What's Holding Back The Mobile Health Revolution?

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Revolution is such an overused term in healthcare -- almost as abused as "innovative." Nonetheless, the emergence of mobile health apps, devices and services really does have the makings of a genuine revolt. And like most revolts, it challenges the powers that be and threatens a redistribution of wealth.

A PWC report from June 2012 sums up the situation, explaining that mobile health offers patients greater control over their medical care, and that doctors are "likely to resist the loss of power implicit in greater patient control." That resistance is likely to slow adoption of these services and tools.

A closer look at some of the PWC report's survey results is revealing. About half of the patients surveyed believe mobile health initiatives will improve the convenience, cost and quality of their healthcare. On the other hand, only 27% of physicians encourage patients to use mobile health apps to become more active in managing their health; 13% actively discourage it. "42% ... worry that mHealth will make patients too independent."

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What's behind the profession's resistance? One possibility: "mHealth is about fundamentally changing the social contract between patients and doctors," said Eric Dishman, Intel's director of health innovation at the time of the 2012 PWC report. And that social contract has traditionally put clinicians in the driver's seat, always making the decisions and charging what the market can bear for their services. It's natural for any profession to feel threatened if that equilibrium is upset.

But while there's some validity to the views of Dishman and the PWC analysts, they do overgeneralize. I've spoken with countless physicians who welcome the advent of the "activated patient" and see value in mobile health. A growing number of doctors also welcome a shared decision-making process with their patients and see the doctor/patient relationship as a partnership.

Many have made a concerted effort to engage patients in digital healthcare by encouraging them to examine patient data in their electronic health record (EHR), for instance. Granted, many patients complain that EHRs put a wedge between them and their doctors because the doctors spend too much time looking at a computer screen instead of maintaining eye contact. But socially skilled physicians are quickly learning how to solve that problem.

The PWC report also offers a somewhat oversimplified explanation as to why many physicians don't encourage patients to get too attached to the mobile revolution. It's not just about losing control of the doctor/patient relationship. It also stems from the belief that without a solid background in physiology and biochemistry, many laypersons are easily duped by false claims. The unfortunate truth is many don't know how to tell the difference between the sites sponsored by the Mayo Clinic and "Marty's Medical Miracles."

But the real solution to that last problem is not for physicians to discourage the use of mobile apps, it's better patient education. That means developing a trusting relationship with patients so that they believe you have their best interests at heart when you try to steer them away from untrustworthy mobile apps and websites. That kind of patient education is the responsibility of all health professionals. The right mobile health tools can only speed up that educational process.