Those who need it most, aren't interested

By Brian Dolan
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Brian Dolan, Editor, MobiHealthNewsMore than three-quarters (78 percent) of the U.S. population is "interested" in wireless health services, according to a survey conducted by Harris Interactive, Insignia Health and CTIA that was shared at CTIA IT & E in San Diego last week. While the survey's top line results are encouraging, the story behind the headline is far more helpful for the industry.

Of that 78 percent interested in mobile health, about half were only "somewhat interested" in mobile health, while the remaining 39 percent were either interested or very interested. While 39 percent of the U.S. population is a substantial figure, the more important question is -- who are these people?

Unfortunately, those most in need of mobile health solutions are the least likely to be interested in them, Insignia Health CEO Chris Delaney explained to MobiHealthNews in a recent interview.

When thinking about mobile health, there are really two challenges for those looking to drive consumer adoption: The low activated population is the most in need of these solutions, but since they don't believe they are really in charge of their healthcare, they are least likely to be interested, Delaney explained. On the other hand, the early adopters are the most activated patients -- meaning they already take pretty good care of themselves. Even if the wireless health industry manages to drive consumer adoption among this group, the effect these services will have on these early adopters' health will be minimal because they are already in pretty good shape.

Delaney's company breaks patients into four levels of activation -- the lowest level, Level 1, are those patients who do not take an active role in managing their own health for a variety of reasons, but mostly because they believe they aren't in charge. This patient group is also known as the "frequent fliers" in the emergency room. The group is also the most likely to be readmitted to the hospital after 30 days. They are also the least adherent to medication and other care plans (Delaney said they are around 20 to 30 percent adherent). They also make up most of the health care costs in the U.S., Delaney said.

On the other end of the spectrum is the most activated patient group, called the Level 4 group. These patients already take good care of themselves -- they are about 80 percent adherent to their medications and are eager to maintain their health regimens and remain in control of their own health. The e-Patient falls into this group. Level 4 patients are very interested in mobile health.

While wireless health cannot just focus on the group that needs these solutions most, it also can't bank on driving adoption among those very activated patients, because results from those early adopter studies and pilots are not going to show the kind of return on investment that payers are looking for to get behind this emerging industry.

Delaney noted that one thing that really stood out among the survey's findings was that physicians are very interested and quite aware of the emerging mobile technology industry and its potential benefits on improving patient care. Delaney said that one curious difference between the way patients viewed mobile health and the way doctors did was that doctors believe mobile health would dramatically improve the relationship they have with their patients. Patients did not see mobile health as a means to strengthen that relationship, but rather as a means toward visiting their doctor less often.

The time to determine the best way to reach the patients that need these products most -- to present mobile health to them in a way that helps them to realize they can take control of their own health -- is now. There is a lot of benefit to be gained from wireless health offerings, Delaney said. This is an industry at its very beginning, but don't assume that the patients most in need of wireless health will be running into their doctors' offices anytime soon to ask about these products.

Delaney's advice: Find the doctors with patients that can benefit from these products. Convince the doctors first and let them convince those patients most reliant on their advice. Folks can't become adherent to what isn't prescribed.

For background on the survey, continue on through the slides that follow. These include an explanation for the four levels of activation for patients, physicians' opinions about their patients' activation levels, patient interest in mobile health, physician interest in mobile health, opinions about mobile health impact on consumer empowerment and its impact on costs savings in healthcare.