mHealth Summit 2011: A 30,000 Foot View 12/7/11

The mHealth Summit 2011 is wrapping up as I write this. The organizers did a great job with the venue and structure. The 2.5 day event was packed full of content, with something for just about everybody – academics, policy makers, entrepreneurs, consultants, payers, providers, pharma, consumer advocates, carriers, hardware makers, engineers, public health experts.

To provide something for everyone, you have to deliver content so broad that there is no way to really capture the essence or feel of the overall event. I still think the marriage of domestic and international mobile health alone is a hard to merge, but when you combine that dichotomy with design sessions, startup pitches, policy workshops, and a host of other very interesting and practically unrelated concepts, you end up with a huge event with lots of different experiences.

I guess that’s maybe what a summit is supposed to be, but in trying to summarize it, I’m struggling. if I was looking specifically at the exhibit hall, I’d say the event was much more focused on consumer health tools, and that’s the basis for the rest of this post.

The common theme, beyond of course mobile and health, that I can find is the excitement/hype around the potential of mobile or connected health services/solutions to empower patients, improve population health, better connect patients and providers (I’m not saying improve the doctor-patient relationship), and increase our knowledge of patients with more data points. The consensus is that mHealth will play a big part in the future of healthcare and have a positive impact on the environments where it is implemented.

If you step back and reflect on the state of mHealth today vs. a year ago at this same conference, you realize we’re basically at the same place with the same need – proven, scalable, mobile health models. Yes, lots of very new, very cool, and very well funded solutions have been launched and are being tested. But for the most part, this hasn’t changed the state of mHealth.

I went back to my post last year at the end of the summit and found this statement:

No matter where you stand on the hype of mHealth, the one thing that is clear is that mHealth is moving at an extremely fast pace in many different directions. I can’t wait for the 2011 summit to compare notes to see what a difference 12 months makes. Let’s hope at that time we have some hands go up when the question of “who is actually making money” is posed.

I could have just reused the whole post. It’s still reflective of the state of mHealth.

This is not to say mobile health hasn’t progressed at all or had major successes this year. Look at examples like WellDoc with its clinical trials and evidence, Walgreens Mobile and RunKeeper with millions of users, text4baby with good (albeit limited) preliminary data, mPedigree’s fight against counterfeit medications, and several other mobile health success stories for this year.

There is no denying that the case for mHealth has grown, but the summit experience still gives the feel of of an event and industry disconnected from mainstream healthcare delivery. This is a sentiment that I heard from multiple people at the event that are on the front lines of healthcare, from CMIOs to smallish practice managers, who were looking — mostly unsuccessfully — for tools they could use today.

Shifting care outside the four walls and into the hands of patients takes time. Maybe mobile health is still in the visionary phase and remains in the realm of academics, in which Dr. Topol and Dr. Kvedar would accurately fit. Both are exceptionally smart and have a clear vision for mobile health’s role today and into the future. I guess they just need to keep carrying the torch a little longer. And yes, this is my nomination of these two as torch bearers.

My major concern walking out of the conference is that I didn’t hear much about clinical transformation, which is required to drive adoption of mobile health among providers. I heard a few questions about it, but nothing consistent or actionable in terms of how we are going to fit many of these mobile health tools into today’s practices or into the workflow of a physician.

It’s a common theme for me when I speak physician friends about connected health devices and additional data points from patients. Without fail, the response is that the apps or services sound very cool, but most can’t figure out what those would look like incorporated into practice. "All that glucose and weight data is great, but how am I going to view it and what am I going to do with it?" It’s also important to note that these are young, smart phone-carrying, unlimited-texting docs, not old, “just let me use a clipboard until retirement” docs.

A very good analogy that I heard this week as representative of the problem was from an MD at the West Wireless Health Institute, who said providers think of themselves as hardened Humvees fighting disease on the front lines. He then flashed to a slide of a Hummer with massive chrome rims and a flame paint job, using it show how docs think about health games specifically as being like Pimp My Ride. Providers can’t really tell if health games (and I’d argue mobile health tools generally) are a fad or something in which they should be associated and promoting to patients.

I am also of the opinion that these tools need provider buy-in in order to be effective. Providers are not going to be replaced by technology. Running two patient care management systems, one with periodic visits with a live doc and another with virtual coaching, home monitoring, social support, etc. doesn’t make any sense. To marry the two and effectively leverage both to deliver quality, low-cost care, you need to change practice.

I really didn’t intend this to come off as negative about the state of mobile health or the progress that is being made. I just feel strongly that as we’re moving forward in developing and testing these solutions, we need to understand how they fit in our current healthcare delivery system. I think they can still be disruptive while not displacing or attempting to replace our delivery system from the start. I don’t have an answer for how to do this, especially since most providers are overwhelmed thinking about Meaningful Use, ICD-10, and a host of other fires in need of extinguishing.

I have a lot more from my time at the summit related to product announcements and press releases that I’ll be posting shortly.

Travis Good is an MD/MBA involved with health IT startups.

  • Excellent insight. Yes, we do have many mobile tools available to the general population and they are adopting those in large numbers. The data produced with those mobile tools is invaluable to doctors, but yet, how do the physicians meld that into their workflow? Great question that should prompt many ongoing discussions for 2012.

  • Excellent summary. I (and many others) would agree wholeheartedly with your assessment of the clinical lag in mHealth. At the end of the day, the folks who are trying to innovate with mHealth solutions seem well-intentioned, but somewhat misinformed. It’s akin to trying to redesign the handle of a bucket to make it easier to throw water onto a fire…while the house is burning. Folks who are talking about “clinical solutions” rarely seem looped into the ‘actuals’ of health care delivery – HEDIS measures and reimbursement policy, organizational workflow challenges, and above all else integration into current care management. While ‘patient-centeredness’ and ‘consumer-orientation’ have emerged as themes du jour in mHealth, these ideas aren’t really about healthcare as much as they are about lifestyle and convenience. An emerging strategy is to use them as a crutch to secure seed funding without real regard for the heart of care delivery challenges.
    While progress is palpable and inevitable, until we start aiming at the right targets, we probably won’t hit them. Thanks again for sharing your thoughts.


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