Mobile health technology needs better usability, infrastructure

Panelists at the iHT2 Health IT Summit dismiss the notion that privacy issues hinder mobile health adoption and point to poor usability and infrastructure as the real culprits.

Discussions about the potential impact of mobile health technology often center on patients' general reluctance to share personal health information (PHI), whether it's with physicians or applications such as personal health record (PHR) services.

John de Souza, CEO of the online health community MedHelp, disagrees.

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In 2008, MedHelp saw "tens of thousands" of posts from women who got rashes and welts after wearing certain Victoria's Secret bras, de Souza said during a panel discussion at last month's Institute for Health Technology Transformation's iHT2 Health IT Summit. That all-too-personal data was powerful, too, as it helped Victoria's Secret trace the problem to a formaldehyde spill at a single factory in China. 

Usability, not privacy, hindering mobile health technology adoption

The incident demonstrated that users are more than willing to share PHI if they think doing so, even in a roundabout way, may make them healthier, de Souza said. This is becoming increasingly true as telehealth and mobile health technology becomes more omnipresent.

Yan Chow, M.D., director of innovation and advanced technology for Kaiser Permanente, pointed to the appeal of new tech such as cameras that monitor vital signs and the Microsoft Xbox 360 Kinect that encourages exercise and can post data to Microsoft HealthVault. This remote patient monitoring technology, while more intrusive than what patients may be used to, may be the difference between remaining at home and entering long-term care, Chow noted.

For de Souza, such developments demonstrate that patient engagement can succeed if technology is compelling and medically relevant in addition to being engaging. The latter is easy, he said, pointing to the wild success of FarmVille and Angry Birds, while the former remains a struggle.

Automation will play a big role in the future of mobile health technology, Chow said, especially as the accountable care organization and other shared savings models place a greater emphasis on preventive care.

However, Chow added, the amount of data on both the patient and the provider side needs to be synthesized in a meaningful way. As de Souza put it, automobile dashboard computers don't send real-time updates on a tire's PSI -- they only alert the driver when the tire needs air.

Patient portals and PHR services that people actually want to use will help, too, said Michael Blum, M.D., CMIO at the University of California, San Francisco Medical Center. It's not just about liking the technology, either, Blum added; patients and providers need to know that it will be "present enough to manifest behavior change" and improve patient health.

Automation will play a big role in the future of mobile health technology, especially as the ACO and other shared savings models place a greater emphasis on preventive care.

To that end, it will be necessary to reconcile clinical and patient data, Chow said. While much of this is administrative -- think of the many addenda to patient records based merely on semantics -- there are clinical implications. Think of the mobile health technology for blood pressure monitoring able to prove that a patient's high numbers during an appointment but low numbers the rest of the year are likely the result of white coat hypertension.

Investments needed to realize mobile health technology's payoff

Improving patient engagement is only half the battle, though. Getting physicians, C-level executives and board members to buy into mobile health technology also matters. Without metrics to prove a guaranteed ROI for initiatives such as physician mobile messaging, this is tough, Chow said.

So is network infrastructure, said Ed Lowell, director of technology infrastructure for Lucile Packard Children's Hospital. For an acute care facility to support mobile health technology, it needs 100% wireless coverage for both cell and Wi-Fi traffic, said Lowell, who is spearheading IT for a construction project at Lucile Packard.

The challenges facing mobile health technology adoption are equally numerous and daunting, but the potential payoff, Blum said, is a move toward personalized medicine, with care tailored specifically to individual symptomatic and, potentially, genomic data. For that to happen, he added, startup funding will have to move beyond wellness applications to tools focused on chronic care.

"The fact that we are profitable should not make us unique," de Souza said.

Let us know what you think about the story; email Brian Eastwood, Site Editor or contact @SearchHealthIT on Twitter.

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