It's a simple question: Do mobile health tools require a doctor's prescription? Or will the main driver for mHealth services bubble up from consumers and patients largely without care providers weighing in?
Throughout the keynote sessions at the mHealth Initiative's event in Washington D.C. this week, the focus was squarely on care providers' adoption of mobile technologies, their integration to EMRs and the opportunity that subsequently created for patients and consumers. While yesterday's morning keynote presentations mentioned patients' self-directed interest in mHealth, it was more in passing, as an after thought or as a consequence of physicians' adoption.
Rob Havasy, an mHI event attendee and business analyst at the Center for Connected Health in Boston reacted to the focus on providers with a succinct message to his Twitter followers: "When providers adopt consumers will engage." That message was also apparent in his recent blog post on the larger mHealth opportunity a few weeks ago (revisit it here).
During lunch another attendee agreed that it needs to start with care providers -- the lackluster adoption of PHRs, like those offered by Google Health and Microsoft's HealthVault, demonstrate that most consumers aren't likely to quickly adopt connected health solutions. These online platforms are most useful when used in conjunction with connected health devices that can populate them with personal health information. Care providers need to educate patients about these devices and services.
Last fall, I interviewed Insignia Health's CEO Chris Delaney who explained his firm's categorization of "activated" patients: 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.
Of course, even e-Patients believe in a strong relationship with their care providers: e-Patient Dave deBronkart recently formed the Society for Participatory Medicine with his physician Dr. Danny Sands. deBronkart said he and his doctor are co-chairs of the organization, which aims to promote best practices for patients working together with their care providers as responsible partners.
While adoption of mHealth services will undoubtedly benefit from a number of drivers pushing it along simultaneously, it seems that right now, anyway, there is a growing consensus that care providers need to step up and punch out a much needed m-prescription.