In his book The Creative Destruction of Medicine, Dr. Eric Topol describes the importance of what he calls a superconvergence of six areas of digital technology (wireless sensors, genomics, information systems, mobile connectivity, the Internet and social networking, and the data universe) which will result in personalized medicine. In a previous post, I gave a general introduction to the relationship between healthcare IT and mHealth, and will now update it in more detail
1. Security breaches in healthcare IT are not good for other technology adoption. The many security and HIPAA breaches which have been publicized, some involving large and reputable healthcare institutions as well as corporations might hurt adoption of PHRs by patients. HIMSS Analytics and Kroll Advisory Solutions study, the number of security breaches is increasing over the past six years despite heavier regulatory pressures. If providers and patients are to embrace mobile health technologies, their faith in all things health and digital needs to be bolstered. This might happen if the mHealth industry itself sets high privacy and security standards, and makes it a point to both publicize and demonstrate its commitment to this issue.
2. The adoption and mobility of EHRs will facilitate mHealth. There are now many EHRs available via mobile devices. Mobility and the introduction of patient portals will both facilitate digitizing healthcare. However, both the delay of implementation of 2 of Meaningful Use and the small percentage of required patient participation will negatively affect the potential impact of patient portals on promoting engagement and mobility. The significant adoption of EHRs to date has set a tome of digitized workflow as well as familiarizing providers with technology as hopefully more a friend than foe. This adoption has provided a level of visibility to the public, which now sees EHRs as an advocacy tool (security issues aside).
3. Big Data from healthcare IT will be available for personalization of mobile health. As the health data universe expands as a result of EHRs, analytics tools, and better computers in general, the potential for the harnessing, filtering, and personalization of the resultant data dramatically increases. Personalization of medicine is necessarily linked to mobility as people become literally more in touch with their healthcare information and management tools. It is up to ingenious and responsible participants in industry to develop ways in which mobile technologies can gather and utilize this data to formulate personalized mobile health care plans and implement them. This will keep people mobile, out of the hospital, engaged in their own care, and provide more and current information to caregivers.
4. Connectivity is the key to the success of digital health. An EHR is only meaningful (I applaud the term’s legislative use) if it causes information to flow from provider to provider, from provider to patient (and vice versa via portals), and from one digital device to another. There are many ‘EHRs’ in existence today which will be unable to meet more advanced stages of MU either by design or attrition, and will disappear. Notwithstanding this programmed obsolescence, there remain obstacles to true Meaningful Use which rely on connectivity. Some are technical and some economic (who is going to pay for the connectivity?). Single product mHealth tech companies may deliver a good product. But it will need to be incorporated into a comprehensive patient management platform. Connectivity will be important in integrating different technologies, even if furnished by a single company. Those who cannot connect (and later those who do not offer a more robust line of products) will not survive.
5. The government has mHealth technology initiatives in place. The government realizes the importance of mobile health technologies to the future of healthcare. There are now multiple government text messaging initiatives as part of more comprehensive mHealth Initiative. Though mHealth is not mandated in the way EHRs are (with financial penalties for lack of adoption), the importance of the initiatives is the validation of the important role that mHealth technologies will play in healthcare.
People are inherently scared of technology because many do not understand it. But they do learn how to work their TV remote control, their cell phones, and their computerized cars. If it is important and almost essential, it becomes incorporated into the fabric of life. Mhealth can be presented as a friendly but important and ultimately essential trusted component of healthcare. Hopefully healthcare IT will have paved some ways for it.