Oakes Allen

Trends in Healthcare IT: Best Practices in Mobile Health

Healthcare reform is challenging the way healthcare companies provide patient care. Creating successful strategies around mobile health models and devices is an important part of the solution.

by Reid Oakes and Chequeta Allen, January 2013

In June 2012, the United States Supreme Court upheld the Patient Protection and Affordable Care Act, eliminating much of the debate and uncertainty around whether or not healthcare reform in the United States would progress. As a result, state governments, physicians, healthcare providers, and insurers must comply with the legislation. These organizations must also revisit their business models not only to meet the requirements of this sweeping legislation, but also to adopt new care delivery strategies that are sustainable, cost-effective, and patient-focused.

One of the most significant changes in the legislation gives state governments the right to choose whether to establish a state-run Health Insurance Exchange or participate in the Federal Health Insurance Exchange Initiative. The result will be a dramatic increase in the number of patients with health insurance coverage across the United States, significantly impacting the volume of care demanded.

For many of these hospitals, health systems, and payer organizations, simply having knowledge of the looming business transformation will not be enough to avert major disruption to areas throughout the organization, including front-end and back-end business operations, information systems, and clinical services.

Among the greatest challenges for provider and payer organizations will be the ability to keep the business transformation models moving forward while the wave of disruption reverberates across the enterprise. Organizational preparedness and knowledge of strengths and weaknesses may factor into the level of response to disruptions.

As numbers of highly skilled caregivers are quickly tapped out to meet the demand, hospitals and healthcare systems already facing bed ratio and staffing challenges may feel further distress that could require them to accept practitioners with lower skill levels. According to McKinsey, the requirements for addressing care delivery in the sickest populations with chronic diseases will become an even greater concern for organizations hardest hit with practitioner skill-level deficiencies, and could place these organizations at high risk for mismanaging certain chronic disease populations.

Characteristics of successful mobile health devices

To prepare for these business transformation challenges, hospitals, health systems, and payers will need to rely heavily on mobile health (or mHealth) capabilities. Healthcare organizations that began this journey earlier started by deploying patient-operated meters, many of which are now in place. For example glucometers—which measure the concentration of glucose in the blood—have been shipping en masse since the 1990s. Providers have found that many of the devices in this category have not been completely effective at delivering reliable information when and where needed at the point of care. They often lose critical data, enable false patient submissions, and even allow non-prescribed episodic use.

Provider and payer organizations will find the best technology support to their business transformation from devices emerging as a part of the mHealth (Connected Health) evolution. These devices ideally have the following characteristics:

  • They support health information exchange across the care continuum and care delivery enterprise, robustly supporting organization-to-organization patient information exchange.
  • They are patient-centric, with active patient engagement during care design and implementation.
  • They meet and can easily adapt to established mHealth standards.
  • They enable broad connectivity and interchange of data.
Since most existing technologies with these characteristics cannot achieve these goals unless they are mobile, the call is much higher for healthcare organizations to adopt mobile device standards in order to best prepare for the wave of innovation ahead in care delivery.


Creating effective mHealth service models

When we think of current wireless, Institute of Electrical and Electronics Engineers (IEEE)-regulated standards deployed in healthcare, we know that we are only seeing the beginning of what is possible in the form of radio wave technologies such as Bluetooth, Wi-Fi, Zigbee, and cellular capabilities based on mobile device standards. In the coming months and years, many new technologies will become available. There is also room for significant growth in the related areas around data model formats and defining end-to-end solutions that move health information promptly and securely from patient to device, device to cloud, cloud to electronic medical record (EMR), and EMR to data center.

Technologies with end-to-end capability will experience the most rapid demand and growth, and will provide the greatest organizational business transformation leaps in care delivery. Once this technology becomes available, organizations that are not rapid adopters will find avoidance to be costly.

Information under these new wireless technologies will be securely shared and accessed from many different locations so that care is relocated from facilities directly to the patient. Patients will be engaged at their convenience and comfort through new service models that improve quality of care at a lower cost.

Patients will expect care delivery that is based on these new mHealth service models and will be aware that their personal data must be de-identified at the time of initial mHealth platform enrollment. Only identifiers for patient devices will be sent across networks and then re-linked at the provider’s system. Patient consent models will be modified to specifically determine who has the ability to access specific types of information and for what care management purpose.

There are a number of provider organizations currently with pilots under way of varying size, complexity, and scope, with somewhere around 1,000 user devices deployed. Historically, the Veterans Administration Medical Center has been the leader in this space with approximately 35,000 connected health devices deployed to date that are actively managing and improving patient care for veterans. Over the next several months and years, Oracle and other technology leaders will develop proof points for business case adoption and growth in this fast-emerging healthcare industry space.

The ultimate rewards of mHealth adoption will be highly beneficial for healthcare payer and provider organizations as well as for patients in all healthcare settings, and can be expected to favorably impact and advance care delivery in the areas of population health, disease management, long-term care, and personalized medicine.

Reid Oakes is executive principal of the Global Healthcare IBU at Oracle. Chequeta Allen is industry marketing director of the Global Healthcare IBU at Oracle.