The Future of Health Care Is in the Palm of Your Hand

by JHI Staff on April 12, 2013

Many of us have become so dependent on our mobile phones for keeping up with the world that it’s easy to forget that it’s only been five or so years since the smartphone really caught on. The technology has advanced so quickly that it’s hardly even used as a traditional phone anymore. You have to wonder what we’ll be doing with these devices five years from now.

One real possibility is that we’ll be getting a chunk of our health care through our phones. We can already consult various medical-advice websites with our PCs—according to one study, 70 percent of Americans with Internet access have gone online through their PC to get health information. It’s not that big a leap to imagine we’ll start doing it with our phones.

The bigger leap would be using our PCs (“iHealth”) and inevitably our phones (“mHealth”) to access interactive, personalized health care services and information. Among the mHealth services that are already under development are those that provide access to test results and other personal health records; schedule appointments and tests; facilitate self-reporting of health data such as weight, diet, or medication side effects to the doctor’s office to help with patient monitoring; and consult clinicians via text message, chat or videoconference. There are even apps that show some promise in providing automated screening of symptoms. (Though not surprisingly, there are for now serious limitations to how much we can count on such apps.)

Much of the world seems amenable to jumping to these sorts of services, according to the results of a just-released survey. A brief excerpt of the findings:

Most consumers are comfortable with having all of their health records securely available on the cloud except for those in Germany and Japan. Nearly half of the consumers surveyed and two-thirds of the HCDMs surveyed would be comfortable sharing and receiving health information through social media channels. Most North American consumers – nearly eighty percent – are comfortable submitting a complete medical history and diagnostic information to help ensure they have all the information available to treat them and offer the most personal diagnosis possible. Ninety percent of Russian consumers expressed comfort, while fifty percent of Japanese customers expressed discomfort with the idea of submitting DNA....

Three quarters of consumers indicate they are comfortable with the idea of communicating with doctors using technology instead of seeing them in person. In China, Russia and Mexico, nearly three-quarters of consumers would be comfortable communicating with a specialist using virtual technology (e.g. video chatting, text messaging) for a health condition.

More than 60 percent of consumers from Germany, Japan and the U.S. indicate being comfortable with the idea of being treated by a specialist using virtual technology.

Note the survey results differed from country to country, which means we have to be careful about assuming that, for example, we can take an approach that might work well in the U.S. and simply implement it somewhere else in the world. Different mixes of services will win acceptance in different countries, and some countries will be ready for a given type of mobile service sooner than others.

In theory, at least, the opportunities to improve health care while simultaneously lowering costs are enormous. In some countries with large numbers of rural poor, such as India and many African nations, mobile phone-based health care services may be the only form of  health care accessible and affordable to those segments of the population.

Meanwhile, in the U.S. and other industrialized nations, the opportunity to provide some types of health care to people in their homes or workplaces—rather than forcing them to come to hospitals and clinics—may not only add convenience, it could also improve patient monitoring and lower the costs of some types of care.

That last point is critical, because the biggest challenge to health care around the world is now the management of heart disease, cancer, diabetes, Alzheimer’s, and other complex, chronic diseases. If mHealth helps make possible the sort of more-frequent monitoring of patients that clinicians need to catch and treat brewing problems and complications before they become acute and require hospitalization, the benefits to our health and to our health care systems’ efficiency could be large.

While mHealth may bring some real improvements, it isn’t likely to be a panacea. The quality of our health care will still be driven by access to highly trained, dedicated clinicians, in whatever form that access takes. It’s interesting to note that the survey I mentioned earlier also came up with this finding:

Patients and citizens will give up anything, including cost, convenience and travel, to be treated at a perceived leading health care provider to gain access to trusted care and expertise.

Patients aren’t going to be happy if mHealth brings them convenient access to second-rate care. That’s why it’s important we stay focused on the fundamentals as we work with our collaborators to build and improve health care systems. But mHealth will gradually become part of the mix, too, both here in Baltimore and at our affiliates' systems around the world.

(By the way, among the many efforts currently under way to build the mHealth platforms we’ll need to make these services fly, one is an ambitious start-up formed last year by a group of Johns Hopkins medical and graduate students. Check out this interview with on-leave Johns Hopkins medical student Ralph Massarella.)

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