mhealth: technology changing health care
TRANSCRIPT
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E. Rachel MutruxDirector, Missouri Telehealth Network
Operations Director, Missouri HIT Assistance CenterState Director, Heartland Telehealth Resource Center
Center for Health Policy Health Policy Summit 2013
mHealth: Technology Changing Health Care
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Jama, 10/24/2013 definition:
“use of
mobile telecommunication technologies
for the delivery of health care and in support of wellness”
mHealth definition
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Mobile Phones & Smart Phones1. Digital divide is smaller for
phones than for Internet2. Mobile phone technology
easier/cheaper to roll out to large areas than fixed technologies
3. Mobile phones immune to social prejudices
Male/female; rural/urban; young/old
Cost effective & cost saving
Why mHealth?
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Dr. Sebelius lists 3 forces driving mHealth1. $$- unsustainable cost of healthcare
2. Wireless & technology!!3. Need for individualized medicine
Per capita spending on healthcare, Kaiser Foundation
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Measurement Tracking- diet, exercise Blood sugar, blood pressure
Diagnostic Portable imaging Sensors
Treatment Chronic disease management Remote clinical trials
Comprehensive Dissemination of health information Disease surveillance Prevention & Wellness interventions Education & awareness Helpline
Applications of mHealth
Klasnja, P., & Pratt, W. (2012). Healthcare in the pocket: Mapping the space of mobile-phone health interventions. Journal of Biomedical Informatics, 45(1), 184-198.
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Nexercise Free app that tracks exercise- GPS Uses support system Allows you to win points- money
Fooducate Scan bar codes to get nutrition
information Grades food choices (A,B,C) Suggests better alternatives
Consumer Focused
Examples
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Clinical Reference Apps The Merck Manual WebMD Medscape
Diagnostic Apps Mobile MIM- FDA approved for radiology AirStrip- Cardiology App- see EKG
Public Health Apps For Cancer prevention- Target Heart Rate
Calculator, Calorie Counter, Cigarette Calculator
Telehealth Apps Videoconferencing Tele MDID- developed here at MU!!
Disease Management Apps Asthma Crohn’s Diary Kidney Diet
Provider Focused Examples
Near Site Clinic – University Hospital
Far Site
Tele- MDID Project
The iPad apps were deployed to 10 far sites, as well as MU dermatology clinics. Pre-launch and post-launch internet-based surveys were distributed to far site patient presenters and dermatology clinic providers in 2013.
9University of Missouri Institutional Review Board (IRB) #1207257.
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Texting improves health outcomes Effective chronic disease management Effective self-management of disease and
successful clinical outcomes Better quality of life Reduction of error Better control of infectious diseases in
developing countries. Accessibility of healthcare in rural areas. Cost effective Better medication adherence Texting leads to better medication adherence Better maternal child health Improve attendance to healthcare appointments
**caveat much research was inconclusive showing need for additional research
Early mHealth research
outcomes
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Current reimbursement structurePhysician concerns
Reducing face-to-face interaction Increased workload
Security, PrivacyUnder-regulation- Over-regulation SafetyBig-Brother
mHealth Challenges
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Estimated 100,000 apps on the market today
Health & Wellness apps are leading adoption!- LoseIt! Fitbit
Healthcare moving out of the Dr. office to the patient
Improve health, increase access, decrease cost
Potential of mHealth
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E. Rachel MutruxPhone: 573-884-7958E-mail:
Contact information:
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Reference List
1)http://www.brookings.edu/~/media/research/files/papers/2012/5/22%20mobile%20health%20west/22%20mobile%20health%20west.pdf2)A mobile telephone-based interactive self-care system improves asthma control Eur Respir J 2011 37:310-317; published ahead of print 2010, doi:10.1183/09031936.00000810 3)Free, C., Phillips, G., Galli, L., Watson, L., Felix, L., Edwards, P., ... & Haines, A. (2013). The effectiveness of mobile-health technology-based health behaviour change or disease management interventions for health care consumers: a systematic review. PLoS medicine, 10(1), e1001362.-4)Lv, Y., Zhao, H., Liang, Z., Dong, H., Liu, L., Zhang, D., & Cai, S. (2012). A mobile phone short message service improves perceived control of asthma: a randomized controlled trial. Telemedicine and e-Health, 18(6), 420-426.5) http://www.fiercemobilehealthcare.com/story/texting-improves-health-outcomes-young-asthmatics/2013-05-026)http://ebn.benefitnews.com/news/mobile-wellness-apps-increase-employee-engagement-decisionmaking-health-out-2729886-1.html?CMP=OTC-RSS7) Ryan, D., Price, D., Musgrave, S. D., Malhotra, S., Lee, A. J., Ayansina, D., ... & Pinnock, H. (2012). Clinical and cost effectiveness of mobile phone supported self monitoring of asthma: multicentre randomised controlled trial. BMJ: British Medical Journal, 344.-Not effective self-management for asthma. 8) Obermayer, J. L., Riley, W. T., Asif, O., & Jean-Mary, J. (2004). College smoking-cessation using cell phone text messaging. Journal of American College Health, 53(2), 71-78. Retrieved from www.scopus.com9)http://www.ey.com/Publication/vwLUAssets/mHealth_Report_January_2013/$FILE/mHealth%20Report_Final.pdf