mHealth: Taking it with the good, the bad and the ugly

I love movies, especially westerns. And, one of my favorites is The Good, the Bad and the Ugly, which I think is the perfect way to describe where we are at today with mHealth.

First, let's start with the good news. While information technology has become ubiquitous in our everyday lives, the healthcare industry has traditionally been slow to adopt IT. Critics have rightfully charged that the medical community's hesitance to embrace wireless technology is counterproductive to the advancement of medicine. Thankfully, that is beginning to change.

Statistics show that physicians, providers and other healthcare professionals are using smartphones and tablets in their work in unprecedented numbers. The percent of clinicians using apps to actively engage in direct patient care has grown in the past year in several key areas, including: collecting data at the bedside; using bar code readers on mobile devices; monitoring data from medical devices; and capturing visual representation of patient data.

The bad part of this mHealth equation is a lack of evidence, a topic I've addressed in a previous column. A recent review of randomized mHealth trials found many studies to be of poor quality and few with low risk of bias and very few with clinically significant benefits for the interventions. In addition, only about 20 randomized clinical trials involving mHealth tools or services have been conducted in the United States since 2008. And, more than half of them have failed to document clear evidence of improved outcomes.

The ugly aspect of mHealth is, without a doubt, security. We're all familiar with HIPAA but mobile devices make compliance very challenging.

Nearly 89 percent of U.S. healthcare workers use their personal smartphones for work purposes. However, when it comes to security, a study found that 41 percent of healthcare employees' personal devices are not password protected, and that 53 percent of healthcare employees access unsecured WiFi networks with their smartphones.

Bring-your-own-device is an mHealth strategy embraced by many organizations that encourages this kind of behavior. Yet, by merging the two communication environments--inside and outside the medical setting--physicians have the potential of getting into trouble.

More than 80 percent of physicians use smartphones or tablets, but very few actually take basic security precautions, such as using encryption to protect their data from unauthorized users. Studies of out-of-the-box security configurations have found that most mobile phones do not meet more than 40 percent of security requirements, such as the ability to encrypt information.

Nevertheless, I'm encouraged by advancements in mobile healthcare technology and the tremendous opportunities for mHealth applications to not only change the way chronic diseases are treated, but also the great potential for consumer-based disease prevention.

There is good, there is bad, and there are ugly parts of mHealth. However, given our nation's skyrocketing healthcare costs and epidemic rates of diabetes and obesity, I remain convinced that the effective use of mobile technology has the potential to fundamentally change healthcare in America. - Greg (@Slabodkin)