A version of this article was originally published February 21, 2011 in The Health Care Blog
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mHealth – otherwise known as mobile healthcare – sounds like just what the doctor ordered to help make healthcare delivery cheaper and more effective. And since the Internet today essentially resides in everybody's pocket, we have what amounts to a last-three-feet problem. So I'm not sure mHealth is ready for primetime, mostly because I don't think our conventional healthcare system is ready or capable of embracing it.
The goal is to have patients wirelessly send appropriate clinical information to their healthcare providers in a timely manner. This would save time-consuming trips to the doctor on their part and, for doctors, ultimately make it easier to retrieve key patient clinical data. Such a system could detect events just before they happen and allow early critical intervention. The problem is that at this point this is just a goal, not reality.
I have looked at a half dozen startups in this space but haven't made a commitment to fund any of them. In many cases, their technology looks promising, but it isn't clear how the company would actually generate consistent revenue. Would the healthcare system reimburse mHealth? Would the doctor know how to interpret the flood of real-time data? Would our system drown under a deluge of alerts, many of which resolve naturally? There are a wealth of questions around these issues.
And this is just the start of the challenges. Unfortunately the human body doesn't have a USB port. Low power, rugged sensors would have to be developed to monitor the body for medically actionable information, a non-trivial task. And while the infrastructure is in place to transmit the data to the doctor, the technology doesn't really exit to massage it in a form he can readily see and interpret in his office, or on his smart phone.
Lastly, even if all the obstacles are surmounted, the question remains whether doctors would actually use this technology. My doctor, for example, uses a state-of-the-art electronic record-keeping and patient management system and is relatively sophisticated, but he is just getting used to working with a computer terminal. He candidly doesn't quite know how he would, for example, use a mobile application that monitored heart rates. It's almost as if a new generation of medical school graduates is needed to recognize the value of this technology.
Frankly, the promise of mHealth suggests an even larger line of thought. Today our nation is trying to figure out how to convert everyone to an electronic medical record (emr). The hope is that when every patient is linked to their EMR, then every doctor that sees that patient has full access to their medical history, and can make better and more cost effective decision regarding that individual's care. But with mHealth you now have a source of real-time medical data. The right way to think of it is that your EMR goes live. It is a real-time status monitor of your health and prognosis. It knows when your health parameters diverge from optimal. It can correlate them to your behavioral choices and your genetic heritage. It knows everything about your body and can help your doctor deliver much better and more personalized health care.
So I believe mHealth is part of a larger revolution in healthcare delivery, a revolution that is real-time, personalized, autonomously monitored, and potentially much more cost-effective. This revolution may well happen. So would say it is inevitable. The timing, however, will rely on our healthcare system moving on from its old ways of delivering and pay for itself.