Table 1.
Overview of the included original definitions of health apps and medical apps sorted by publicationa.
| Author, year, country | Definition of health app | Definition of medical app |
| Klasnja and Pratt [54], 2012, United States | “At the core of many mobile phone health applications is a single strategy: using the phone to track health-related behaviors, physiological states, symptoms, and other parameters relevant to health. [...] In addition to automatic detection of health-related behaviors, a number of phone-based health applications can connect, often wirelessly, to devices for measuring and uploading physiological data.” | “Medical apps are used to diagnose, self-manage, monitor and treat conditions, provide decision-support, and collect health-related information.” |
| Scherenberg and Kramer [55], 2013, Germanyb | “Transferring the established health definition of the WHO from 1946, health apps can be described as mobile applications that aim to positively and sustainably influence physical, mental and social well-being on the basis of scientific evidence.” | —c |
| Albrecht et al [21], 2014, Germany | “To better define the term ‘health app,’ we would like to suggest using the definition provided by the World Health Organization (WHO) in 1946 that defined health as ‘a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity’ (WHO, 1948). Apps that are in accordance with this definition of health—including apps that deal with wellness and fitness—can be summarized as ‘health apps.’ Health apps generally address healthy individuals who are simply interested in obtaining general information about their body and health status and want to keep fit and stay healthy.” | “Apps dealing with the prevention of or aid with diagnostics and treatment of diseases as well as injuries could also be added to this category, but since they touch on areas typically covered by medical professionals, assigning the label ‘medical app’ seems more appropriate to underline the diagnostic and therapeutic aspects of such apps. Medical apps usually target health care professionals as well as patients that have already been diagnosed with a specific—often chronic—problem.” |
| Aungst et al [56], 2014, United States | “Usually, apps designated for health and fitness are meant for daily use by patients, performing such functions as calorie and diet recorders, exercise assistants and patient diaries.” | “[...] apps categorized as medical are usually designated for medical professionals or as supportive apps for patients with a medical condition. [...] What sets apart a medical app from others is that they can play a role as a clinical tool in medical practice. They are utilised by allied health professionals in medical education, at the point-of-care, through direct interaction with patients, and as clinical references.” |
| Boudreaux et al [57], 2014, United States | “Phone application designed to promote health behavior or health maintenance [...], with the majority being related to diet and physical activity.” | — |
| European Commission [58], 2014, Belgium | “Lifestyle and health apps are primarily apps that directly or indirectly promote healthy behaviors, quality of life, and well-being for individuals.” | — |
| Seabrook et al [59], 2014, Canada | — | “Medical applications (‘apps’) for mobile devices such as smartphones and tablet computers provide health care professionals, patients, and the public with a growing number of specialized tools and resources.” |
| Gehring et al [60], 2014, Germanyb | “The term ‘Health App’ therefore refers to mobile applications that aim to positively and sustainably influence physical, mental, and social well-being on the basis of scientific findings. [...] In addition to apps that are intended to assist with relaxation (wellness), those that prescribe or accompany a physical work out (fitness) also belong to the category of ‘health.’” | “Among the large group of ‘health apps,’ there are of course also apps that have their mission in the prevention, detection and treatment of diseases and injuries. These are genuine medical topics and a differentiation into ‘medical apps’ (apps with a medical purpose—derived from the Latin ars medicinae, ‘medical art’ or ‘medicine’ [...]) is appropriate here in order to emphasize the diagnostic and therapeutic aspect.” |
| Powell et al [61], 2014, United States | “mHealth apps are mobile device applications intended to improve health outcomes, deliver health care services, or enable health research. [...] Because apps can be used to inexpensively promote wellness and manage chronic diseases, their appeal has increased with health reform and the increasing focus on value.” | — |
| Aitken and Lyle [53], 2015, United States | “The availability of consumer apps continues to grow, particularly in the area of health care apps. Commonly referred to as mHealth apps, these apps assist consumers in self-management of overall wellness, disease prevention and disease management.” | — |
| Lucht et al [62], 2015, Germanyb | “Health apps aim at maintaining fitness and supporting a health-promoting lifestyle. These apps are offered in the ‘Health and Fitness’ category.” | “In general, medical apps are apps for health care professionals that support their everyday work, as well as apps for patients to better manage mostly chronic diseases. These apps are mainly found in the ‘Medicine’ category of the two major app stores (Google Play, Apple iTunes).” |
| Albrecht and von Jan [63], 2016, Germanyb | “Health apps can be defined as apps that provide users with functionalities for the areas of health, medicine, healing or wellness and thus, in a broader sense, transfer the WHO definition of health (WHO 1948) to the app area.” | — |
| Kramer [35], 2017, Germanyb | “Health apps address healthy users who want to use the app to support themselves in a health-promoting lifestyle, and who want to strengthen their resources—for relaxation, for a better understanding of health or illness, for a healthy, active lifestyle—with the help of an app.” | “Medical apps address patients or their family members who are looking for support to better manage their daily lives, e.g., with a chronic disease. These apps are designed to strengthen the ‘self-empowerment’ of those affected to manage their disease. Medical apps also include apps that support health care professionals (physicians, nurses, therapists) in their daily practice or clinical routine, e.g., with reference works, dosage calculators, and medical decision-making aids. In the English-speaking world, medical apps are also referred to as medical apps.” |
| Morse et al [51], 2018, Malaysia | “Mobile health (mHealth) applications (apps) are software that are incorporated into smartphones to improve health outcome, health research, and health care services.” | — |
| Evers-Wölk et al [64], 2018, Germanyb | “Basically, health apps are application programs for mobile devices, in particular smartphones and tablets, whose aim is to have a positive effect on the user’s health.” | “Medical apps that address either medical professionals or must be classified as medical devices due to their medical indication. Applications that are specifically intended to detect, cure or alleviate diseases, illnesses and physical injuries are classified as medicine and medical science.” |
| Gregor-Haack [65], 2018, Germanyb | “Health apps are applications for citizens and patients whose primary goal is health or health promotion. According to the WHO definition of health, health apps are mobile applications that ‘positively and sustainably influence physical, mental, and social well-being on the basis of scientific findings.’” | “Medical apps are a smaller group of health apps that are specifically related to medicine. These include applications for service providers to support everyday professional life as well as applications for patients for the self-management of mostly chronic diseases.” |
| Groß and Schmidt [66], 2018, Germanyb | “A distinction must be made here between health apps, which are primarily aimed at medical laypersons interested in health, and medical apps, which are aimed at representatives of the health care professions. Health apps are much more common, mostly available free of charge in app stores and not subject to regular quality control. They range from pedometers, nutrition and weight control tools, fitness-related applications, the collection of (disease-related) user measurement data, to medication management.” | “A distinction must be made here between health apps, which address primarily laypersons interested in health, and medical apps, which address representatives of the health care professions. Medical apps focus on medical and nursing functions and often relate to the areas of diagnostics and therapy; they are regulated by the Medical Devices Act. Examples include medical reference works, calculators (e.g. for drug dosages) or the presentation of medical documents and images.” |
| Moshi et al [67], 2018, Australia | — | “One form of mHealth is mobile medical applications (MMAs) also known as ‘apps.’ These are a type of software available for mobile platforms (e.g., smartphone, tablet, smartwatch). In a medical context, MMAs may be used by patients to self-manage and/or screen medical conditions, rather than presenting at hospitals or clinics for additional appointments. MMAs may also allow for medical practitioners and/or allied health workers to remotely monitor, screen and manage their patients.” |
| Heretleif et al [68], 2021, Germanyb | “The delimitation is based on the consideration of three central perspectives: the user perspective, the technological perspective and the regulatory perspective. Health apps are primarily aimed at health-conscious users and offer support in the areas of prevention, education and health promotion. They are generally not aimed at healthcare professionals. From a technological perspective, their focus is on the collection, recording, processing and visualization of users' health-related data. A not insignificant proportion of apps focus purely on imparting knowledge. From a regulatory perspective, it is worth noting that, unlike medical apps or DiGA, health apps are not generally subject to any specific, binding regulation.” | — |
| Wang and Qi [48], 2021, China | “Mobile health applications, the principal manifestation of mobile healthcare, refer to health applications based on mobile terminal systems such as Android and iOS that provide services such as medical information inquiry and symptom self-examination. Mobile health applications allow users not only to seek answers to health problems but also to gain access to healthcare, exercise and fitness, health management, and other related services anytime and anywhere. Mobile health applications alleviate the shortage of health information resources to a certain extent, provide a convenient way for users to obtain health information and services, and play an important role in spreading health knowledge and meeting the users’ need for health consultation.” | — |
| Volpi et al [69], 2021, Brazil | “Mobile health apps (mHealth) offer a way to monitor patient’s health conditions, such as diet, body weight, blood pressure, mood, and sleep, among others, and can be used in combination with traditional health care to facilitate access to health information [...]. Thus, mHealth apps might increase awareness of needed behavioral changes and the adherence to healthy habits, along with the health care provider’s awareness of what the patient is doing [...]. Moreover, mHealth apps can guide illness self-management, providing patients with psychological support and decision-making support, and facilitating collaboration between health professionals, patients, and their families.” | — |
| Golden et al [70], 2021, United States | “In recent years, mobile health (mHealth) apps on smartphones have become ubiquitous tools for personal health management and behavior tracking. mHealth apps can provide individuals with continuous feedback on health status and progress, push notification reminders, and other useful engagement features.” | — |
| Racioppi et al [71], 2021, United States | “The Health apps specifically have the potential to enhance patient/provider communication and assessment through active and passive evaluation and tracking. Smartphone mobile applications are able to record self-reported patient outcomes, whereas activity trackers such as the Apple Watch and Fitbit are able to collect real-time physiological data such as heart rate and step counts.” | — |
| Tobias and Spanier [72], 2021, Israel | “Health apps can monitor health conditions and alert the patient or attending physician about deterioration.” | — |
aOf the 22 definitions of health apps, 9 (41%) were in German and translated into English. A total of 45% (10/22) of the publications came from Germany, and 32% (7/22) came from the United States. Other definitions were identified from Asia (3/22, 14%) [50,53,54] or South America (1/22, 5%) [55]. For medical apps, of the 11 definitions, 6 (55%) were published in German. As for health apps, most descriptions for medical apps came from Germany (7/11, 64%) or the United States (2/11, 18%), only 9% (1/11) came from Australia [71], and 9% (1/11) came from Canada [72].
bGerman publications translated by the authors (MF, HHD, and TJ) into English.
cNo definition given.