MobiHealthNews recently interviewed Carrie Varoquiers, President of the McKesson Foundation, to learn more about the foundation's recently launched Mobilizing for Health grant initiative that has an annual budget of $1.5 million to fund innovative mHealth research projects.
Why did the McKesson Foundation decide to launch its mHealth initiative? How does it relate to the foundation's other activities?
The McKesson Foundation has an annual grant of just over $5 million a year -- so, we're a small foundation -- relatively speaking. We have been funding chronic disease management programs, specifically focused on diabetes, at community health centers across the country. Right now we are focused on diabetes, but we rotate the conditions we focus on every three years: We will move to heart disease then COPD and asthma and then lastly cancer during the next 12 years.
We had been funding diabetes management programs at these clinics, and we continue to do that, but we realized that with our limited budget we were only touching 150 or 200 people at each clinic. If we were to invest in research in mHealth that helps to answer some of the unanswered questions around mHealth, we could potentially affect millions of patients. We realized that there was a great opportunity for us to help build the evidence base for positive health outcomes. I think there is a lot of potential in mHealth to positively affect patients' lives, in particular low income patients' lives.
That, in a nutshell, is why we picked mHealth as an area of focus.
And the Mobilizing for Health initiative is not the Foundation's exclusive focus?
The Foundation also supports our employees’ community involvement efforts -- much like other corporate foundations -- through traditional matching gift programs and volunteer grants, etc. We are focused on chronic disease management over the next 12 years and that does take various forms including our grants to community health clinics, walks and other fundraisers... The Mobilizing for Health initiative though is our largest grant-making program. We are investing $1.5 million in that program annually.
Will the Mobilizing for Health grant initiative continue on once the three-year focus on diabetes ends in two years and the foundation moves onto heart disease?
The potential to use mobile phones in healthcare can translate over many disease states. We are not concerned that once we change our focus and move over to heart disease, that we will have to stop the Mobilizing for Health initiative. That won't happen. As you know there are so many co-morbidities. Right now, researchers will be looking at blood glucose, but they are also going to be looking at weight, blood pressure, etc. They will probably track very similar biometrics once we focus on heart disease. We don't see that shift as being a great bit of change necessarily.
Any reason to start with diabetes?
This is the first condition for the rotation. When we were focused [more broadly] on chronic disease management, truth be told it was very difficult to get employees motivated about "chronic disease management." It's not easy to get 32,000 employees to "Walk for Chronic Disease Management," for example. The minute we personalized it with a specific condition, everyone got involved. Diabetes certainly touches a very large number of people and unfortunately its [prevalence] is going nowhere but up. There is no reason really for why we started with diabetes first before heart disease, but we do have a number of employees personally affected by diabetes.
One of the goals of the initiative is to fund mHealth devices and services that could find widespread adoption and also improve access. Which or what mHealth technologies do you believe have the potential for widespread adoption? Would that list be limited to text messaging, for example?
Text messaging is certainly something that needs further investigation. We are interested in research proposals that involve text messaging because it is so ubiquitous and inexpensive, but I am not a clinician nor am I an mHealth expert. The foundation is looking for innovative proposals from researchers and there might be something out there that I certainly haven't thought of yet. We are open to that. We do believe text messaging holds great promise, but still have a number of questions about whether it can deliver positive health outcomes. If prices dropped on some of the remote monitoring devices then they could be adopted on a wide scale. It's just a matter of the price point being inaccessible right now.
So, the Foundation is also potentially interested in dedicated, wireless-enabled personal health devices, too?
Yes, we are open to that. I highly doubt we will get a lot of proposals from researchers that use wireless remote monitoring devices because we are looking for low-cost and wide scale adoption. I don't think those devices are there yet from a price perspective.
The first round for Mobilizing for Health grants in 2010 is now closed. That means the foundation is currently evaluating proposals? Can you tell us a little bit about the proposals so far?
Yes, we have received proposals focused on text messaging from some of the top tier research institutions. We have a very strong group of letters of intent to review.
Another requirement was that the proposal expressed an intent or strategy for integrating the service into the HIS infrastructure?
We think that it's really important if you are collecting data or sending data via the cell phone that it needs to be easily integrated into an electronic health record, if one exists. These clinicians and clinics do have EHRs in some cases and there needs to be some information if we are going to be using mobile phones back to the provider via the health record. Now, I don't know if that's always possible, but we want researchers to discuss how that would be managed or if it could be something that happened in the future.
The next round starts again in April 2011?
Yes. The call for letters of intent is wide open to everyone. We just pull it down to a group of finalists to submit a full RFP. In the world of philanthropy some funders requires some grantees to fill in a 50 page RFP and we didn't want to put our applicants through that if they didn't have a chance of being funded.
Thanks for your time today, Carrie. Any closing thoughts on mobile health?
Well, there are so many unanswered questions. That's really the intent of the Mobilizing for Health grant initiative: Let's start answering some of these questions about what works and doesn't work. Let's share real evidence and results to back those claims up. I think we will learn just as much from case studies about what doesn't work as those that discuss what does work, but presenters at mHealth industry events need to be more open about sharing the failures.