I'm getting a sense that a lot of people in health IT in general and mobile health in particular are losing sight of the big picture. This isn't about making a quick buck, exploiting the prevailing inefficient fee-for-service environment or impressing young, healthy people with flashy apps. It's about saving lives, preventing harmful errors and building a smarter, safer health system. Do the right thing and the money will be there.
That's the message I got from Kaiser Permanente President and CEO George Halvorson earlier this month at the World of Health IT conference in Copenhagen, Denmark. "If something makes care better, then you use it and you don't look at the cost," Halvorson told me in an interview at the official residence of the U.S. ambassador to Denmark, Laurie Fulton.
He then cited the late management guru W. Edwards Deming. "Deming basically said you don't focus on costs, you focus on the most elegant process and nine out of 10 times, the most elegant process will cost less," Halvorson said.
Lest you think I was living it up in Europe while all of you were toiling away at your regular jobs, I had to cut my trip short—scrapping a planned week of vacation in Italy—and fly to Washington on very short notice because my father was dying from a rare, insidious, little-understood, degenerative neurological disease called multiple system atrophy, or MSA.
He passed away peacefully and without pain at Georgetown University Hospital on May 11, just a day after I arrived from Denmark. The people and care at Georgetown were great, but they could not in my dad's final four days make up for the terrible experience my dad had for 3½ weeks at a community hospital plagued by broken processes, inadequate communication and neglect for what is really important: care quality.
As sad as it has been to lose my father to such an evil disease at the relatively young age of 68 and to know that he was suffering at hospital that apparently cared more about generating revenue and protecting its reputation, I was heartened to find that some people really do want to build safer healthcare environments. The compassionate, well-coordinated care my dad received at Georgetown was one example, but I'm supposed to be talking about mobile health in this forum. I'm happy to report that some in m-health are ready right now to effect systemic change for the better.
On Tuesday, just hours before I returned home from my 18-day odyssey, I covered a forum at the Brookings Institute that examined how mobile technology influences health innovation. The discussion provided hope that some people do have their eyes on the right prize.
"If you have access to information, you can save a life. You can make better decisions," Dr. Antonio Marttos Jr., director of teletrauma at the University of Miami's William Lehman Injury Research Center, said during the event, which was webcast live. Mobile devices are sparking a "cultural change," Marttos added, something physicians are slowly starting to understand.
But the transformation is not happening fast enough for a lot of people. According to epidemiologist Alain Labrique, director of the Johns Hopkins University Global mHealth Initiative in Baltimore, the "pilotitis" that plagues adoption of new technologies needs to disappear. Instead, he said people need to think about how to "mainstream m-health into health systems. How do we integrate these technologies to enhance the way we deliver public health on a global scale? How do we make these technologies help us do things better?"
Sure, nobody wants to act irrationally and implement something that will only exacerbate problems, but too many administrators seem to be making excuses not to take action. HIPAA often is the culprit, and not necessarily for the right reasons. "HIPAA risks seem more important to some than whether technology works," suggested Darrell West, vice president and director of governance studies at Brookings.
That may be because doctors and those who run hospitals don't want to cede control of important health care decisions to patients. Julie Kling, mobile executive business lead for health insurer Humana, noted that mobile apps can lower the cost of getting health information to consumers and help people manage their own health. That can lead to better care and, as an extra benefit, save money, which is why Humana is not dragging its feet while academics study the efficacy of innovations that one does not need a medical degree to use.
"We're not waiting for that analysis to make these tools available for our members," Kling said.
The status quo is deeply entrenched in our badly broken healthcare industry, and people like my dad suffer needlessly every day because of it. Improvement cannot and should not have to wait. Better ideas are out there, and many of them are as close as your mobile phone.
"The fact is, most folks are never more than 4 feet away from their phones, and that includes [when they are in] the bathroom," noted Morgan Reed, executive director of the Association for Competitive Technology and a member of the mHIMSS advisory council. Better health is right at your fingertips. If only it could also be in every hospital.