Couple of interesting related commentaries I’ve seen this week are “Is mHealth/eHealth becoming a ‘Field of Dreams’?” by Donna Cusano, Editor at Telecare Aware, and “Don’t Call The Mobile Healthcare Revolution A Revolution – Yet“, by Dave Copeland, writer at ReadWriteWeb. Both highlight for me how easy it is to become jaded at the hype that’s being made by smartphone mHealth app developers.
One particular problem I see in Dave Copeland’s piece is that a lot of the problems that are being identified are actually insignificant or nonexistent in the real world:
“Everybody we spoke with was in agreement that mobile health care apps, from pedometers to track whether patients are getting enough exercise to more sophisticated apps that will allow a doctor in New York to make a diagnosis on an MRI taken in Africa, will revolutionize the way we get (and stay) healthy. But it could take longer than we’re being led to believe”
Mobile based pedometers are already being used by millions of Japanese senior citizens and they’ve come preinstalled on Raku-Raku (easy to use mobiles designed for Japans senior citizen market) mobiles for years. Guess what it’s useful, but the challenge isn’t getting the technology it’s developing the services. In the US where the vast majority of patients don’t have an accessible electronic health record or the ability to communicate electronically with their Doctor we’ve got a lot of more fundamental challenge to contend with first – thankfully providers like KP are doing something about this important first step.
The cost of MRI units are a long way from dropping to such an extent that the cost of the reader is a major barrier. Similarly they’re some way from being installed in a facility that has no means of getting a fixed line connection. It’s also more likely that there would be more opportunity in the reverse situation eg. a Doctor in Africa reading a scan from a patient in New York.
Let’s instead focus on some real immediate opportunities
The first thing that’s needed is an appreciation that everyone is at a different stage with the adoption of technologies. So let’s ignore attempts to claim the future is here already and let’s look to leverage the technology patients already have:
In a modern society this is truly a rare thing but it probably feels even rarer if everyone you know personally has super range of the latest consumer electronics. But as we approach patients with some of the greatest needs we’ll increasingly find individuals who live with insurmountable economic challenges, with ingrained habits that they find hard to change, aren’t prepared to buy/use unfamiliar gadgets, etc
But don’t dismiss the technology they already have. Look around, don’t they have locks? A safety cooker? An intruder alarm? A smoke detector?
Imagine what the “quantified self” movement looks like for an independently living disabled senior and it’ll probably look more like a mobile connected Smoke Alarm that can add value to existing systems (everyone has/needs a smoke alarm), is low cost, provides help when needed with little/privacy concerns (when you have a fire that’s not a priority).
It also starts with a value proposition that your customer will understand. If you are disabled, deaf, live alone, have a very specific health condition, have COPD and a home filled with O2 gas, etc, etc, it’s easy to see the value of automatically communicating this key information to emergency services, responders and carers eg. “there is a fire in my home and I’m physically disabled, o2 gas cannisters in home, and my 2 neighbours both have keys and are also being sent SMS notifications”
What’s so good about this approach is that the only technology adoption hurdle is amongst the patients carers/providers.
Only have a basic mobile
No ifs or buts, you must start trying to use SMS with your patients as soon as possible. For long term this is your biggest opportunity to control future healthcare expenditure. In 2017 there will be mobiles you can talk to, that’ll read your blood pressure, ECG and blood glucose when you just hold them but your patients stand the chance of missing out on this if they don’t get mobile connected.
Start with basic services such as SMS appointment reminders. These free up the time of receptionists so they can give more time and attention to those patients who need it most.
PC and Mobile
We all know 80% of US internet users have searched for online health information so why not leverage this, and let patients use the web and their mobile to communicate with you. With your help these patients efforts will be 100 times more effective so enable your patients to share online health information with you. This is your biggest and most obvious opportunity to directly incentivise and reward your patients for taking a more active role in their own health management.
If it won’t fit with your existing practice partner with a dedicated remote care provider who can help you bridge the gap.
Web enabled mobiles
If you’ve got patients with phones that have the mobile web give them secure mobile access to your patient portal – exactly like KP have done. Also provide an app as it can improve usability – but watch out for the privacy issues that might reveal the personal info of patients to other parties.
Video Mobile/Tablet or Webcam
Be sure to use effective tools (if you don’t it will bankrupt you, work you into the ground, cost you in legal fees, etc) to support it but you can now get up close and personal. If you’re not yet convinced of video calling or had a bad experience take time to watch this trauma Surgeon’s Tedx talk.
If you’re a Doctor who doesn’t yet appreciate the benefits of video consulting with your patient don’t assume that a patients interest means there is something wrong with your telephone skills. There might not be any problem it’s just that your patient may want or feel the need for a better way for you to show how you feel when discussing something as sensitive and important as a healthcare decision.
With the possibility of your patients now being available to you at your convenience this is your opportunity to create an alternative to in person office consultations, introduce new working opportunities for Doctors, increase access to high quality care, avoid unneccessary in person visits and help patients flip the waiting room experience.