The ideal mHealth may many meanings from different perspectives. For the provider taking care of patients with multiple chronic diseases, it may be a platform that incorporates multiple system sensor and monitoring capabilities which transmit only actionable alerts, with minimal intrusion to the provider with clinically insignificant data points. For the patient, it would involve no education, equipment in the home, and limitless communication with the provider. For the developer/entrepreneur it would be a blockbuster technology that would meet criteria for the Tricorder X Prize competition currently underway (a technology with diagnostic capabilities of board certified physicians able to recommend therapeutic options, with cloud storage). For the hospital it would be a set of technologies personalized for each patient capable of seamless transition to the outpatient setting, totally connected to the EHR. To insurers it would be solutions that are cheaper than providers, with outcomes than are better, and which connect to the insurer’s PHR. To the CIO, it would be technologies that operate within the health information exchanges of the hospital, ACO, local and state governments.
Many of these visions will be realized, some earlier than others. These goals need not be mutually exclusive and have different barriers and facilitators. The key to this success is the realization that any technology crosses many disciplines and stakeholders. Government, insurers, regulators, providers, engineers, HIT personnel, patient, and caregiver. Attention must be paid to all of these on some level for the technologies that are most complex and geared towards diagnosis and therapy. Healthcare in this regard should be approached as an assembly line where both multiple simultaneous and sequential actions are performed. There are design, adoption, implementation, and maintenance/follow-up aspects of mHealth. They cannot operate in a vacuum. Input from clinicians in most phases is critical. Workflow and behavior issues of end users are also important. How many of these things do you consider when thinking about wireless technologies?
