As HIMSS14 approaches, we are sharing a pre-show guest blog series from health IT industry experts on trends you can expect to hear about at the event. Below is a guest contribution from Justin Barnes, a vice president at Greenway, chairman emeritus of the national Electronic Health Records Association (EHR Association) and co-chair of the Accountable Care Community of Practice (ACCoP).
Few, if any, aspects of healthcare have historically grown as quickly as mobile delivery. If you are reading this on a phone or tablet, you have a sense of mobile technology. If you can similarly access EHR functionality integrated with patient records, you have reached one forefront of mobile care. And if you are considering downloading mobile medical applications for informational, clinical or financial reasons to further streamline your care network, you may well have reason to pause: Do they work? Are they safe for patients? Meet data security or HIPAA compliance? How to choose?
The subset of mobile medical applications - more than 40,000 alone labeled for healthcare available today - is of course the explosion within the growth, for both care providers and patient-consumers. Described as anything from the Wild West to an innovation panacea to an opportunistic hindrance, a variety of steps in recent months and into the new year are settling the industry’s approach to mobile apps and mobile delivery toward the potential of meaningful interaction between provider and patient:
• In December, HIMSS published its nearly 50-page comprehensive roadmap, Mobile Health Apps: A Practical Guide for Healthcare Stakeholders, recommended reading for any practice, health or hospital system.
• The annual mHealth Summit, also in December, drew more than 5,000 attendees with intent to foster best practices within health systems, pharma, policy and payers, and featured international speakers.
• In January at the IHE North America Connectathon, the inclusion of standards organizations within the personal health apps, device and mobility segment, invited to pursue integration with healthcare information technologies, is an important step in the maturing of mobile health.
• And likely no other step was as anticipated as last September’s FDA final guidance on mobile medical applications. Here the agency stated that medical devices, accessories to regulated medical devices, or apps that transform a mobile platform into a medical device carrying certain levels of risk, are subject to oversight. For example, those providing a medical image for diagnostic purposes from a PACS archive onto a smartphone or tablet, or an app that offers ECG capability to detect abnormal heart rhythms or diagnose a heart attack.
The FDA’s narrow regulatory definition was itself recognition of the maturity of mobile EHR and personal health record technology excluded from oversight, as well as apps that measure, monitor, offer lists or reminders, self-manage or offer simple clinical decision support around symptoms or drug checks.
Continued Growth and Challenges
This of course leaves a very large market the health IT industry must continue to vet on behalf of providers and patients.
The Robert Wood Johnson Foundation predicts a 25 percent growth in available apps annually, and that 500 million consumers and providers worldwide will use a mobile health app within the next two years. That’s a predicted $8 billion market by 2018, says GlobalData, a 44 percent annual rise from the $500 million market experienced in 2010.
It’s no wonder that Apple and Google recently secured meetings with FDA officials in preparation of bringing products to market. Thankfully what is also maturing is the infrastructure around mobile data, as global firms such as Intel advance secure cloud technology and data warehousing, because much of healthcare delivery and therefore mobile health is driven by data.
At my company, Greenway, we have approached mobility on two fronts. One is providing applications to place EHR functions onto phones and tablets. The other is integrating vetted apps into the EHR through API technology and then available to providers and their communities of health.
The next step is bringing providers and patients together.
Patient-Provider Convergence Still Forming
Right now there are sophisticated apps that providers can display on tablets with anatomical images, showing patients precisely what a procedure entails and allowing notes, drawings and enhanced visuals. Patients can use it as well to send back follow up queries, all of which can enhance the provider-patient relationship.
For patient-consumers, there are healthcare plan apps that locate providers and hospitals in network, details out-of-pocket costs per provider and include patient discharge satisfaction surveys and board certifications.
Still to come though is full integration of provider and patient apps that advance clinical care and outcomes, or help patients manage – not just understand – their medical condition or latest monitor rates. But should apps give rise to a real-time mobile consultation?
This is the challenge for the health IT and the healthcare industry overall to address. It’s a matter of determining the right ongoing remote or mobile link between provider and patient that can be merged into workflows, not add costs, can be billed when appropriate, merged into patient records and satisfies care coordination payment and delivery models.
The foundations are being laid to mature mobile health on these fronts, because how far away are we from patients being prescribed an app? Or more so from patients asking their providers for one?