This week’s mHealth Summit in Washington, DC, features scores of presentations, posters, and corporate announcements demonstrating the typical chaos of emerging technology markets: the Big Question at this stage on S-curves for new tech is always, “what’s the timing of the pace of change,” or for you mathematically-inclined readers, “what’s the slope of the mHealth adoption curve?”
Before we address that question, let’s be transparent about the fact that there are several definitions of just what ‘mHealth’ is: purists may conceive it as covering only those health tools and applications that ‘go’ mobile–that is, that are deployed via mobile phones and devices like tablet computers. Then there’s the other end of the spectrum (pardon the tech-pun) embodied by the West Wireless Health Institute‘s concept of infrastructure-independent health care. My friend and long-time colleague Matthew Holt, co-founder of the Health 2.0 Conference, addresses this idea with his paradigm of “un-platforms.”
Wherever your own idea about “mhealth” sits on this continuum, it’s crucial to recognize that mHealth does not equal only mobile phone apps. There is a lot of hype around health apps for smartphones, but the traction is already with text messaging on simple phones in developing countries, doctors accessing prescription drug information on their beloved iPhones, and a growing number of people quantifying themselves through wearable devices that provide health-promoting nudges throughout the day.
What’s driving the adoption behind these programs? First, it’s about the value that the program offers the health system, health provider, and individual health consumer. Cash-strapped developing countries have leapfrogged over developed nations’ health systems– where health capital is sunk into hospital beds, legacy IT systems, and incentives that aren’t well-aligned with providers to deliver health care at the most appropriate, efficient site. In the developed world, providers deliver care based on how to maximize reimbursement — often in higher-cost-than-necessary settings — but paid-for by both public and private payers. In poorer countries, necessity is indeed the mother of invention — read “adoption” — of mobile health.
For doctors, mHealth adoption is rooted in being productive – another kind of profit maximization based on doing more in less time. For patients, growing co-pays and coinsurance sharing can motivate the patient-as-consumer to opt into self-care through tools like the FitBit and Withings scale that I personally use, or Fooducate for making healthy food buying decisions at the grocery store (which I also regularly use).
So, value becomes an underlying driver of mHealth adoption, where there is transparency of transaction costs in health care, and flexibility for stakeholders to make choices.
What of “values” driving the adoption of mHealth? That’s a softer issue, but no less potent than “value.” We’ve learned through the Great Recession of 2008 (ongoing in much of the U.S. and world economies) that individuals want to engage with organizations and institutions that embody their values. One of the big consumer shifts in the post-recession is DIY – the emergence of the creative economy, where people want to do more for themselves, from home improvement to self-improvement and cooking. People have lost more than a little faith in institutions – business and government – being hard-hit in the stock market seeing retirement funds fall, witnessing home values plummet, losing jobs, or losing faith in public institutions.
For health providers, autonomy and self-determination continue to be a value in practice. So adopting tools that bolster practice productivity and empowerment can delight the health practitioner. Those organizations who enable that garner trust, appreciation and brand loyalty. We’ve seen this, for example, with Epocrates, which continues to enjoy high take-up by physicians for its growing portfolio of mobile applications.
Whatever analyst forecast you read on the mHealth market — and you have your pick of many these days — remember that value + values will drive adoption.
Health Populi’s Hot Points: While there’s a go-go mood about mHealth adoption, a few significant barriers remain to be addressed: building out broadband to people who especially need it and don’t have it, aligning payment for health care so that providers will adopt the right tools for value-based and connected health; and patient engagement with their own health.
While a cadre of pioneering doctors, providers and patients have begun to engage with mobile health tools and apps, 2012 could be the year when we may begin to stop using the “m” and see mobile as just another infrastructure option for delivering health to engaged, activated patients.