While the Pew Research Center's numbers are encouraging for proponents of mHealth, they miss the larger issue. John Moore, managing partner of healthcare IT analyst firm Chilmark Research, says an uptick in mobile health adoption is simply "not happening yet."
Within healthcare organizations, "mHealth today is still being driven and paid for by marketing," Moore says. "[They] see it as a consumer loyalty play. It's not getting the clinician involved."
Even though nearly all facilities support mobile devices of some kind, whether it's iPads or pagers, almost two-thirds lack a formal, written mobile strategy, according to a recent Amcom Software survey. Roadblocks to creating such a policy include low funding, poor leadership and a lack of awareness of major mobile health issues. Despite supporting mobile device use, 37 percent of organizations without a mobile strategy have no plans to develop one, the survey says.
Moore cites several additional reasons healthcare organizations and patients alike are slow to adopt mobile health:
- Despite the fact that doctors love the iPad and the new iPad mini, incorporating mHealth technology into a physician's encounter with a patient is a substantial change management hurdle.
- Under the United States' prevailing fee-for-service model, there is no incentive for a physician to, as an example, view a photograph of a rash that a patient took with her mobile phone and tell her that she need not schedule an office visit, Moore says.
- While Pew notes that one in five smartphone users has downloaded an mHealth app, Moore says that, according to mHealth application developers, use tends to drop off after only a couple months. Patients want to know that "someone on the other side is looking at this and giving [them] feedback," Moore says, but primary care physicians "just aren't there."
- A lack of interoperability among mHealth applications and the clinical applications that a physician uses keeps information in silos. Until a patient's food app can connect to his diabetes management app, there's no incentive to use either, Moore says.
- Technology infrastructure in hospitals, by and large, is not ready to support mobile health. As one CIO told Moore, "We're just now laying the foundation to digitize our system. What you're talking about now is on the seventh floor."
One answer to the infrastructure question, according to John Walls, vice president of public affairs for the Wireless Association CTIA, is improved wireless spectrum planning, especially as more people-and devices-use the network.
"The problem is increasing demand and finite supply," Walls says. "It's in the public's best interest for the FFC to treat growing demand to encourage the market and not deter it." When this happens, he adds, the impact on mobile health could be tremendous, with patients getting information from healthcare providers they can act on immediately and physicians receiving data from patients far more often than a yearly checkup cycle.
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