Introduction vs Adoption of #mHealth Technology


Before the adoption of new technologies which will undoubtedly improve healthcare (as it has the retail and finance sectors), it must be introduced in ways which are digestible, scalable, and subject to rapid iteration. Is mobile technology different from the adoption of any other change in healthcare delivery? I think not. The culture of care certainly requires change as care models are changing. The point of care is shifting to the home, professionals other than physicians are delivering most of the care, and digital technology is becoming a fact of daily life.  With this care shift is the shift of daily tasks to mobile technology. Most mobile tools utilized today by physicians is related to reference or other resources geared towards them, not the patient or care. I suggest a few ways in which the introduction of mobile healthcare tools to physicians will itself lead to adoption. Baby steps are needed in this process contrary to what I see as industry’s ‘Build it and they will come’ philosophy, with its predictable disappointment.  The following suggestions are predicated on good medical app development practices.

1.    Involve physicians in clinical pilots.  This accomplishes three things: It introduces physicians to mobile health tools and processes involved in using them. It serves an avenue for user experience feedback from both clinicians and patients, and might provide some outcomes data.

2.    Establish a network of key opinion leaders. Peer to peer education has a successful track record in both the Pharma and medical device sectors. The ‘in the trenches’ experience provided by these KOLs is invaluable in conveying information and addressing concerns of physicians.  It speaks to pain points, benefit to patients, and healthcare and business models.  These KOLs using digital tools themselves via closed professional social networks is a model I would look forward to being useful.  KOLs have impact via presenting data at professional society meetings, discussing new technologies via traditional media outlets as well as social media.

3.    Payers incentivizing physicians to use good tools (portal, diabetes tools).  The use of mobile health apps and other tools (communications, delivery of educational content, and interoperability of data with EHR) might promote or even necessitate the use of robust patient portals. This therefore accomplishes two things which will benefit patients. Payers are in the unique position to incentivize both patients and providers to take advantage of these mobile tools. In what way can payers incentivize physicians? How about having a physician directory which spotlights those who utilize mobile health technologies?  Like-minded patients who desire to become more participatory in their care will gravitate towards these providers, thereby potentially fostering good relationships even before they meet.

4.    Patients introducing technology. Changing behavior in the doctor-patient relationship can be a bidirectional process. Just as physicians can change patient behavior, patients can exert influence as consumers on physicians by asking questions about the use of digital technologies by their physicians. These inquiries might get physicians thinking. Patients who suggest medications based on DTC marketing ads often receive them. Patients who are proactive are better patients.

5.    Medical school courses for students. Digital natives (or close to them) are now medical students. There is much enthusiasm by students for the use of mobile technologies in healthcare.  Many are designing apps or anxious for others to do so. There are many reasons why medical schools are at the forefront of mobile medical apps. A ‘bottom up’ approach seems logical  in this arena because of the slow pace of the change in healthcare culture by the establishment. Mentors in medical school might not be champions of mobile health tools for many reasons. As often is the case in politics of many sectors of society, the new generation is the source of execution of the dreams of others.

Though none of these points are revolutionary, they should provide sources of consideration for starting points of those interested in this sector. There needs to be a distinction made between introduction and adoption of technology, as I believe they are considerably different. Thinking about the process this way might result in less frustration by the industry, investors, and create a different model for implementation and sales.

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About davidleescher

David Lee Scher, MD is Director at DLS HEALTHCARE CONSULTING, LLC, which specializes in helping digital health technology companies, their partners and clients. As a former cardiac electrophysiologist and pioneer adopter of remote patient monitoring, he is uniquely qualified to address both clinical and operational concerns of clients. Scher was Chair of Happtique's Blue Ribbon Panel which established standards for certification of medical apps in the categories of safety, operability, privacy, and content. He is a well-respected expert in mobile and other digital health technologies and lectures worldwide on technology and its impact on patients and healthcare systems.
This entry was posted in clinical trials, digital health, Healthcare IT, medical apps, medical devices, medical education, mHealth, mobile health, pharma, remote patient monitoring, technology, telehealth, wireless health and tagged , , , , , , , , , , , . Bookmark the permalink.

2 Responses to Introduction vs Adoption of #mHealth Technology

  1. Arlen Meyers says:

    We are creating a Digital Health CRADLE-Collaborative Research and Development Learning Ecosystem- at the University of Colorado to fill these gaps.

  2. In the near term, adoption will depend on physicians being paid for a procedure. Unfortunately, payers are actually in reverse and taking steps away from the progress that we made in Texas. Specifically, Blue Cross Blue Shield of Texas enacted a policy in 2009 to pay an endocrinologist for remote video consults on par with face to face in-office visits. A few months ago that agreement was cancelled in spite of excellent result metrics including clinically significant improved patient outcomes, patient satisfaction and the lowest rate of ED utilization in the country.

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