5 reasons why physicians will love mobile health

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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  • Anonymous

    I agree that this will make coordiated care much easier and more transparent.  So, who offers the technology?  What are the top 5 proven companies that can stand behind their product?

    • David Lee Scher

      There are hundreds of companies offering technology in this area,  However, few are either unique or deliver a true quality value proposition.  The sector is young.  The problems lie in obtaining development funds.  You will begin to see movement in this area by large companies like Verizon, Qualcomm, AT&T and others.  Insurers are getting into the mix as well. For more information, I would recommend joining the Wireless Health group of Linkedin.  Few companies can back up claims with clinical studies, which are what traditional stakeholders like payers, physicians, and hospitals will ask for (not to mention VCs). Even the ones that have done studies have only included less than 100 patients as a rule (some have included up to 180), and this is not good enough to make general efficacy or cost efficiency studies. Welldoc, GlucoMon, and DuetHealth are companies that have done trials. 

  • Anonymous

    “Most patients do not take the responsibility they should for their own health.”

    Agreed.  Nearly everyone I’ve talked to says they don’t have a clue how to participate in their healthcare except to do what they are told.  They withhold information because they either don’t think it is important or don’t know how the doctor will react to their disclosure.  They are often afraid to ask questions, forget to ask them, or don’t know which questions to ask.  By the time they get home, many patients don’t remember what their doctor said.  If the doctor gives them written instructions, one in five will not be literate enough to read them (believe me, they have good skills in hiding that fact, and you can’t tell whether or not they can read just by looking at them).  

    These barriers to patients taking responsibility have to be dealt with before much will change on the part of patients.  Doctors have training programs to learn their role in healthcare.  

    Who teaches patients how to optimally participate?

    • David Lee Scher

      This is the golden grail, Nancy.  All of society needs to be educated about why patient-centric healthcare is the best and that they have the responsibility and ability, with proper tools and support from the provider community to accomplish this.  There needs to be a type of Manhatten Project by the government to do this.  Once this is accomplished, the McDonald’s Empire will begin to fall because of lack of demand. Groups like the Society for PArticipatory Medicine are leading the way in this regard as well. 

      • Anonymous

        We don’t really need another government project.  What we need is to teach patients that we need their help to kill paternal medicine so they can become partners, not children in the doctor-patient relationship.  Then teach them HOW to be partners.  This can be done in the exam rooms, waiting rooms, community settings, schools…  It can be done by a variety of people, not just physicians.  We need to take advantage of every teaching opportunity to make the whys and hows of patient participation common knowledge.

    • Anonymous

      Ultimately patients make their own decisions about health and treatment. You can have the best physician in the world, but if the patient doesn’t follow the treatment or follow up with a physician then it is worthless. With the use of mobile phones, there is a new opportunity to interact with patients. Mobiles apps can breakdown communication barriers. I believe this is a major opportunity to reduce cost and improve patient care.

      • Anonymous


        I think perhaps you have missed my point.  Patients do not know HOW to effectively participate.  All the mobile technology in the world won’t fix that.  They need to be taught–deliberately, systematically, clearly to gain the essential skills required to become engaged. I am sure that someday there will be an app for that.  But it won’t be enough to make a difference.  Why?  Poverty.  Illiteracy.  Access.  Just to name a few.  With growing unemployment (watch the rates jump as troops come home), fewer can afford the smart phones and are downgrading to dumb phones.  Additionally, many patients who would benefit the most–the chronically ill–often have limited incomes with no hope of increasing them enough to gain access to the technology.  Some with dumb phones are giving them up in favor of buying food or medicine.  I know several folks who have given up mobile phones and home Internet service so they can afford to keep the heat on.   Mobile technology is no help to them.Even if patients have full access to mobile technology, it will do them no good if they don’t understand their role and know HOW to fully participate in their healthcare.  It requires far more than just following doctor’s orders.Unless we can first fix the problem of patients not know how to be engaged, spreading the problem across technological platforms will only make things worse.Let’s start with teaching patients how to be engaged before we get distracted by gadgets.

        • Anonymous

          Certainly no one solution solves the problem for all patient demographic segments.  Medical education is probably low on the list of priorities for illiterate and under educated patients or even patient’s that don’t have the money to feed themselves. With the growing usage of mobile devices and the Internet, it can serve to help reduce medical cost for patients in several demographic segments. In the end patient’s have to want to improve their health and become more educated on medical care for any solution to be successful. Technology is only a tool.

          • Anonymous

            “patient’s (sic) have to want to improve their health and become more educated on medical care for any solution to be successful”

            Agreed.  But I can’t agree that “medical education is probably low on the list of priorities for illiterate and under educated patients or even patient’s (sic) that don’t have the money to feed themselves.”  People in these demographics want excellent healthcare just as much as any other demographic.  But they are the least likely to get even adequate care because they are the least likely to self-advocate.  In my experience, they can easily learn self-advocacy once someone takes the time to teach them.

            It isn’t all about how educated a person is, either.  I know several people with advanced degrees who had no clue how to engage in their healthcare until they were forced to learn because of a medical catastrophe.

            Have you seen how many books, blogs, websites, etc. are written about patient participation?  Have you seen any written by patients who didn’t have to learn the content piece meal because of some personal medical crisis?

            Patient engagement is not common knowledge.  Even doctors can have trouble engaging healthcare as patients and revert to the “child” position–establishing paternal doctor/patient relationship instead of a participatory partnership.  They have admitted as much in books, interviews, blogs, and more.

            If doctors struggle with this, how can we expect patients to do it on their own?

            Regardless of any other influences on healthcare, it can never be participatory until patients are routinely taught participatory skills.  

            There are many solutions to teaching patients to become partners.  Most are inexpensive and low tech.   Patients of all educational and income levels will benefit.  

            If you teach them, they will participate.

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