Everyone makes New Year's resolutions, and most of them last as long as the hangover. We feel the spirit of the moment, make these grand promises for the year ahead … and in the cold light of January, those ideas just don't seem so good anymore. Maybe we keep it up for a while, just to look good, but the excitement wanes.
Sounds just like mHealth, doesn't it?
We're there – we're almost there – but then again, we say that every year, and at this time every year we make the same bold prediction for the following year: that mHealth, telehealth, telemedicine, digital health, connected health, whatever, will finally get over the hump and become mainstream. We've got the proof now that it works, that it saves money and lives and makes people smile and doctors happy and all that.
But go into the nearest hospital and you'll probably see a doctor or nurse walking down the aisle with a paper chart in hand (and their cellphone in their pocket). Walk into a doctor's office and you'll see bookshelves full of charts, a waiting room full of people with minor ailments or conditions that could be solved through a simple online consult, and a doctor more stressed than President Obama's scheduling secretary or Justin Bieber's chaperone.
Sure, it takes time for these things to catch on, but does it really have to take this long?
So, in the spirit of the holiday, here's my list of mHealth resolutions for 2015. And let's see if we can't follow through on them. Maybe there's an app to help us along, give us support when we start losing interest ….
1. We resolve to reimburse doctors for mHealth. No more sitting around trying to define telehealth and argue that a doctor needs to see a patient in person before seeing that same patient online or on video. If a doctor can reasonably treat someone over the phone, over a video-feed on online, let him or her do it and let him collect compensation for his time and expertise. Set universal standards for care, and make sure both doctor and patient know just what can and can't be done through mHealth.
2. We resolve to establish clear rules and regulations for mobile medical apps. Can the FDA handle the workload? Does Congress need to step in and set things in stone? Do we need another office to handle these responsibilities, and would that really hinder innovation? On a basic level, the challenge seems clear – find a way to make sure that any app that can be used to make a diagnosis or medical decision is regulated. If the app can cause any sort of harm, it needs to be governed. If it presents data as facts, that data needs to be verified. And if it just helps the process, moving data around, speeding it along or presenting it to the right people a the right time, then let's get out of the way and let it work.
3. We resolve to avoid the "consumer-facing wearable" hype until it actually means something to doctors. This one is tough. Smartwatches, fitness bands and all manner or wearable devices are all the rage these days, but doctors aren't buying into them. They may be giving consumers what they want, but they're not helping doctors do their job. Maybe Apple, Samsung, Microsoft, Google and others will bridge that gap this year with devices that generate meaningful data for clinicians, but let's not crown any of them as successes until the testing is done. And just as important, stop pinning your hopes on new devices. The key to bridging that gap between consumer and clinician lies in finding out what consumers already use, not expecting them to glom onto the next big fad.
4. We resolve to tackle the "engagement" issue. Forget "patient engagement" – that's an overused and inaccurate term. It's "consumer engagement." And this dovetails nicely with my previous resolution. Consumers want one thing from healthcare, and clinicians want something else. The key to engagement lies in tapping into what the consumer wants and making it relevant to healthcare – in other words, finding a way to make healthcare a good thing, rather than something you only think of when you're sick. We've heard all this talk about how we're moving into consumer-directed healthcare, but the healthcare community needs to step up and create the landscape through which that consumer will travel. While it's up to the consumer to make that final decision, it's up to healthcare to ensure that he/she has all the facts.
5. We resolve to help doctors embrace mHealth. Sure, they're hesitant to try out new things. Then again, they've got EMRs and ICD-10 and meaningful use and ACA mandates to worry about. And they're got sick patients to treat. Until mHealth is easy enough to slip right into their daily activities, it won't be adopted by the mainstream. Just like with consumers, find out how doctors do their jobs now, and prove to them that mHealth will make their jobs easier and better. Don’t just throw something out there and expect them to adopt it. Sounds simple, but how many doctors have enjoyed moving onto an EMR platform?
6. We resolve to make mHealth security simple. Hacking and data breaches are becoming all too common these days. Often, clinicians will make the argument that saving a life is more important than going through the necessary steps to protect patient data. If pressed to jump through a number of security protocols, they'll find ways to get around them. The industry needs to address this from the top on down, and make a commitment to privacy and security measures that don't interrupt the clinical workflow. No one said it would be easy, but if a doctor is faced with the choice of providing three different types of authentication or finding a loophole to treat a patient in distress, he or she will go straight through that loophole.
None of these resolutions are earth-shattering – or even new, for that matter. But they're basic, and necessary if mHealth is ever going to get beyond that stage where it's separate from healthcare. And in the spirit of the new year, it's nice to just get them out there.
Now check back with me in 12 months. Better yet, send me your resolutions, suggestions, rants and raves. It'll feel good to be engaged.
