mHealth13: Patient-centered care will drive mobile adoption

Mobile technology may be the future of patient-centric care, but better evidence is needed to take it to the next level, according to a panel of experts speaking Tuesday morning at the mHealth Summit in Washington, D.C., at FierceMobileHealthcare's executive breakfast panel "mHealth's Role in Patient Engagement."

Cleveland Clinic Chief Medical Information Officer David Levin (pictured second from right) said that while he's devoted most of his career in bringing technology to healthcare, it's mainly been a failure and there's much more to do. Technology shouldn't put more space between the provider and the patient, but all too often, he said, it does.

The question Levin said he's been asked repeatedly: "Why is it going be different this time?" His response: It's a perfect storm now, and it's become about value-based, patient-centric care. Results, he stressed, are really going to matter.

Consumerism is contributing to the success of mHealth, too, Levin said. It's a major change in the way people live--they won't accept not getting their health data and not using mobile apps to participate in their own healthcare.

"We imagine things that will actually change people's behavior, but we're often wrong," Levin said, harping that health IT is not usually designed with the patient in mind. "Good design takes into account human factors and what motivates people, and [what integrates] into and IT ecosystem," he said.

Sid Kosaraju (far left), managing director for Accenture, said that we've come to a place where everyone is online and that their needs need to be serviced. "I think we're in the middle of a care transformation where ability is being transformed by tools," he said. Those tools, he added, are used in four equally important settings: staffed beds, face-to-face, in-home and virtual.

Nasrin Dayani (second from left), executive director of AT&T ForHealth, AT&T Advanced Business Solutions, agreed. Consumerism, she said, allows people think of health management as part of their daily lives.

"We need to stop talking as patients and start talking as people," Dayani said. "People don't want think of themselves at patients. I know I'll personally use mHealth apps if they help with my everyday life and become part of my lifestyle."

One of the biggest technology challenges for providers is leveraging the data explosion to make Meaningful Use make sense to their patients, Dayani said. She added that patients don't need incentives to use technology--they just need something useful.

"There's a big gap--how do we fix it?" she said. "Eighty percent of mHealth apps don't get used beyond one month ... they're not being integrated in workflows or being made part of the care delivery system."

To that end, Steven Steinhubl (center), director of digital medicine at the Scripps Translational Science Institute in La Jolla, Calif., said that there will "always ... be snake oil salesmen out there," which, he said, can put mHealth in a bad category.

"We have to be able to provide an evidence-based roadmap to show how we get there," Steinhubl said. "There's a great need for more evidence as we move forward."

The panelists also discussed the difference between "meaningful use, lowercase" and the Meaningful Use--actually getting patients to understand and interact with their data in a personable way vs. the government incentive program. One physician in the audience asked the panel about strategies for patient engagement in Stage 2 of Meaningful Use and how physicians can educate patients in the right way, saying that physicians can be just as lost understanding Meaningful Use as anyone else.

Levin responded that there's informed consent, and then there's giving tips to patients about what to do next to be a part of their own care. He said that having multimedia available in a portal to be able to present patients directly is one way to do educate patients meaningfully.

Dayani said now that it's possible for physicians to use EMRs to send patients articles, videos and apps, they can keep track of what's been sent to patients--but stressed that the content has to be useful.

Added Levin: "[Meaningful Use] is about stuff we should be doing anyway. But it's not perfect."

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