Five Reasons Native Apps are Beating the Mobile Web, and 10 Reasons Why They Shouldn’t

cute woman texting

Right now there is a conundrum facing many companies that are trying to reach customers on mobile devices. Do I develop a native application for the device –which really means developing several native applications in order to connect with users of iPhones, Andriods, and Blackberries? Or, do I develop a mobile Web site accessible through various mobile browsers? Perhaps you should do both. Yet if you have limited resources, like most of us, you’ll need to make some choices. What is the best investment?  That all depends on your business goals, who you need to reach, and ultimately who you believe will control the world mobile devices.

Why native apps are winning now:
  1. Easier to monetize (this is the most important reason):
    • People are more willing to pay for something tangible, such as a new app, than they are to access a Web site.
    • Apple iTunes, Google Andriod Market, Amazon Andriod App Store have created a market for buying and selling apps.
    • Apps can garner additional revenue from advertising placements within the app.
    • In app purchases offer new ways to generate revenue by allowing users to buy added features, upgrades, virtual products from within the app.
  2. Better UX: With a few exceptions, the user-experience for native apps is better than most mobile webs;  Many mobile sites are mostly crap.
  3. Better integration with device capabilities: If you are creating features that are tightly integrated with the device (i.e., GPS, accelerometer, compass, camera, address book, calendar), then an app may be a better choice. Though, I should note that Safari already has integrated support for their accelerometer and gyroscope.
  4. Better performance: Native apps run faster -usually. This is especially true for highly complex and interactive applications.
  5. Some apps need to be native: Apps which are extremely complex and highly interactive, e.g. games like Super Monkey Ball, are best developed for native platforms (see #4 above).
For certain types of applications, developing a native app makes more sense right now.  In particular, this is true for graphics heavy games, or apps that need to be tightly integrated in the capabilities of the device. However, for most others, there are pretty compelling reasons to hope for a future where mobile web sites are the norm. 

Why I believe the mobile Web should win:

    Andriod and Firefox logos

  1. Access to 100% of smartphone users: With a mobile Web site, you have the potential to reach 100% of smartphone users, on every platform.  Your iPhone app will only reach about 7% of the total mobile market.
  2. Standards-driven platform: It’s easier and more efficient to build for a single, standards-based platform (such as HTML5); sure, you’ll still need some code to translate the experience across multiple devices, but writing that code will be easier than developing multiple native apps. For more on mobile Web standards see WC3 and WURFL.
  3. Easier to maintain, support and upgrade: A mobile web site will be easier to maintain, support and upgrade compared with separate apps for several platforms; again, you can use one set of rules to adapt code so it works  across all devices. Plus, you can release updates as often as you want.
  4. Improved results for mobile advertising:  For any online ad campaign to work, you need to have a great “post-click” experience. It’s no different for mobile. Where will your mobile ad take you? A well-designed mobile landing page will likely be your best bet.
  5. Performance will keep getting better: Mobile browser performance is already improving with HTML5, accelerated CSS, and better JavaScript.
  6. Better UX is within our grasp: Some mobile web sites already offer an excellent user experience. As companies direct more resources, innovation, and focus on mobile customers, mobile UX will improve greatly. Here are a few great examples of mobile Web sites:,,, Amazon. For additional mobile design inspiration, check out these well-design pages courtesy of Designmodo.
  7. No gatekeeper: Anyone can get to your mobile site; unlike creating app, you are not at the mercy of someone else (e.g., Apple, Google) who controls entry into the app store.
  8. No revenue-sharing is required: App stores demand some pretty significant revenue-sharing agreements, before they’ll agree to accept your app. Not so with a mobile Web site –you keep control over your entire revenue stream.
  9. Better for search and SEO: Unlike an app, mobile Web pages can be crawled and indexed by search engines. This is important so users can discover your content through searches on relevant keywords. In addition, other sites can link to your mobile Web site content, which will improve your search rankings (as long as your mobile site and main Web site are hosted at the same domain).
  10. You just don’t need an app:  Assuming you’re not creating a graphics-intensive game or building features around tightly integrated capabilities of the device, a mobile site is going to be just fine.

In the end, you need to be clear on what audience you want to reach and how quickly.

If you already have a large number of customers who expect to access your services from their mobile device, you may opt to develop apps for multiple platforms and a mobile site.  Otherwise, set your priorities, consider the issues noted above, and think about where we are headed. I believe mobile Web sites and hybrid apps (skinned browsers) will beat out the App universe –except in the case of games and certain business apps.  Why? For the reasons I mention above, plus just take a look at how SaaS products continue to erode the sales of many desktop applications.

7 Reasons Why EHRs Matter Now

Doctor using touchscreen display

In the future, electronic health records (EHRs) will integrate family histories, comprehensive genomic data, and real-time biometric data, with the growing trove of health information already being captured. The expectation is that these advances will lead to improved and more personalized diagnoses, treatments, and prevention plans. Of course, we’re not quite there yet. However, forces have begun to align to make the latest EHRs more useful and ready for adoption.

EHRs are poised to become the norm for every hospital, outpatient clinic, medical group, and private practitioner. And I believe that is a very good thing. 

re’s why you should get on board now:

  1. Paper records are inefficient – Just like older card filing systems in libraries, paper records are, well, inefficient. They can’t be in two places at once, they can be misplaced, handwritten notes may be illegible, they take up physical space, they aren’t integrated with claims and billing, and the information within them isn’t easily shared. Those using EHRs will have an initial learning curve, but ultimately they will improve administrative efficiency, making medical record-keeping faster, better, and easier.
  2. EHRs are good for patients – EHRs improve a patient’s access to useful information. While patients can’t directly access an EHR, most EHRs will enable patient access to certain medical information through a patient health record (PHR). The typical PHR gives patients an easy, secure way to access appointments, prescriptions, test results, immunizations, preventative services, and secure messaging, which facilitates much better communication between a patient and their doctor.
  3. EHR solutions are good now, and they will continue to get better – The usability, technology, and capabilities of EHRs has improved greatly. They are designed to work with more specialties than ever. They are becoming easier to use, less costly to implement and maintain, and more connected to an entire ecosystem of useful tools and features. In particular, cloud-based systems, such as that offered by Practice Fusion, will allow small groups or private practices to get up and running quickly, without upfront investments in technical infrastructure or specialized IT knowledge (check here for a complete list of certified EHR products).
  4. Better Access to Data – The ability to aggregate medical data for certain patient populations should help physicians monitor how well their patient’s are controlling conditions such as diabetes, heart disease, and hypertension. They’ll also keep track of immunizations and preventative care needs. However, the biggest impact of this data may not be to an individual doctor’s patient panel. Anonymized (de-identified) data extracted from EHRs may ultimately be used for improve predictive modeling, comparative research (comparing drugs, treatments or medical devices), real-time surveillance (to track the spread of TB and other infectious diseases), and adverse event monitoring.
  5. Government incentives – The HITECH Act of 2009 provides incentives of up to $44,000 over 5 years to eligible professionals who adopt, implement, upgrade or demonstrate meaningful use of certified EHR technology. But you should start now. The maximum incentive is only available for those who demonstrate “meaningful use” by 2012 (Also see the Medicare Electronic Health Record Incentive Program for Eligible Professionals PDF for a good summary). To receive the latest updates on these incentive programs, subscribe to the CMS EHR Incentive Programs Listserv.
  6. Healthcare Information Exchanges – The holy grail of health care data interoperability is the healthcare information exchange (HIE). HIE’s allow the sharing of healthcare information electronically across organizations: within a hospital system, community, or region. By linking patient data with multiple providers, HIEs improve the continuity of care. Secondly, the exchanges reduce the expenses and time that would otherwise be spent for duplicate tests, locating missing patient information, printing and copying documents, scanning and faxing documents, mailing patient charts, and the manual communications needed to verify the delivery and receipt of information, referrals, and test results.
  7. Good Data Security and Privacy Compliance Data security and privacy compliance may be the most important things for health information systems to get right. The good news is that the tools you need for excellent data security and compliance with privacy rules are readily available. In fact, any worthy EHR solution will embrace these features: secure data warehouses, backup systems, redundant power supplies, data encryption, and a Certificate of Compliance by an Authorized Testing and Certification Body for each EHR module. There are even more novel solutions to address the complex flow of data in HIEs. For example, trust networks, like those designed by Resilient Network Systems, allow owners to apply customized privacy policies to control access and use of their data.

There is a vast graveyard of well-documented failures that have left many skeptical about the benefits of EHRs.

EHRs and EMRs have been around for over 30 years and I’ve seen first-hand how much money has been wasted on HIT systems. Why do they fail? There are plenty of good reasons EHRs or other ehealth initiatives may fail. Here are just a few:
Stack of patient medical records
  • EHRs are not a substitute for good medicine
  • You did not fix broken processes or redesign workflow before implementation
  • You expected to solve a problem the EHR was not designed to solve
  • Your EHR was poorly designed
  • Your EHR was poorly implemented
  • Your training was inadequate
  • You did not get buy-in/commitment from staff
  • You selected the wrong solution for your practice
Still, I was struck, though not surprised, when I saw the recent electronic health records study published in the Archives of Internal Medicine on January 24, 2011, concluding that there is no consistent association between quality indicators and the use of EHRs.  The study, entitled Electronic Health Records and Clinical Decision Support Systems, Impact on National Ambulatory Care Quality focused on the use of electronic health records (EHRs) and Clinical decision support used in the ambulatory setting between 2005 and 2007.
To be clear, it wasn’t so much the results or conclusion of this study that struck me. You see, PLoS Medicine recently published a meta-analysis examining 53 systematic reviews that assessed the impact of various ehealth interventions. In his review, The Impact of eHealth on the Quality and Safety of Health Care: A Systematic Overview, Sheikh and his colleagues reached a similar conclusion. According to the authors, “many of the clinical claims made about the most commonly deployed [digital health] technologies cannot be substantiated by the empirical evidence.”
What struck me was the futility of anyone who might use these articles in their attempts to argue against, or delay the implementation of EHRs.
Deep down, even the most stubborn physicians know there is no stopping the accelerating pace of EHR adoption. Resisting this change will not stop it from coming. That would be like continuing to use the typewriter in hopes of slowing down the spread of personal computers. It’s already happening and nothing you do now is going to stop it.
No one denies that technological innovations can improve health care, and no one can stop the move away from paper-based patient record systems.
Are EHRs perfect now? No. But their designs, features, and usability have gotten pretty damn good, especially in the last few years. As I’ve described above, there are compelling reasons for more medical practices to adopt EHRs now.  With wider acceptance there will be more data and more innovation, which will ultimately lead to the promised improvements in clinical quality and health outcomes we are expecting.

Books, Publishing, and Marketing for Authors

Over the last couple of months, several people I know have approached me to assist them with marketing their recently published books. This got me thinking about the direction of the book publishing industry and how author’s are better equipped than ever to reach out directly to their potential readers. Yet, most authors still rely on their publishers to market and promote their books.

The book industry is going through a massive change, not unlike the music industry already has. E-Readers are getting a lot of recent attention, but there are huge changes occurring for authors, publishers, and the marketing of books. Here are a few insights I have gleaned:

  • Book Publishers are Dead – Just like the record labels, publishers are no longer necessary to create and publish your book. With a manuscript in hand, authors can now publish on their own through services like Lulu,, iUniverse, or CreateSpace (an Amazon company). Sure, there may be some upfront expenses, but those costs are fairly low and will continue to drop given options like ebooks and print-on-demand.
  • New Content Distributors for Books – Who will own the new method of book distribution? As with LPs and CDs, paper books will largely give way to ebooks. The new ebook distributors will control the marketplace. The winners? We’ll see. Those with eReaders are getting an early start, but I’m betting on Amazon, GoogleBooks, Apple (think Tablet PC + iTunes + eBook Store), Sony.
  • Social Media for Marketing Books – There are many ways for authors to directly reach out and get found by their target audience. Similar to traditional marketing, the first step is to understand your audience: who are they? where are they? what do they need? But unlike traditional marketing, using social media and inbound marketing let your potential customers find you. A great place to learn more about this is HubSpot. HubSpot provides excellent and free resources (including Inbound Marketing University), plus they actually use these practices in marketing their own business. 

So, my message to authors is “get found.” Understand your audience, create useful content for them (videos, blogs, articles, ebooks), optimize your content (make it easy to find), then promote the hell out of it (Twitter, Facebook, RSS feed, join/create community). It will take work. You may need help. But unless you already have celebrity author cred, you have no choice.

Marketing in the Present

Wow, the world of marketing and PR has changed so much in the last few years. It’s no longer an option to rely on traditional means of advertising and communications to get out your message. In fact, you are no longer in control of your message.

For anyone trying to grow a business, trying to communicate with customers, it’s time to embrace the current state of affairs. This means letting go and reaching out using new strategies, tools, tactics and technologies. It’s not about announcements, broadcasts, or controlled messages. It’s a conversation. And how do you start this conversation?

A great conversation begins by having something to share that’s interesting, engaging, provocative. Next, you need to be responsive and remain alert as these conversations emerge, spread, and evolve. Whether you start such conversations yourself, or not, you need to participate in them. Start one, find one, change one, just be part of the conversation.