A new study led by Karl Landsteiner University of Health Sciences reveals major blind spots in India’s digital health landscape.
Krems, Austria, 15 April 2025. Smartphones are changing the way people manage their health – but when it comes to heart disease in India, app stores are lagging far behind. Despite heart disease being the country’s leading cause of death, accounting for over 28% of all fatalities, a now publishedstudy shows that only a tiny fraction of more than 200,000 health-related apps available in India actually addresses this urgent health issue. The research, conducted at Karl Landsteiner University of Health Sciences (KL Krems), involved a large-scale analysis of app store data from Apple and Google using natural language processing and clustering techniques. It showed, that very few health apps offer content in Indian languages, making them inaccessible to large segments of the population. Among the heart disease–related apps identified within the English-language pool, most are free – but they are rarely rated or reviewed, suggesting limited use. These findings highlight a major disconnect between digital health innovation and public health needs – and underscore the importance of rethinking how mobile technologies are deployed to combat serious conditions in low-resource settings.
Mobile health (mHealth) apps are often seen as a promising way to close healthcare gaps, especially in places where access to doctors or hospitals is difficult. With India’s smartphone user base expected to surpass one billion, the country offers huge potential for digital health tools. But so far, scientific studies paving the way for exploiting this potential have been small or focused on narrow app categories and did not address heart disease specifically. To change this, the Division of Biomedical and Public Health Ethics at KL Krems developed a systematic and scalable method to examine what is really out there in terms of mHealth offerings – and what is lacking.
App-solutely Surprising
“The numbers really surprised us,” says Dr. Keerthi Dubbala, MBBS, MPH, a researcher at KL Krems and lead author of the study. “We sifted through over 227,000 health-related apps, but only around 2,200 had anything to do with heart disease. And even those often lacked key features like local language support, user reviews, or clear, engaging descriptions.” Alongside gathering this data, Dubbala’s team categorized the apps and looked at user engagement, content focus, and technical accessibility – offering a much clearer picture of what’s currently available.
Their findings are sobering: just 0.5% of Google Play Store apps and 1.4% of Apple App Store apps were heart disease-related. And over 70% of those had no user ratings or reviews at all. While it’s good news that most were free, their relatively large file sizes and patchy update history could make them hard to use on older devices or with slower internet – especially in rural areas. Support for regional Indian languages was rare, even though previous research shows that regional-language apps often perform better in terms of user engagement.
Categories & Clusters
Using machine learning, the team sorted the apps into three broad categories: clinical (focused on treatment and monitoring), fitness and lifestyle (covering things like diet and exercise), and sleep and wellness (which included meditation and stress reduction). Most fell into the clinical category, but these apps also had the least user engagement, the shortest descriptions, and the smallest file sizes. “Even the apps that are most relevant in terms of content seem to struggle when it comes to actually reaching and helping people,” says Dubbala. “That might be due to visibility issues, poor design, or simply not offering what users need.”
“In a time when chronic illnesses are on the rise and digital health is gaining ground, this study sends a clear signal,” says Giovanni Rubeis, senior author of the study and former head of the Division of Biomedical and Public Health Ethics at KL Krems, who has since joined the University of Greifswald in Germany. “It’s not enough to simply have apps – they need to be easy to find, easy to understand, and genuinely helpful.” The team’s approach, he explains, offers a way to systematically map and analyze the mHealth ecosystem, giving researchers, developers, and policymakers the tools they need to identify gaps and take targeted action. For India – and for many countries facing similar challenges – that could make a real difference.
Original publication: Exploring Heart Disease–Related mHealth Apps in India: Systematic Search in App Stores and Metadata Analysis. K. Dubbala, R. Prizak, I. Metzler & G. Rubeis. J Med Internet Res 2025 | vol. 27 | e53823. DOI: 10.2196/53823. https://kris.kl.ac.at/de/publications/exploring-heart-disease-related-mhealth-apps-in-india-systematic-
Karl Landsteiner University of Health Sciences (04/2025)
The Karl Landsteiner University of Health Sciences (KL Krems) is an educational and research institution on the Campus Krems and recognised throughout Europe. KL Krems offers modern, demand-oriented education and continuing education in medicine and psychology as well as a PhD programme in Mental Health and Neuroscience. The flexible educational programme is tailored to the needs of students, the requirements of the labour market and the challenges of science. The three university hospitals in Krems, St. Pölten and Tulln and the MedAustron Ion Therapy and Research Centre in Wiener Neustadt guarantee clinical teaching and research of the highest quality. In its research, KL Krems focuses on interdisciplinary fields with high relevance to health policy – including biomechanics, molecular oncology, mental health and neuroscience as well as the topic of water quality and the associated health aspects. KL Krems was founded in 2013 and accredited by the Austrian Agency for Quality Assurance and Accreditation (AQ Austria).
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