The expression “There’s an app for that” is fairly accurate when it comes to everyday tasks or those related to convenience services. Though most apps are downloaded and either used once or a couple of times and never again, we have come to somehow been lulled into a comfort zone, knowing that they are within a click away. The emergence of mHealth apps, mHealth app stores, remote patient monitoring, telehealth, body sensors, and rapid personalized genomic decoding are advances which will help millions of people. But it is people like Twitter icons and patient advocates @ePatientDave (Dave deBronkart) and @HugoOC (Hugo Campos) and organizations like the Society of Participatory Medicine who will ultimately bring mHealth to the masses by empowering others to realize that these are tools of engagement, allowing patients to become the sources of healthcare information itself from which emanate relationships with providers.
The adoption of mHealth technologies is dependent upon other ‘human factors.’ The UK has officially encouraged physicians to prescribe mHealth apps and the role and scope of FDA oversight is still being debated in the USA. We are debating whether physicians should correspond via email with patients, whether patients should have direct access to data derived from devices implanted in their own bodies, and whether it is a good idea for providers to have teleconsultations with patients who are in a state different from where the physician is licensed. We are still in the Stone Age regarding reimbursement of mHealth services. Sooner or later the work of improving the treatment patients must begin. This is not so much a question of kicking the can down the road which is seen with the physician SGR pay fix, or party politics seen with debate over mandated health insurance, but of a lack of focus by the healthcare industry to recognize the potential benefits of mHealth and clamor for its utilization. I would welcome a transference of enthusiasm from the telecoms, consulting firms, and healthcare analysts to the true stakeholders in this regard.
Technology is the relatively easy part. Who would have thought this ten years ago? The human aspect is still a key component. Bioinformatics personnel will help determine what data to mine and how to filter it. Chief knowledge officers will be needed to help translate informatics to clinical practice. Clinical providers will still need to review the algorithms by exception, receive the actionable alerts by the remote monitoring systems, adjust care with patient status changes, and still have those difficult end of life decision discussions. Real people will be the developers, champions, providers and patients of mHealth apps. I look forward to the partnership of people and technology to improve the healthcare ecosystem.
