At the ATA 2010 event in San Antonio this week, the U.S. Army's mCare project team leaders led a deep dive session into the Diversinet-powered mHealth service for "wounded warriors."
Right now, mCare sends daily messages to Army Reservists and National Guard members recouping in their home locations right to their own mobile phones. mCare is currently up and running at five separate military medical care sites that serve soldiers (at home) in 26 states. Among other things, health tips, appointment reminders and general announcements are distributed from a secure central web site where health care providers can enter and control the message content, as well as review acknowledgements and delivery confirmations. The mCare app is available on each of the major carriers in the US, but it does require users to have text messaging enabled as well as a data plan.
"[mCare] is a secure app [for wounded warriors] that works on their own mobile phones, Holly Pavliscsak, mCare Project Manager said during the session. "It was critical that the patient was able to use their own mobiles, therefore, mCare had to work on multiple devices and with various wireless carriers. The app had to be easy to install, remove and use, while providing enough value to users so that they would want to engage with it regularly."
"Of course, there are pitfalls and challenges every step of the way for mobile health services," Pavliscsak said. "For example, two of the major US wireless operators have 'open' networks, which means they don't have a lot of limitations for apps and devices running on their networks. The other two major carriers have 'closed' networks, which require a lot of testing and validation. Conveniently each of these carriers use a different testing center -- so it ends up costing twice as much money. Mobile health is not for the faint of heart. I would encourage all of you if you are getting into mobile health, to find good partners who know how to do this – like Diversinet. Another key for mCare is that it was governmental venture. I don't think we could have done it otherwise," Pavliscsak said.
The primary concern from care providers was that they did not have time to send and receive text messages patients, Pavliscsak said. Providers were mostly concerned about having to "free form" text messages and field them as they came in. That’s why mCare has a web interface on the backend for care providers that serves as a dashboard for them to monitor their patients.
Pavliscsak said there are a number of misconceptions about mCare. mCare is not distributing cell phones to soldiers. It does not expect patients to perform complicated technical tasks. mCare also is not asking care providers to free form text messages between patients and providers.
The biggest barrier for mCare adoption so far, according to Pavliscsak was that, although most phones have SMS and data plan capabilities, not all patients have a data plan activated.
Pavliscsak was joined on-stage with colleagues Jeanette Rasche, mCare Technical Director and James Tong, mCare Project Officer, who shared a number of interesting statistics about the mCare program.
Each mCare patient receives a minimum of 6 messages per week, meeting or exceeding the Army’s required contact rates for Wounded Warriors receiving outpatient care in their home communities. Furthermore, the system is improving appointment attendance rates. Since the project deployed in June of 2009, over 2,200 messages have been sent with an over 87 % response rate. Of those messages, the vast majority -- 63 percent -- were for appointment reminders, while 17 percent were related to health and wellness tips, 12 percent were messages about the soldier's unit, 7 percent were suggestions for other resources, and only 1 percent were text messages. Here are some other interesting metrics from the presentation:
75 percent of mCare users preferred multiple messages per week for tips, resources, etc.
94 percent said mCare's tips were either very or somewhat helpful and relevant
66 percent of users said mCare improved communications with their care team
25 percent of mCare participants have feature phones
75 percent have smartphones
50 percent of those have BlackBerry devices
25 percent have iPhones
5 percent use Android devices, but the mCare managers expect that to grow quickly
AT&T is currently the carrier that the majority of users has a contract with