issues in mobile health (robyn whittaker)
TRANSCRIPT
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