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Issues in Mobile Health (Barbara Mittleman)


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Issues in Mobile Health (Barbara Mittleman)

  1. 1. mHealth- new opportunities, new questions<br />Medicine 2.0<br />Stanford University<br />September 2011<br />Barbara B. Mittleman, M.D.<br />Director, Public-Private Partnership Program<br />National Institutes of Health<br /><br /><br />
  2. 2. Mobile technology<br />New connections:<br />People to people<br />e.g., case management<br />People to information <br />e.g., reference material, health education<br />Information to people <br />e.g., remote monitoring<br />Social Media make new connections, mobile technologies make new connections.<br />New connections means new relationships and new challenges….<br />
  3. 3. But… issues and questions<br />? Reliability<br />Device- QA/QC<br />Communication- voice, text, image<br />Coverage- cost, availability<br />? Security<br />Confidentiality- HIPAA<br />Hacking/unauthorized access- cybersecurity<br />? Privacy<br />Personal- right to privacy and/or desire for privacy<br />System- data use for proprietary purposes<br />
  4. 4. Relationships<br />New ways of interacting<br />Person to person via the device<br />Person to device<br />Automation <br />New amount of information<br />More information<br />? Different information<br />New flow of information<br />More often, more continuous<br />Do we know what to do with this?<br />
  5. 5. Standards<br />Device function- analytical and performance standards<br />Information transfer- speed, timing, auditing<br />Security-device security, information security, transmission<br />Privacy-societal and/or personal standards, legal rights<br />Use- when, how, in what conditions and/or circumstances, data analysis and transformation, algorithms, coordination with other data sources, automated responses and interactions<br />Payment- public, private; ?dependent on geography and/or SES<br />Regulation-FDA, FCC, CMS, other?<br />Evaluation-what outcomes and what parameters?<br />
  6. 6. Standards (2)<br />Who is responsible for setting and enforcing standards?<br />How should these be assessed and refined?<br />What outcomes are we seeking? <br />
  7. 7. Roles<br />Who does what?<br />Who is responsible for what?<br />Who is supposed to keep tabs on the information? On the patient? On the outcome? On the cost?<br />What if the patient is responsible and cannot undertake that responsibility?<br />What if the systems can’t talk to one another?<br />How to customize?<br />
  8. 8. Recap: the challenges<br />New relationships<br />New data flows <br />Coordination of people, information, and responses<br />Outcome assessment<br />Cost assessment<br />
  9. 9. NIH’s view: PPPs forSynergyand the Public Health<br />Enhance regulatory decision making; <br />Improve public health<br />Improve Public Health; Opportunities presented by science<br />FDA<br />NIH<br />PARTNERING<br />FOR THE <br />PUBLIC HEALTH<br />Improve patient care; Improve public health; reduce cost<br />Expedite delivery of devices and services<br />PUBLIC<br />INDUSTRY<br />Alignment of business practices and overlap of mission are necessary for the parties to engage successfully.<br />More petals on the diagram can represent more interests…<br />