The plethora of mobile devices now used in the U.S. healthcare system has the potential to transform the industry. But so far they've had a much bigger effect on the work habits of physicians than on the care they provide to patients.
That could change as new reimbursement models emerge. "If you can imagine a world in which physicians and hospitals are paid based on the outcomes of patients, some of these technologies may be very integral to them getting paid and enabling them to do the right thing for the patient," says Dr. Mohit Kaushal, chief strategy officer and executive VP of business development for the West Wireless Health Institute, a nonprofit medical research organization.
John Moore, founder and CEO of Chilmark Research, agrees. "A lot of healthcare institutions are starting to look at these applications and how they might be deployed within the context of getting patients to better self-manage their care," he says. "As providers take on more of the risk in these new reimbursement models, they're going to give these tools to their patients and say, 'We want you to use this to help you take better care of yourself and track your care over time.'"
Many consumers, of course, already are using standalone mobile health applications to stay well, and those with chronic conditions such as diabetes and hypertension are using specialized apps to manage their care. But the potential for the latter group of apps will be limited until providers are ready to receive, process, and act on the data generated in them.
While definitions of mobile healthcare usually focus on smartphones, tablets, and other mobile devices, home monitoring of patients is part of the same trend. Then there are provider-specific apps, including physician reference and rounding apps such as UpToDate and PatientKeeper, mobile electronic health records, wireless medical devices in hospitals, and mobile administrative apps that replicate the billing and appointment-making functions of a hospital's patient portal. The heightened ability for physicians to do clinical work on their mobile devices, and communicate directly with patients' smartphones, is laying the groundwork for much bigger changes.
Between 20,000 and 30,000 mobile health apps are available to consumers today. The vast majority of them are aimed at people who want to track their fitness or diet or look up healthcare information. For example, there are apps that record how far you walk or run, how many calories you burn, and how many hours you sleep. You can use other apps to weigh yourself or check your blood pressure. A whole new category of social gaming apps lets users compete with family and friends to lose weight or increase exercise. Users can also share health information with one another and create online communities.
Among the best known examples of mobile health apps for people with chronic diseases is WellDoc's DiabetesManager, which lets users enter blood glucose readings and other data into their smartphones.
They receive feedback, either on their mobile phones or on a website, from a "virtual" expert who coaches them on managing their condition and provides tips on diet, exercise, and other lifestyle factors. A trial of DiabetesManager showed a decline in HbA1c readings--a measure of long-term blood glucose control--of 1.9% among the WellDoc users, compared with 0.7% in the usual care group.
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