ISSUES IN mHEALTH

Panel:

Robyn Whittaker, MD PhD, mHealth researcher, Public Health Physician, Commonwealth Fund Harkness fellow 2010/11

Barbara Mittleman, MD, internal medicine/rheumatologist, Director NIH Public-Private Partnership Program, co-chair of the first mHealth Summit

Wendy Nilsen, PhD, Health Scientist Administrator Office of Behavioral and Social Sciences Research NIH

mHealth research project

• To identify the key issues facing the implementation of mHealth in the U.S.

via– Environmental scan– text4baby case study– Key informant interviews

Panel Session

• Overview of research & key issues in mHealth (RW)

• ‘Big picture’ issues (BM) • Research issues (WN)• Opportunities to address mHealth

issues

mHealth the delivery of health-related

services via mobile communications devices

Portable PersonalConnected

Prelim findings: interviews

Interviewees N=27

Federal gov (HHS, DoD) 11

Integrated health systems 2

Academics 6

Private mHealth companies 4

Wireless networks 2

Private sponsors/funders 2

low middle high0

2

4

6

8

10

Priority of mHealth

Transformative?

No:• an extension of current health communication or current models of care

Yes:• from provider & location

centric system to patient-centered anywhere care

• from provider control to individual locus of control

• change the way we search for and use information

“a great equaliser”

Issues in mHealth: categories

1. Policy & regulatory

2. Wireless environment

3. Health system

4. mHealth in practice

5. mHealth research

Policy & regulatory issues

• Privacy +/- data security• FDA regulation• Bandwidth spectrum availability• Medical practice regulations e.g.

practice across states/countries, regulated roles

Wireless environment issues

• Large number of wireless networks• Working across platforms & other

proprietary complexities• Potential costs to users

Health system issues

• Who pays/reimbursement• Competing priorities & opportunity

cost• Integration into existing systems,

practice & EHRs• Clinical roles & accountability• Lack of demonstrably sustainable

business models

mHealth in practice issues

• Immature understanding of how to do it well (what, for whom, and why)

• Lack of demonstrated added value of existing initiatives & focus on where it can add value

• Lack of theory & evidence base• Technology focus/legacy systems

mHealth in research issues

• Need for more high quality research demonstrating effectiveness & cost-effectiveness

• Mismatch in pace & flexibility of research with tech developments

• Measuring reach & access into under-served populations

Opportunities in mHealth U.S.

1. Optimising opportunities provided by health reform environment

– CMMI, Beacon demo projects, EHRs

2. Some degree of federal level guidance

– Strategic collaborative (open) approach

3. Improving mHealth practice & research

– Iterate, integrate, improve

Acknowledgements

• Dr Kyu Rhee• Health Resources & Services

Administration, U.S. Dept of Health & Human Services

• The Commonwealth Fund• All interviewees