Molly Joel Coye, MD, is the Chief Innovation Officer of UCLA Health and director of the Institute for Innovation in Health at UCLA. The founder and CEO of the Health Technology Center (HealthTech), she has also served as New Jersey's Commissioner of Health, director of the California State Department of Health Services and head of the Division of Public Health Practice at the Johns Hopkins School of Hygiene and Public Health. She is an elected member of the Institute of Medicine, chair of the Board of Directors of PATH, a member of the Board of Directors of Aetna, the American Telemedicine Association and the Springboard Life Science Council and a past member of the boards of the American Hospital Association, the American Public Health Association, Cholestech, The California Endowment and the China Medical Board.
Q. What's the one promise of mHealth that will drive the most adoption over the coming year?
A. One of the most exciting new features of mHealth is the emergence of whole libraries of text messages that can be directed to specific sub-populations of chronic disease patients. The impact of companies like CareMessage is impressive, especially in light of the very low cost and low IT burden for the health providers. They began by helping federally funded clinics serve low-income patients, but it has far broader application.
Q. What mHealth technology will become ubiquitous in the next 5 years? Why?
A. Applications that more precisely match consumers and patients to doctors and hospitals in their area, add price transparency and cost calculators and feature Yelp-like reporting of patient experiences with the providers.
Q. What's the most cutting-edge application you're seeing now? What other innovations might we see in the near future?
A. I would keep a close eye on the applications that offer online diagnosis or triage. We’re piloting Zipnosis now, and we’re excited about the potential of applications like this to drastically reduce the demand for in-person visits with physicians or EDs when patients have minor episodic problems. Consumer preference for these kinds of solutions is going to be a big driver, too.
Q. What mHealth tool or trend will likely die out or fail?
A. Attempts by integrated health systems to maintain their own libraries of curated applications for consumers – few systems will want to make the investment required to keep this current, and few consumers will care to use the health system as their guide for the use of apps. Possible exceptions might be curated libraries offered by providers or assisted living facilities for seniors and their caregivers.
Q. What mHealth tool or trend has surprised you the most, either with its success or its failure?
A. One of the ironies of having spent hundreds of millions of dollars on healthcare EHRs is finding it so difficult to work with terrific new apps and other cloud-based solutions, because most of them can’t provide or receive data from all the EHRs (or from each other). It’s still early, but I am hopeful that some of the non-healthcare sector platforms like Salesforce may bring real leverage to mHealth – and all cloud-based solutions – by solving the need for multiple interfaces with enterprise EHRs.
Q. What's your biggest fear about mHealth? Why?
A. Not surprisingly, it is that the ability of provider organizations to sort through all these potentially beneficial new offerings is pretty limited – they are all overwhelmed with multiple other new opportunities and challenges. Most of their IT staff are fully occupied with upgrades to the EHRs, normal operations, security threats, etc. I have a lot of sympathy for them, but it does mean that the funnel is smaller and good products don’t make it through.
Q. Who's going to push mHealth "to the next level" – consumers, providers or some other party?
A. I think it will be led by a combination of sensor development, platform integration (perhaps from outside of healthcare) and consumer demand for convenience. The dark horse is the possibility that pressures to drive down healthcare costs will actually cause providers to realize that they can use mHealth to massively shift care “upstream” – help patients change behavior and prevent costly episodes.
Q. What are you working on now?
A. My mom was a mental health planner, and when I was a public health commissioner I did a lot of work on policy and services in behavioral health. At UCLA, we’re integrating behavioral health directly into primary care very successfully. And I’ve just become involved with an online mental health service, Big White Wall, that was first developed in the UK – where it has been very successful – and is now being introduced in the U.S.
