Advanced Feature Set
Going beyond MVP, you may start adding features that further improve the quality of care and bring more comfort to patients and healthcare professionals.
Group chats and calls
Group chats and video calls are necessary to allow a doctor to add their colleagues to an ongoing call with a patient for a quick, on-the-spot consultation. Doctors can also hop on a group call to review lab test results.
Integration with EHR
It goes without saying that accurate patient history is a must for any healthcare organization. Being able to sync patient info gathered during a consultation directly to an EHR system can save med personnel a lot of time.
VR for telepsychiatry
Mental health sessions can be enhanced with a virtual setting that helps establish trust between specialists and patients.
A telehealth app may incorporate an e-prescription component to expedite the process of prescribing meds.
To make the process of joining a call for patients as seamless as possible, you might need to integrate a payment gateway. That way, patients will be able to pay for the services right in the app, before a call. Many telemedicine apps implement this functionality via a web view to bypass Apple/Google commissions.
Integration with peripheral IoT devices
Certain medical specialties may benefit from connecting a telehealth app to a medical device like intraoral cameras used in teledentistry.
Integration with Healthkit and GoogleFit
To make sure doctors have a full understanding of a patient’s condition, it makes sense to integrate a telehealth app with Apple’s Healthkit and Google’s GoogleFit. These services supply all relevant patient health data.
Chatbots can be an excellent tool for triaging simple cases before a call and as a help desk alternative.
Module for medical assistants
Most advanced telehealth apps sometimes include a separate UI for nurses and other medical assistants that may join the call to update health data, notes, and everything else that doctors can absolutely live without.
4.5 Steps to develop a telemedicine app
Step 1: Choose a platform
Before you commission your designers and start coding, you need to decide which platforms to custom develop your app for. iOS and Android for mobile, web and native for desktop. Your target geography and app functions will direct your choices.
If you remember our recent article about making health apps for the iPhone, we discussed why an iOS-only approach works best for the USA, and an Android-first approach for the rest of the world.
For the sake of this article, we’re focusing on the US market.
Mobile: iOS or Android?
The iPhone makes up for 55% of the total smartphone user base in the USA with Android accounting for the remaining 45%.
These statistics may sway you to build an iOS-only version of your telehealth app because iOS users are known to spend up to three times more than Android users.
But at 45%, Android users are too many to be ignored, so you need to factor this into your long-term planning.
Naturally, React Native is almost always the most sensible platform to begin with, given the likely need to cater to both iOS and Android devices.
Desktop: native or web?
You will need a web app for patients who cannot access an iOS or Android device, as well as for physicians to manage their workflows and patient files.
The cost of building a web app and a native app is almost the same. In fact, a web app can be converted into a native desktop app that works on Mac, Windows, and Linux using tools like Electron. Slack is an example of software built with Electron.
Choosing between SaaS and custom build
A SaaS solution does not give you the liberty to personalize the front-end experience beyond a logo and name change. Other than that, the app is identical to all their other customers’ apps.
If you want to control exactly how your app looks and functions, you’ll need a custom-built solution. In this case, say, telenursing app development services from healthcare app development experts may come handy.
A custom mobile app is developed using open source or paid APIs. This gives you granular control over your entire app. By using TURN servers and protocols such as WebRTC to handle your videotelephony, we can create a telehealth platform that works just the way you want it.
Is SaaS cheaper than a custom build?
SaaS solutions typically come with a monthly subscription fee. They can be deployed relatively quickly because there is little to no programming involved. The monthly payment is usually adjusted according to user volumes. This is an overhead you have to maintain indefinitely.
SaaSs may initially appear to be the cheaper option, but it can become the more expensive choice once you outgrow the capabilities of your SaaSs product. When you reach that stage, you’ll be back searching for a custom solution to meet your growing business needs.
Also, you have no control as to when or what changes your SaaSs provider makes to your app. They can remove features and update policies on a whim. And because they have to support many clients, this may lead to some uncomfortable compromises for everyone.
Yes, a custom-built app may be more expensive in the short term because of development and maintenance costs, but you get more value out of it in the long run.
Carefully weigh the cost-to-benefit ratio and product-market fit before deciding which way to go. A custom-built app offers absolute authority over every aspect of your app, including branding.
Step 2: Design the perfect telehealth app
User experience design
The user experience design is the most critical aspect of the entire app design phase.
Many entrepreneurs come up with great app ideas and build apps that work very well from a technical standpoint but end up failing because the user experience is out of touch with the target audience.
It is not enough to have the right technology. You need to understand the people you are trying to help.
The UX design stage is where this can be prevented.
You will be designing two sides of your app – a provider backend and a front-facing patient side.
Be sure to simplify the onboarding process as much as possible by limiting the number of screens to a maximum of three. Too much information and you could make it difficult for your users. The copy must be written in 3rd grade English. Everyone can understand that level of English. You’re not trying to impress users. You want them to do exactly as you say without second-guessing.
Time spent on every call will be charged, so strive to make the app as easy to use as possible. The provider and patient need to concentrate on the consultation, not trying to figure out how to navigate and use your app.
After your UX wireframes are completed, you need to set up a focus group and conduct user testing. Get their feedback, revise the design according to their recommendations. Repeat the process until you are satisfied.
Once this stage is complete, you’re ready for the next one – User Interface Design.
User Interface Design
The User Interface Design stage adds skin to the UX wireframes. Colors, buttons, fonts, and all other visual aspects of the app come to life in this stage.
Different colors and button sizes need to be tested. User behavior is affected by colors and the position of components on a screen. The UI must then be converted into a working prototype using a process similar to our rapid prototyping process and also subjected to user testing.
Like the UX stage, revisions must be made as needed until you are satisfied.
Please note that this is but a brief glimpse of the whole design process. For a more in-depth look, please read our 7-Step Ultimate Guide to Mobile App Design. I highly recommend that you check it out.
Step 3: Choose APIs you can use to integrate into your app
Building a telehealth app in the absence of market-ready APIs can easily take 1 to 2 years. But with the components now readily available in the market, a telehealth app can be built in 3-6 months.
This doesn’t diminish from the fact that it is still a very difficult and time-consuming task to make the APIs work as desired. Let’s take a look at some of the leading ones:
VSee SDK is a rich telemedicine API that integrates end-to-end encrypted video calls into your mobile app for iOS and Android, as well as native apps on Mac and PC.
It’s HIPAA compliant and has its own server-client, so you don’t need to provision a server to set it up. It drastically reduces the technical workload, allowing you to focus on user experience and interface design.
However, the drawback is that it’s not open source, and there’s a significant cost barrier to get the customizable codebase. Access to the codebase can cost as much as $20,000. Failure to get that would mean you have to settle for their SaaSs option, which provides no personalization besides a name and logo.
This API allows you to integrate real-time communication capabilities into your app on multiple platforms, including Windows, Mac, Linux, iOS, and Android.
It has built-in text chat, so you don’t need to use a separate text chat API. It also supports screen share as well as multiparty video calls for group video conferencing.
Vidyo’s not an open-source product. It offers minimal customization because they emphasize embedding their software into your app. That makes it similar to a SaaSs product with limitations to customization.
WebRTC is a free and open-source platform that enables real-time communication in web and native apps. It has simple APIs that have been optimized to transmit audio, video, and data. Supported browsers are Firefox, Opera, and Chrome on desktop and Android.
Native support is also available for Android and iOS. macOS and Windows are not supported.
The setup of this API is more involved than the others, but it’s very customizable.
OpenTok is a cloud-based WebRTC platform. While WebRTC is an open-source, the software that powers OpenTok is not. With that being said, it offers all the customization potential you’d have on your own WebRTC deployment.
Owned and developed by TokBox, OpenTok also allows you to integrate video, voice, text messaging, and screen sharing into your app on the web, iOS, Android, and Windows. It doesn’t support macOS.
OpenTok supports HIPAA compliant app development. The developer building your app is responsible for configuring the app per HIPAA requirements.
Dr+ On Demand is powered by Twilio Programmable Video API. It works on all browsers without users installing any plugin and on iOS and Android.
It integrates with platform APIs like iOS CallKit, ARKit, and more. This makes it very versatile with many possible functionalities you can add to your app. It’s incredibly agile and can easily be scaled from starter to enterprise instantly.
Twilio boasts a lower latency than all other available platforms, claiming up to 50% better video quality.
Twilio also has APIs for SMS messaging, voice calls, text chat, email, fax, and even WhatsApp. Of all platforms, Twilio is the most robust and offers the best integration options.
Acuity has been designed to support the healthcare industry’s needs and, as such, is HIPAA compliant. You’ll need a Powerhouse plan for you to enter into a BAA with Acuity Scheduling.
How do you select the right APIs?
This depends on your choice of platform and what functions you need. The best combination, however, is using React Native as your platform, Twilio — for video and chat. The chat must be encrypted with Virgil Security’s end-to-end encryption SDK.
Step 4: Test your telemedicine app
We can’t stress enough how important that stage is. Making sure your app works flawlessly is a huge milestone in the telehealth app development journey. You should have your app developers execute peer code reviews. At the same time, the QA team carries out unit tests on various devices.
Even though a properly setup QA process implies frequent testing after each sprint, do plan for a final quality assurance round that includes regression testing and covers everything you’ve already tested during previous sprints. We recommend performing stress testing before the launch to see if the app can hold an inflow of new users.
Step 5: Deploy and maintain your app
Finally, once the app has been developed, it’s time to move it to a live environment and into the app stores where customers can download it.
IOS and Android receive updates every year. It’s essential to update the app accordingly to make sure it continues providing the best user experience.
5. How Much Does It Cost to Develop a Telehealth Application
The cost of developing a telehealth app may vary from US$59,000 and all the way to US$149,000, depending on its complexity. On the lower end, we are talking cross-platform mobile apps that reuse as much as possible from a rather simple web telemedicine app. And on the higher end, we mean an advanced web platform with native mobile apps specifically optimized for smartphones and tablets.
6. Time to Make a Telemedicine App
Now that you know how to develop a telehealth app and what it costs, it’s time to build one. At TopFlight Apps, we specialize in building health apps for iOS, Android, and the web. We’ve proven our salt’s worth and helped health startups like Xzevn, Smarter Symptom Tracker, and RingRx create successful businesses by building robust apps that meet and exceed their needs.
Do you have a telehealth app project? We’d like to help you with it. Get in touch here.
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