An mHealth perspective from Institute for the Future

By Brian Dolan
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Mobihealthnews recently caught up with the Institute For The Future's Health Horizons Research Manager Vivian Distler to discuss the current and future states of mHealth, iPhone 3.0, the MD-LINK, "artifacts from the future" and more.

Given the Institute For The Future's (IFTF) name, I assume it is focused on the future of healthcare, but how would you characterize the state of wireless medicine or mHealth as it exists today?

MD LINKAlthough our 2009 research agenda is called Health Care 2020, IFTF's focus is not exclusively on the future of health care. Since the introduction of our Global Health Economy Map of the Decade in 2006 (PDF), we have been thinking about health expansively, going beyond health care to include biopharma, food, beauty, medical technology, consumer electronics, and information. One of the big stories we identified at the time was mobile health, and we have been following this trend ever since. Last fall, we hosted a conference for our clients specifically on the topic of mobile health, during which we examined everything from concepts of mobility and our mobile society to health management devices, services, and applications.

Certainly, the advent of the iPhone 2.0 OS marked a leap forward in terms of the availability of health and wellness-related mobile applications, and now the iPhone 3.0 OS will likely have a significant impact on mHealth, for both consumers and medical providers. It is hard not to be excited about Johnson & Johnson's demonstration of its new Lifescan app that will enable users to upload their glucose readings and send them to caregivers, and also provide anytime, anywhere functionality like meal builder information and data tracking.

It is important to keep in mind, however, that at least for now, a large segment of the mobile health market--domestically and globally--is not going to be able to take advantage of features like the new "Push" capability offered by the iPhone. Instead, SMS text messaging will continue to play a critical role in promoting behavior change and making health information available to cell phone users.

Finally, I would be remiss if I didn't at least point out that medical devices are also becoming more lightweight and mobile. In many instances, these advances have been generated by the demands of practicing medicine and promoting health in developing countries. In fact, we should note that innovations in all aspects of mHealth are happening globally.

What is the IFTF's vision for the future of mobile phone-enabled healthcare, wellness and medicine? 

Well, we don't predict the future at IFTF. And the forecasts we developed as part of our mobile health research initiative in 2008 are still only available to our members.

However, I can share with you an example of an "artifact from the future"--a plausible, internally consistent scenario of the future represented as an object that may be found in everyday life in five to ten years. This artifact is one of several we developed for Deloitte's Life Sciences group as part of our Industry Compass 2.0 project. (You can see all of the artifacts here)

The "MD-LINK" (pictured) is an off-the-shelf phone/PDA/Health monitor that offers the following features: doctor-programmed goal reminders; calories-burned monitor; and connectivity for EKG, EED, GSR, blood pressure and glucose monitoring (sensors sold separately). Some of this basic functionality is already supported by existing apps; this more sophisticated device will combine them all, probably in less than five years.

Note, however, that our framing of the significance of this artifact is not about technology. It is about the role the workplace will play as a focal point for health management. MD-LINK is a "Corporate Health Program Approved" device; it is a plausible example of how employers will put pressure on employees with respect to health maintenance, illness prevention, and productivity.

What can physicians, nurses, clinicians and other hospital workers do now to prepare for mHealth? What are the first steps necessary to ensure a practice is able to leverage mobile in the future?

Change can be scary, especially for professionals and institutions that are very set in their ways. Willingness to embrace, rather than resist, mHealth is an important first step. From a technology standpoint, I hope that we will eventually see standards of interoperability that will allow for seamless, secure data sharing and communication.

Will mobile solutions primarily lead to cost/time efficiencies for caregivers or better care for patients?

Hopefully both. Although initial investments in mobile solutions may be significant, I do think they will ultimately pay off in terms of cost and time efficiencies. For patients, mobile technology is literally putting health care into their own hands.

I think the evolution of blood glucose monitors provides a case in point. These devices moved first from the clinical setting to the home, then to anytime, anywhere usage. They've gotten smaller and less invasive, and now they can "talk" to a patient's circle of caregivers--healthcare professionals, family, friends--in real-time, via wireless technology, and provide immediate feedback to the patient.

We could tell the same story, though on a less pervasive scale, about cardiac monitoring devices. Although early adoption costs may be high, how could the ability to track heart arrythmias 24/7 over a period of weeks, as the patient goes about his daily life--rather than being confined to a hospital bed for a day or two, or encumbered by an awkward device--not lead to efficiencies and improved care over time?

How do you envision mobile phones and other devices leading to more consumer-centered care and wellness? Can you give some examples?

At the Institute, we look for signals, or signs of change, on which to build our forecasts. As I noted before, the iPhone has generated an abundance of health and wellness-related apps. I can't tell you which ones are good or bad, but their existence is an indicator of a shift toward more consumer-centered care based on mobile technology.

I think that we will also continue to see the evolution of devices that facilitate self-monitoring and reporting of a variety of metabolic and physiological conditions, with many possibilities for feedback loops that will promote self-efficacy. People will be empowered with information that they can use to take better care of themselves.

What specifically is the IFTF working on in regards to mHealth currently and how can mobihealthnews readers and others in the emerging industry get involved?

I regularly blog about mobile health-related signals on the IFTF/Health website. Our interest in following these trends continues to be an important part of our research for our Health Care 2020 project.