[Ed Note: Originally posted 9 Feb. Updates in brackets]. Over 17 hours of program time were devoted to 25+ speakers and maybe a hundred participants discussing the mHealth Revolution at the TEPR+ conference sponsored by the Medical Records Institute last week. Though I missed the first day of sessions with my social marketing class at GWU, I left a micro-blizzard in Maryland early Wednesday AM to get to Palm Springs in time to present on The Cell Phone Culture and Healthcare that afternoon.
Among the highlights for me was a chance to catch up over lunch with Peter Boland at BeWell Mobile who I first met at the Mobile Persuasion conference two years ago where he presented their diabetes and asthma management apps. Arlene Harris of Jitterbug previewed some of the health apps they will be releasing along with their new phones for the over-50 crowd later this Spring. Paul Adkison from IQ Max talked about their apps to enhance delivery of services by mobile health providers – home health care providers also receive particular attention from HeathWyse. IQ Max was one of several vendors who presented there that are using web browser-based solutions to eliminate the need to tailor apps to each mobile device and carrier.
Barry Green of Med Practice Informatics made the case with a hypothetical example that using free text messaging portals for such things as patient visit reminders, notification on lab results and 48 hour follow-up inquiries could cut costs of a small office practice by $39K over 5 years and increase revenues perhaps by $25K. Real world data would help the argument – though it has some appealing face validity to it. Three themes during the discussion that caught my interest were (1) the changing patient-provider relationship that new technologies encourage (demand?) where 2-way conversations are needed, (2) the privacy concerns raised by SMS as it relates to HIPAA (and most people in the room seemed to think that with consent, such communications were more secure in many ways than voice or email), and (3) providers believe that SMS provides a method to document phone consults in states that reimburse for those services (rather than “he said, she said”).
The issue of the security of mobile data transmission came up in many different ways, particularly in the context of Personal Health Records. Jay Couse described Diversinet’s AllOne Mobile wireless encryption software to support the next generation of consumer health services such as PHRs and medical billing. Their system uses a two-factor authentication system that seems to be state-of-the art (if it’s good enough for the Defense Department …). What was important to me is that they were using a consumer-oriented approach towards applying this technology on mobile devices rather than cramming every feature into an interface that most people could never use (pass the DVR programmer please).
The liveliest session was with Don Witters of the FDA Center for Devices and Radiological Health. He spoke about their concerns with how electromagnetic compatibility (EMC) among wireless devices (especially in health care settings, but also think cardiac pacemakers and other implantable devices), the quality of wireless services (dead zones), coexistence of devices (what other wireless devices are going to be used), data integrity (garbled or lost in transmission) and security are vital to safe, secure and reliable use of wireless technologies in health care. He noted, and raised concerns in the audience, that FDA covers any device that diagnoses, treats or prevents a disease. When asked specifically – Does this cover an MRI app for an iPhone? A patient reporting their blood glucose level via SMS to their physician who then adjusts their insulin dosage with a return SMS? The answer was a clear “We don’t know.” And to his credit, Don was not being cagey – merely pointing out that the mHealth Revolution is happening without any group of people from the regulators, industry and academia considering a basic question (among many others): when does a mobile phone become a health device? He encouraged mobile device and software application developers to talk with the FDA about their work before going to market. His take home message for me was that the new administration will be putting on a big push for mobility in healthcare over the next few years. We are all stakeholders in how this process unfolds, and should start talking now with each other about setting standards and processes for the field to ensure safe, secure and reliable deployment of mobile devices and software. When do they become ‘medical grade’ and not just ‘cool?’
[Ed Note: Read more on Witters' presentation at mobihealthnews.]
Peter Waegemann from the Center for Cell Phone Applications in Healthcare announced the formation of the mHealth Initiative Inc that will serve as a convener and networking platform for companies and individuals exploring and advancing mobile applications in healthcare. This organization will be the successor to C-PAHC. Hopefully it may also be a place from which to get these conversations started and sustained.
[Ed Note: More about TEPR+ also at mobihealthnews. Pdfs of the presentation slides from the conference are now available at the TEPR+ site. Click on the Category drop down box for Main Conference Sessions and then mHealth under Track to view and download them.]