2015 envisaged an increase in the use of mobile communication devices for the health and well-being in cloud services. Mobile health or as abbreviated mHealth is an emerging and rapidly developing field. Over more than approximately 100,000 (may not be the exact) mobile health apps are available across various healthcare platforms. mHealth can contribute towards the empowerment of both the physicians and patients. What is that 2016 has for mHealth? Will mHealth play a potential role in the transformation of healthcare in 2016?

Well, as I was keenly exploring answers to such questions, the webinar hosted by the Boston Technology Corporation was an eye-opener. This webinar was onJanuary, 14th 2016 at 11:00 AM EST.

Hosted by two eminent Digital Health innovators, Jared Johnson: Founder, Ultera Digital, Digital marketing thought leader and speaker. Shyam Deval: President, Americas at Boston Technology Corporation, the webinar covered current challenges in mobile health app implementation and the common practices that could be followed to overcome such challenges.

  1. How e-patients envision the future of care
  2. Digital health pain points for clinicians
  3. Lessons from early adopters
  4. Keys to overcoming pain points

The presentation started with defining the Empowered doctor as one who engages with patients and is equipped with the right tools and technologies and thus enabling themselves to provide better care to the patients. Jared then went ahead defining the Empowered patient (e-patient) as one who engages with the doctor and has access to the right information and right digital tools that empower and enable them to participate in their own care.

The discussion became more interesting as more points on e-patient vision for future were discussed. What is that patients using mHealth apps actually look forward to see in their apps?

e-patient vision for future

Patient engagement is a key factor that any patient would seek for. More demand for mHealth and digital health as standards for providers and medtech companies were certain things that patients as e-patients would want to have.

In future patients using mHealth apps would want to partner with providers to encourage them to do their own health data research. Access to PHI in secure ways is yet another important consideration for an e-Patient using mHealth apps. Patients are looking forward to wearables and Internet of Things (IoT) to be common in the exam room:

The Consumer Electronics show (CES show 2016) that featured various fitness trackers such as Apple watch and other consumer technologies relevant to healthcare are  the key decision making platforms to help achieve  such technologies common in daily healthcare practice. e-Patients are demanding for rural residents to have access to better care via telehealth and mhealth kiosks and lastly demand for patient advocacy to happen automatically.

During the presentation Jared mentioned few movements already happening in the e-patient space, e-patients.net and Quantified self were the two such specified.

Going ahead the webinar went to define few pain points in the digital health space that are currently faced by physicians. Few quotes by Dr. Rob Wachter (chief UCSF medical centre) on the Digital Doctor were briefly spoken about.

Digital health pain points for clinicians

Some of the challenges that clinicians face in the implementation of mHealth apps were then summarised. Some of these included:

Not sure where to start

Though many apps are available but many are not used for their actual purpose or explored by the physicians for what they are meant for. For instance, there are currently about 165,000 apps for consumers and health care providers, however 90% of the healthcare community downloads just 12% of such apps. Probable reasons can include non-intuitiveness of the apps, lack of training and many more.

Poor usability of digital tools

96% of doctors have smartphones but only 10 % are actually using them to access EHRs perhaps due to the lack in ease of use. Another reason can be the lack of understanding in the clinical workflows and not taking into account the clinical inputs from the care taker.

Confusion regarding the enormous patient-generated health data

At the end it becomes a difficult task for the clinicians to come to a solution of the data that is collected. Sometimes it amounts to being held in insecure ways. Most of the time such data sits un-analysed.

Questions about reimbursement

Many physicians are unsure of how they would be paid for certain medical procedures if performed a certain way. Recently there were 200 odd bills introduced for telehealth, however the payment and reimbursement models for such on-line consultations remain a question.

Other pain points covered were the paternalism vs. e-patients concerns, cost, time and resources.

Moving forward, few organizations as early adopters that are trying to address these pain points were highlighted.

Early adopters

Few healthcare and Health IT organizations are already taking baby steps to help revolutionise the healthcare system with the help of mHealth apps. Some great examples are listed below.

Ochsner health systems who provide a provision in their hospital lobby where patients can be prescribed the relevant apps. Cedars-sinai have integrated EHR to wearables for 87,000 patients. Kareo Apple watch app which is a Physician scheduling app available for wearables. Certain mHealth apps where patients can access their full billing details have also been recently introduced. Conversa Health and few others were also touched upon as early adopters of mHealth.

After discussing the digital pain points in a clinical system and lessons from early adopters, few key points to overcome such points were then discussed.

Keys to overcome pain points 

Like challenges faced in any Health IT product implementation, the usage of mHealth apps in health facilities by physicians also have their own limitations. We discussed some of these in Digital pain points. However, the webinar gave an insight on how these challenges can be crossed by following certain tips or guidelines.

Believing in the value of partnering with patients 

No Health IT system is used to its fullest potential unless it involves a two-way communication. The Doctor-patient interaction and the app provider-partner channel is the best means to increase wide spread adoption of mHealth apps.

Becoming familiar with digital health solutions 

Thorough knowledge and research of any HIT tool is a must for a healthcare provider and patients who wish to go the app way for an efficient and quality care.

Partner early with technology innovators and give clinical input to improve the digital tools and solutions being created 

Involvement of clinicians/nurses in the design and implementation of mHealth apps can help save lots of workarounds in developing such apps. Moreover, such an involvement from the healthcare provider perspective can also help design efficient and meaningful apps and ease their implementation process, thus increasing its wide spread adoption.

Some other key points briefly touched upon were interoperability with the EHR as the hub of all data, integration of wearables and Internet of devices, recognizing the marketing benefits of being an early adopter, and focusing on human behaviours and usability best practices.

The presenter emphasised that for mHealth apps to find space in empowering the healthcare industry, a physician should see e-patients as their greatest allies and not their greatest challenge.

Later in the webinar, principles for a good UX vital for success of mHealth apps were discussed.

Good UX vital for success of mHealth apps

The usability aspect of any mobile health solutions for all care takers and providers is critical. The reason discussed was that the users who use mhealth apps are also consumers of other apps like banking apps and travel apps, and they expect the same degree of sophistication from mhealth apps. Hence consumer expectations are seeping over from one industry to another.

So why can’t a patient engagement app be as polished as other apps such as Flipboard or Evernote?

Understanding the end user, making usability intuitive, the simple the better usability were initial points that were put forth by presenter Shyam Deval. Designers should have the ability to differentiate and pick and choose scenarios between simple vs. complex gestures like double tap and rotate, pinch and zoom. Another point emphasised was to understand the human behaviour as such and the end user to see what would suit them well. Trying to put oneself in the user’s shoes and analysing the requirement will help design efficient UX. The presenter discussed how good GUIs can help the user to effortlessly narrow down to what they are actually looking for in the app. The need to be original and unique in app design and looking for smarter and innovative ways to design can be means to engage with the end users. Finally, any good UX design will have good readability and visual impacts. The presenter urged the need to finalise a design after thorough usability testing, which can save lot of time, effort, and resources, thus reducing the cost of overheads and re-work. I would like to add that an end user involvement right from requirement analysis through design to implementation and UAT will be an added advantage to build efficient apps in less time and reduced cost.

The webinar concluded with the quote ‘After all an app’s design decides the app’s destiny’ and also highlighted the importance of considering privacy and security features like HIPAA while designing.

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A freelance Digital Health research analyst currently based out of Weybridge, Surrey, UK. I provide a range of services catering to the Health IT and healthcare industry. With over 18 years of work experience in the Health IT industry, I offer consultancy in Health IT system requirements and design, testing, user scenarios, user manual documentation, blog writing and more, as will be evident from my website www.digitalhealthwrite.com. I’m passionate about collaborating with physicians, startups, NGOs and educational institutes in the field of healthcare and Health IT to explore the options of resolving practical problems in healthcare with the help of technology. You can follow me at @DigiHealthWrite and @radhikabio28

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