Issues in Mobile Health (Robyn Whittaker)

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  • 1. ISSUES IN mHEALTH
    Panel:
    Robyn Whittaker, MD PhD, mHealth researcher, Public Health Physician, Commonwealth Fund Harkness fellow 2010/11
    Barbara Mittleman, MD, internal medicine/rheumatologist, Director NIH Public-Private Partnership Program, co-chair of the first mHealth Summit
    Wendy Nilsen, PhD, Health Scientist Administrator Office of Behavioral and Social Sciences Research NIH
  • 2. mHealth research project
    To identify the key issues facingthe implementation of mHealth in the U.S.
    via
    Environmental scan
    text4baby case study
    Key informant interviews
  • 3. Panel Session
    Overview of research & key issues in mHealth (RW)
    ‘Big picture’ issues (BM)
    Research issues (WN)
    Opportunities to address mHealth issues
  • 4. mHealth
    the delivery of health-related services via mobile communications devices
    Portable
    Personal
    Connected
  • 5. Prelim findings: interviews
  • 6. Transformative?
    “a great equaliser”
    No:
    an extension of current health communication or current models of care
    Yes:
    • from provider & location centric system to patient-centered anywhere care
    • 7. from provider control to individual locus of control
    • 8. change the way we search
    for and use information
  • 9. Issues in mHealth: categories
    Policy & regulatory
    Wireless environment
    Health system
    mHealth in practice
    mHealth research
  • 10. Policy & regulatory issues
    Privacy +/- data security
    FDA regulation
    Bandwidth spectrum availability
    Medical practice regulations e.g. practice across states/countries, regulated roles
  • 11. Wireless environment issues
    Large number of wireless networks
    Working across platforms & other proprietary complexities
    Potential costs to users
  • 12. Health system issues
    Who pays/reimbursement
    Competing priorities & opportunity cost
    Integration into existing systems, practice & EHRs
    Clinical roles & accountability
    Lack of demonstrably sustainable business models
  • 13. mHealth in practice issues
    Immature understanding of how to do it well (what, for whom, and why)
    Lack of demonstrated added value of existing initiatives & focus on where it can add value
    Lack of theory & evidence base
    Technology focus/legacy systems
  • 14. mHealth in research issues
    Need for more high quality research demonstrating effectiveness & cost-effectiveness
    Mismatch in pace & flexibility of research with tech developments
    Measuring reach & access into under-served populations
  • 15. Opportunities in mHealth U.S.
    Optimising opportunities provided by health reform environment
    CMMI, Beacon demo projects, EHRs
    Some degree of federal level guidance
    Strategic collaborative (open) approach
    Improving mHealth practice & research
    Iterate, integrate, improve
  • 16. Acknowledgements
    Dr Kyu Rhee
    Health Resources & Services Administration, U.S. Dept of Health & Human Services
    The Commonwealth Fund
    All interviewees