1. Mobile health technology will increase patient engagement. Most patients do not take the responsibility they should for their own health. They are likely preoccupied with all the stresses of everyday life and might therefore take the ‘I feel good, so I must be’ approach. They possibly mutter these words after wiping their faces, hurriedly walking out of McDonald’s for lunch. Or is it because of mistrust of their physician who they get to see for a big 15 minutes that the electronic record time slot permits? Or that they are caregivers to others and sacrifice their own well-being for that higher purpose?
Providers get frustrated over patients’ non-adherence, or lack of follow-through on basic advice (lose weight, quit smoking, exercise). However, given time restraints and possible lack of specific instructional tools to provide, physicians themselves may be partially responsible. Wireless health technologies can address all the obstacles mentioned above. They can provide caregivers with tools to better monitor and care for their loved ones. They can help with making physician appointments, increase adherence of lifestyle change instructions, vital sign and other types of monitoring (heart rhythm, blood glucose, cholesterol and other parameters), and connect to ancillary services such as rehabilitation, medical equipment companies, home nursing, insurance company case manager, and the patient’s electronic health record portal. All of these conveniences and tools that require patient and/or caregiver input will result in patients’ realization that their outcome is a direct result of the extent of their own participation.
2. Mobile health technology provides more than snapshot data. Physicians seeing patients every 3, 6, or 12 months have only the answer to “So, Mr. Smith, have there been any changes in your health status since we last me?” Wireless health can provide the clinician with data points of much shorter intervals than those of office appointments. Trending of data becomes more meaningful. One may increase surveillance of such things like shortness of breath (related to congestive heart failure), blood glucose levels, heart rates, with titration of medications or changes in lifestyle (vacation, exercise, dietary adjustments, etc).
3. Mobile health technology is mobile. There’s nothing more attractive about mHealth to a provider than the fact that its results are accessible anywhere. Data can be obtained in the operating room, on a tablet while talking to a colleague or walking in the hospital on rounds, or on a cell phone in the car (pulled over to the side of the road, of course) or in the bathroom (old school ultra compulsive docs).
4. Mobile health will make office encounters more meaningful. Because there will actually be more patient-provider interaction via mHealth, with the transmission of messages and data on frequent intervals, populating theelectronic health record (EHR) seamlessly with information, the visit to the office will take on a new meaning. It will become a review of the data, and focus on the humanistic side of medicine, that of actually discussing with the patient how he or she actually feels. It will be a time of dialogue, and not data entry or point and click with the occasional upward glance from the computer. The data and messages may be reviewed prior to the visit and discussions may be prompted by observations made of the mhealth-derived information. The absence of a caregiver at the visit may not be as detrimental if the caregiver also received mHealth messages and data. A summary of the visit may be transmitted to the caregiver via wireless technology.
5. Mobile health technology will improve the doctor-patient relationship. The deterioration of the doctor patient relationship over the past ten years may be attributed to many factors. The Internet is a source of medical information for patients. Most people have at one time performed health-related searches on the Internet. Some physicians react negatively to this. Some state that they do not want patients receiving misinformation, as Internet information is not policed. Physicians are under time constraints and some feel they do not have time to discuss a patient’s Internet-search determined differential diagnosis. Patients are mistrustful of physicians new to them. Only 60% of prescriptions furnished by a new physician will be filled because of mistrust. Physicians may present themselves with negative body language because of stress. Points 1-4 made above will help in improving the doctor-patient relationship by increasing patient participation, improving communication, and providing more accurate data to providers.
An estimated 75% of physicians have either an iPhone or iPad. They are adopting EHR technology and are busier than ever. Mobile health promotes patients as partners in healthcare and a coordinated care effort involving the patient, caregiver, and provider. As a practicing physician, I recognized the utility of EHRs and remote monitoring (of cardiac rhythm devices). I look forward to the many possibilities of mHealth improving the quality of practice for physicians.
David Lee Scher is a former cardiologist and a consultant at DLS Healthcare Consulting, LLC. He blogs at his self-titled site, David Lee Scher, MD.
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