In the health IT industry, a lot of the focus on mobile health (mHealth) lies on the provider side—specifically how digital health tools are helping clinicians be more “mobile” within their workflows. In fact, this was precisely what HCI Senior Contributing Editor David Raths wrote about in this year’s Top Ten Tech Trends. This perspective is undoubtedly exciting and fascinating, and worth a read if you haven’t seen it already. But there’s another angle to mobile computing that has perked my interest lately—that being the care management side to mobile health tools, and how patients, in addition to providers, are using these technologies to improve their care.
Indeed, for the May/June issue of Healthcare Informatics, I wrote a fairly lengthy feature (now online!) on how mHealth tools are paving the way for better chronic care management. While doing my research for the story, I quickly noticed three important trends: First, the level of significance that provider organizations are putting on patient engagement shows how they are increasingly willing to adapt to the way healthcare is changing; Second, much of this engagement is starting to be done via mobile technologies; and Third, while the era of patient-generated health data (PGHD) is upon us, plenty of work is still needed for this type of data to be integrated into electronic health records (EHRs).
Regarding the first point, as I wrote in the feature, according to findings of the 26th Annual HIMSS Leadership Survey, sponsored by the Chicago-based Healthcare Information and Management Systems Society (HIMSS) and released at the annual HIMSS conference this past April, “patient satisfaction, patient engagement, and quality of care improvement have raced to the top of healthcare CIOs’ and senior IT executives’ agendas in the past year, a stark change from previous years which found that health IT leaders were more focused on business and financial goals. Nonetheless, it’s been a struggle for physicians to truly engage their patients, especially the 45 percent of U.S. adults with at least one chronic condition, and particularly in underserved populations.”…As such, “another recent survey from HIMSS found that more than 90 percent of survey respondents are utilizing mobile devices within their organizations to engage patients in their care.”
Certainly, healthcare delivery is no longer limited to face-to-face encounters between patients and providers, a concept that has been pushed by the federal government when you consider their recent meaningful use Stage 3 proposals. In practice, there is clear evidence that mHealth tools can be effective for chronic disease management—a HIMSS case study gives an example of how this can happen in the real word. In Sacramento, Calif., a mother posts the results of her son’s latest round of treatment for neuroblastoma on a protected social network website. More than 2,500 miles away in North Carolina, a man who has been struggling to control his diabetes receives a text message from a health coach about a recent spike in his blood sugar level and asks what he ate for breakfast. Every day, from every corner of the United States, people are turning to mobile technologies to help them understand, manage and cope with chronic illness. According to the Pew Research Internet Project, 72 percent of Internet users look online for health information and one in three cell phone owners have used their phone to access health information.
Leading provider organizations such as Duke Medicine and Stanford Health Care are following this trend, using mobile tools to improve care, both of which I wrote about in the feature. Another innovative patient care organization, the New York City-based Mount Sinai Hospital and LifeMap Solutions, also in New York, recently announced the launch of a large-scale medical research study that uses Apple’s ResearchKit to help individuals who suffer from asthma to participate in studies right from their iPhone. The Asthma Health app is designed to facilitate asthma patient education and self-monitoring, promote positive behavioral changes, and reinforce adherence to treatment plans according to current asthma guidelines. The study tracks symptom patterns in an individual and potential triggers for these exacerbations so that researchers can learn new ways to personalize asthma treatment, officials say.
While Duke and Stanford have been slowly progressing with integrating this data into EHRs, in a recent interview, Yvonne Chan, M.D., Ph.D., director of personalized medicine and digital health at the Icahn Institute for Genomics and Multiscale Biology at Mount Sinai, told me that the Asthma Health app is in the research phase now and that when it comes to care management, it’s important to take baby steps. “This is the very first step. We are essentially collecting information, developing algorithms, and the next phase is further validated before you can start providing actual medical management feedback,” she said. “Integrating this into the EHR is something we definitely want to do down the road.”
Even the organizations that are incorporating patient-generated data into EHRs are doing it slowly, with plenty of challenges. Still, the market for wearable technologies continues to grow with a seemingly limitless future— market researcher Visiongain recently assessed that the value of the global wearables technology market will reach $16.1 billion by the end of this year. Other analysts predict that the wearables market will grow tenfold to $50 billion over the next three to five years.
And for certain healthcare organizations, the opportunities to leverage the wearable data go beyond just tracking. Nick Reddy, senior vice president of information system investments at the Dallas-based Baylor Scott & White Health, touches on this point in an interview featured in this year’s Top Ten Tech Trends on consumer-generated data. “The prevention side of healthcare is where the clinically-relevant things are happening, compared to just the 10 steps that are tracked by a wearable device. “We want to spin business intelligence and analytics on it,” Reddy said. “If you’re a diabetic and you haven’t been walking your steps or taking your [metmorfin], let’s flag you so your case manager can intervene. That’s where our roadmap is taking us,” Reddy said, referring to the Baylor Scott & White Quality Alliance (BSWQA), a 3,700 physician-strong network that is one of the largest accountable care organizations (ACOs) in the country.
At the core of all of this—patient engagement, mHealth tools, and EHR integration—is one very important factor: the patient, or as some now call us, the “consumer.” Are we ready for this type of engagement and activeness in our own care to be able to lower costs and improve health outcomes through the use of mobile tools? I think we’re certainly on the way there—and if you look at how the federal government wants to shape the healthcare industry—we better be.
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