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August 04, 2010

Healthcare Providers Debate mHealth Opportunities, Obstacles at Leadership Summit


The World Congress 2nd Annual Leadership Summit on mHealth wrapped up Friday, July 30, with inspiring discussions of mobile health innovation and opportunity—tempered with pragmatic caution about the slow rate of adoption and the multitude of challenges ahead. 

Common themes emerged from the two day summit. (For a summary of the first day, see World Congress Holds Leadership Summit on Mobile Health.)   There is enormous potential of mobile technology to impact the availability, quality and cost of care, but there are also barriers. Simple yet effective solutions like daily remote monitoring of weight for CHF patients, text messages to pregnant teens and wellness apps for businesses raise our hope and expectations. But the complexity of the healthcare industry, the unclear regulatory environment, incompatible systems and standards, reimbursement concerns, and the competing interests of various stakeholders make innovation and adoption difficult. Successful mobile initiatives tended to be those that engaged users, were relatively low-cost, and demonstrated a high return on investment.  And while improved access to health information through mhealth initiatives may lead to patient empowerment and better health management, questions remain about portability, privacy, liability, and physician workflow.

Starting off the second day of the summit, Yan Chow M.D. from Kaiser Permanente spoke about the potential of the “telehealth revolution” to transform patient care, using specific examples from his organization. He explained how his Innovation and Advanced Technology group looks to a variety of different sources for new technology ideas, and reviewed some of the many questions his group asks in evaluating whether new health information technologies are likely to be effective as well as a good fit for Kaiser. Dr. Chow also discussed health care technology innovations such as remote patient monitoring, biometric devices, virtual reality, biometric facial recognition, automatic handwashers, and courier robots, as well as the challenges of creating HIPPA compliant, seamless EMR’s.

An mHealth perspective from India was offered by Prof. K. Ganapathy of Apollo Telemedicine Networking Foundation. He spoke of the tremendous potential for expansion of mobile health technology in a country with 1/6 of the world’s population, especially given the extensive use of cell phones there. He saw India’s lack of legacy systems not as an obstacle, but more of an opportunity to leapfrog over the digital divide without having to deal with expensive “unwiring.” Despite infrastructure challenges, Ganapathy had many examples of mobile health technology already reaching those in need in India, through “hospitals on wheels,” text messaging reminders about infant vaccinations, and even telemedicine consultations on moving trains.

A vision of the future in which telesensing technology goes far beyond just voice and video was presented by Sid Ahuja of Alcatel-Lucent (News - Alert) Ventures. Ahuja discussed advances like digital stethoscopes, implantable sensors to detect intra-disc pressure, and telestroke remote diagnosis. To prevent information overload, sensory input could be monitored by systems much like the human autonomic nervous system, in which much data is collected in the background but only important information is sent along to interrupt users and alert them to situations needing attention.

Generating consumer mobile engagement was the topic of a panel moderated by Sherri Dorfman of Stepping Stone Partners. She highlighted themes of targeting mobile messages to selected segments like teenagers or minorities, creating personalized educational or motivational messages, and using gaming and crowdsourcing to reach consumers. Panelist Ben Rubin from Zeo, which produces personal sleep coaching devices, gave some practical tips based on Zeo’s recent rollout of their mobile platform. Robert Havasy from Partners Healthcare System and Center for Connected Health, described the “real world” challenges of developing a pilot program for text messaging pregnant teens and patients in addiction treatment programs. Tim Kierschnick from Kaiser Permanente described some the features of their mobile platform and discussed closing the “eDisparity” gap, with better ways of reaching users of varying socioeconomic status, ethnicity, language, age, and health status. Julie Kling from Humana Inc discussed their mobile communications objectives, including enhancing member experience, decreasing administrative costs, and improving health outcomes; she also passed along some lessons learned from consumer feedback and discussed Humana’s health entertainment and urgent care finder apps. And finally Bud Flagstad of UnitedHealth Group shared their mobile health approach, including use of an eligibility-based system to guide users to relevant information, and mobile apps that help find in-network physicians or allow users to compete in healthy challenges.

Does mobile health technology actually lead to positive health outcomes? That was the question tackled by participants in a panel moderated by MedHealthWorld’s Mary Cronin (News - Alert). She noted that while there have been a number of exciting developments in mhealth technology, data on outcomes is still scarce because mobile health initiatives are so recent. She asked panelists to check in with real-world examples of positive mhealth outcomes, as well as to discuss how providers and others are using mobile technology. Mohit Kaushal M.D. from Connected Health and the Federal Communications Commission acknowledged that while the U.S. lags behind in mobile infrastructure and adoption, he was hopeful about the government’s ability to help mobile health move forward. Mark Trigsted from Diversinet talked about a “wounded warrior” initiative in which secure encrypted mobile phone connections were used to help injured soldiers deal with depression and other post-combat health complications. Laure Park from Quest Diagnostics shared the practical ways in which Quest’s mobile applications are helping physicians, patients, and employees access information for improved health outcomes, but she also acknowledged challenges such as broadband limits and obstacles preventing patient access. Rounding up the panel, Neal Sikka, MD, from George Washington University Medical Center provided an ER physician’s perspective on patient and physician use of mobile devices. He discussed innovations such as telestroke monitoring, and remote wound care monitoring via mobile phone.

A final debate concluded the conference: Are PHR’s dead? Despite low consumer adoption rates, both Steve Munini from Dossia and Charles Parker from Continua Health Alliance (News - Alert) saw plenty of potential in the use of Personal Health Records. Munini noted the drawbacks of many PHR’s, and observed that after initial enthusiasm consumers are generally reluctant to manually enter data. However, he saw great value in PHR’s for self-insured employers, where adoption rates and ROI are high due to lower medical costs. Similarly, while Parker was also concerned about low rates of PHR adoption, he saw solutions to perceived barriers and much potential in the integration of health monitoring device data directly into PHR’s.


Ms. Graham is a writer and editor with a current focus on health and wellness. To read more of her articles, please visit her columnist page.

Edited by Erin Monda
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