Adoption of mHealth: Chicken or Egg?


There seems to be universal agreement among all stakeholders in health care that mHealth technologies will play a significant role in the future. The questions are how far into the future and how will they find their way to patients. These questions are largely dependent on regulatory issues and business model plans respectively. There are a few things happening now which might make all the pieces come together to get mHealth off the ground.
The paradox of getting mHealth technologies to patients who need it the most (those with chronic diseases recently discharged from the hospital) is that hospitals are not jumping on the bandwagon. Few technologies have undergone studies, which is important to clinical institutional adopters. However, The Johns Hopkins University has recently undertaken an initiative to perform clinical studies of medical apps (see http://www.fiercemobilehealthcare.com/story/johns-hopkins-test-mobile-medical-apps/2012-03-19). Those studies will be critical in giving credibility to the apps which payers would desire. How do the technologies get adopted if they are not proven to work? How do they get shown to work if they are not adopted? Another fly in the ointment is the FDA which is still determining regulations which will govern mHealth technologies. There are FDA hearings this Thursday and Friday over the issue issue (http://mobihealthnews.com/16681/fda-mulls-the-role-of-screening-apps-devices/).
The other issue I believe is important is the mechanism in which mHealth technologies are prescribed. There is no established or described method of automated or semi-automated app prescribing based on a patient’s clinical profile. It will be a while before wireless tools become a part of clinical decision support. However, it WILL happen. Connectivity will be a key factor in this aspect of the workflow as well.
The chicken or egg issue arises again when we discuss who will oversee this automated technology prescribing. There is going to be a demand for clinicians with expertise in wireless technologies, perhaps specialized case managers who will do patient education both at the point of care in the hospital as well as at home. The education must involve caregivers as well. We must start training these kinds of people soon, as the technology is first implemented, not after it is in widespread use.
One therefore appreciates multiple concerns regarding mHealth adoption. There are certain things required to BE in place and not FALL INTO place. The vision many of those in mHealth have is the same. As in most things, the devil is in the details. However, if industry, regulators, providers and other stakeholders keep the patient in mind first and foremost, it will happen and succeed.

About davidleescher

David Lee Scher, MD is Founder and Director at DLS HEALTHCARE CONSULTING, LLC, which specializes in advising digital health technology companies, their partners, investors, and clients. As a cardiac electrophysiologist and pioneer adopter of remote patient monitoring, he understood early on the challenges that the culture and landscape of healthcare present to the development and adoption of digital technologies. He is a well-respected thought leader in mobile and other digital health technologies. Scher lectures worldwide on relevant industry topics including the role of tech in Pharma, patient advocacy, standards for development and adoption, and impact on patients and healthcare systems from clinical, risk management, operational and marketing standpoints. He is a Clinical Associate Professor of Medicine at Penn State College of Medicine.
This entry was posted in clinical trials, digital health, education, FDA, Healthcare IT, healthcare reform, informatics, mHealth, mobile health, smartphone apps, technology, telehealth, wireless health and tagged , , , , , , , , , , , , , . Bookmark the permalink.

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