Don’t forget, mobile is but a tool in the wider effort to improve healthcare

By: Neil Versel | Jul 31, 2012        

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Neil_Versel_LargeWhat follows are some controversial remarks from last week’s 4th annual World Congress Leadership Summit on mHealth in Boston, where I represented MobiHealthNews as a panel moderator.

In the final, sparsely attended session on Friday afternoon, after many registrants had headed to the airport, Paul Meyer, chairman and president of Voxiva, the company behind Text4Baby and other mobile health coaching programs, dropped this bombshell: “I honestly think there shouldn’t be a fifth annual conference,” he said. Mobile health is not a field. Mobile health is a tool.”

Meyer, a former speechwriter in the Clinton White House who started Voxiva to help monitor disease outbreaks in developing countries, further said he would rather have been in Louisiana that day at a conference on diabetes prevention. He then added, “I think we’re done talking about the widget. Mobile health is a widget.”

For me, this recalled a similar eye-opener at a larger, higher-profile event put on by the same company, Woburn, Mass.-based World Congress. Five years ago at the World Health Care Congress in Washington, D.C., then-Tennessee Gov. Phil Bredesen let out his frustration with the slow pace of progress in health IT. “Enough with the grants, enough with the conferences, enough with the pilot programs,” he said, while sharing conference stage with people who give out grants and sponsor pilot programs.

I mentioned this last year when the struggling Mobile Health Expo announced plans to start up a policy organization called the Mobile Health Association, which it did soon after. The association has touted a “tour” of 33 events with a total of more than 730,000 attendees this year, but it really only means that it has booth space and an educational program at massive conferences like the American College of Cardiology’s annual meeting and the huge Medica show in Germany.

Already we’ve seen the demise of the mHealth Initiative and the largest mobile health event, the mHealth Summit become a HIMSS property. The Wireless Health group on LinkedIn has morphed into the Digital Health group.

What this tells me is that mobile and wireless health do not exist in a vacuum. They are part of the wider fields of health IT, medical devices and health informatics.

While I think there definitely is room for a fifth annual Leadership Summit on mHealth and other small-scale meetings – just as there is plenty of reason for mobile health to be part of bigger events like HIMSS and Medica and there is huge demand for news in publications like this one – Meyer is spot on. Mobile health is not a field. It’s a tool, just like any other technology.

Sometimes we focus too much on labels when we should be concentrating on making healthcare safer, more efficient and more affordable. When I’m a patient, I don’t care how that happens. But it needs to happen.

  • http://www.wirelesslifesciences.org/ Rob McCray

    I did not hear Paul’s comments but certainly agree with the sentiment.  No matter what adjective is used (wireless, mobile, digital, connected, electronic, etc.) the only term that is important to the consumer or patient is that which follows these descriptors – “health.”  That is what the consumer wants.  Even focusing on “health care” places too much emphasis on the service rather than the product and in addition it continues the disengagement of consumers and their own health which has lead to much suffering from chronic disease and extraordinary demands on health care systems.  

  • http://twitter.com/danmunro Dan Munro

    Great observation – and I agree – but will mobihealthnews become digihealthnews? ;-) This is also a hot-button for Matthew Holt – who’s railed against the mHeath moniker since it’s inception. I’m finding more and more that it’s far less about technical innovation – and much more about business model innovation (and adoption) – at scale. Healthcare is also pretty unique in that “lower-cost” isn’t always a benefit. Sometimes (surprisingly often) – it’s a barrier (because it’s someone else’s revenue).

  • Jim Bloedau

    Nice reporting Neil.  Let’s
    be clear, the “xHealth” labels past, present and future are mostly  for conference organizers, marketers and
    developers, not so much  for the patient
    or provider and it will be a long time before they consolidate to where it will
    just be called “health.”  So what do we
    do during the interim to make healthcare “safer, more efficient and more
    affordable ?”  Anyone who has worked with
    patients clinically knows that the patient will be looking not just for an
    episode of care, but a sense of “caring” over the long term to keep them
    motivated to be responsible and make the best of the health they have.  They and their care givers aren’t concerned about
    the labels only the results and the sense that somebody cares. The early “hotspotting”
    that Atul Gawande and others have written about and PCMH models are proving
    this out.  This will happen long before
    you become a patient Neil, I hope.

  • Matthew Holt

    I shouldn’t say I told you so, but I told you so. However, the struggle to convince mainstream health care organizations to adopt consumer & user friendly technologies of all types is far from over.

  • DiogenesRedux

    It seems that technology is the only way to get the “art” of health care under (more) control.
    Technology can aid in well-care, walk-in heath care using advanced diagnositc technologies, and using trained and technically proficient nurses, certified and trained in implementing diagnositic technology to speed the process and lower costs substantially.

  • Christopher Wasden

    I completely agree.

    The final paragraph of my most recent report says “Ultimately, mHealth will probably become so commonplace as to fade from
    notice. According to Dr Benjamin, in several years “the bits of mHealth that
    work won’t be called ‘mHealth’: they will be called ‘health’, in the way that
    nobody talks about ‘electric health’ and no country has a ‘stethoscope society’.” mHealth will have reached its full potential when it becomes ordinary.

    I spend a lot of my time focused on what else needs to change to enable mHealth to make a difference. We have the technology but we have too many barriers to its adoption. We need to fix these parts of healthcare in order to use mHealth tools effectively.

  • Derek Newell

    Sorry to crash the party – I’ll be the lone dissenter here!

    Paul Meyer’s comments almost completely contradict each other. On the one hand he is calling mHealth a “widget,” you couldn’t hardly use a more degrading word, and on the other hand he is clearly annoyed at the slow adoption of mHealth as evidenced by his comments,“Enough with the grants, enough with the conferences, enough with the pilot programs.”Why would he be so annoyed? Because mHealth has the power to do so much good and he is in as good a position as anyone to know it. Mobile devices add a dimension to health that connected devices don’t. It’s not even close. Your smart phone is personally and situationally aware of who you are and what you do in a way that no other technology has ever been. Arguably, mobile health has the power to transform health and health care in ways no other technology has. I agree we should be focused on deploying it and solving the real world problems using this technology, but calling it a widget radically diminishes the power and potential of mobile health. It’s also likely to slow adoption even further, because who NEEDS to adopt a widget?In my view, giving it it’s own category illustrates that importance. Sure it is just an extension of the internet, but that is like saying the automobile was just an extension of the horse and buggy. Mobile devices are the way that most of the people in the world will take advantage of the internet for the foreseeable future.When a technology is truly transformative, we always give it it’s own category, even if it was an extension of an earlier technology. Web2.0 was just an extension of the internet, so why call it Web2.0? Because it represented a new way to use the internet, now it was interactive and could be more than just a publishing platform. Was it completely different and transformative? Yes. (Maybe Matthew can help us understand what Health2.0 is the extension of ;)). The same holds for “social media.” Why do we need a new category for an interactive media experience? Because it is so transformative!I would argue we always put transformative technologies, even when they are just extensions of an old technology, into a new category. We are early in the hype cycle of this technology for sure. Will mHealth fall by the wayside like some other technologies or will it stand on it’s own as a major IT pillar for healthcare?  I believe mHealth is transformative enough to stand the test of time and will prove to be a tool so powerful that we will need conferences around it indefinitely (there are some very, very large conferences centered around tools). It’s not the solution to every problem, but it enables things that were never possible before. 

    Calling it a widget, just degrades it’s importance in my mind. 

  • Paul Sonnier

    Great commentary, Neil! I appreciate the mention of the Digital Health group on LinkedIn, too. As a technologist, I have always been fascinated by the way technology impacts and transforms our lives for the better. This was why I first got excited about the impact wireless technology is having in terms of empowering consumers vis-a-vis their health (sports, fitness, wellness, etc.) and the way in which wireless is also improving the healthcare and medicine.When Dr. Eric Topol came out with his book, “The Creative Destruction of Medicine: How the Digital Revolution will Create Better Healthcare”, I was delighted, because he cogently captured the higher level digital technology in medicine. For me, Dr. Topol perfectly described the underlying, technological groundswell of disruptive change (overdue in many cases) that we’re seeing in the areas that all of the commentators below (and I) focus on.So, I didn’t change my group name/focus from wireless to digital because I thought wireless was not impactful, but because it’s part of the technology “stack” (as Rob McCray has described it) that includes the eight macro, digital technology trends converging with – and transforming – health and healthcare. These comprise the super-convergence Dr. Topol describes in his book:- Wireless Sensors and Devices - Genomics - Social Networking - Mobile Connectivity and Bandwidth - Imaging - Health Information Systems - The Internet - Computing Power and the Data Universe (Big Data)Thanks again for all that you’re doing, Neil. You were the first reporter to mention my group and, as I’ve seen, still willing to tell the unvarnished story about every topic you cover.Best regards, Paul Sonnier Founder, 12,000+ member Digital Health group on LinkedIn: http://linkd.in/DigitalHealthGroupHead of Digital Health Strategy, Popper and Company: http://popperandco.com/Mentor, Blueprint Health: http://www.blueprinthealth.org/   Recent Media: https://www.wirelesshealthstrategies.com/Recent_Media.htmlThe Digital Health Blog: http://wirelesshealth.wordpress.com Twitter: http://twitter.com/Paul_Sonnier

  • http://twitter.com/voxivapaul paul meyer

    Hi Derek,  I certainly wasn’t trying to say that mobile health tools aren’t critically important.  After all, I’ve spent 11+ years of my life building mobile health services and advocating for their adoption.  I think they can and will play a central role in helping us live healthier lives and helping the health care system deliver better care.  And I agree with your point that the personal nature of mobile phones make them particularly powerful in health.  Perhaps I am hoping we will soon get to the point when we can just take for granted that any effort to improve health will incorporate mobile tools and then we can stop having conferences about them.    
    BTW – regarding your comment about me contradicting myself, the quote on “Enough with the grants…” was Tennessee Gov. Phil Bredesen’s, not mine.

  • http://twitter.com/voxivapaul paul meyer

    Hi Derek,  I certainly wasn’t trying to say that mobile health tools aren’t critically important.  After all, I’ve spent 11+ years of my life building mobile health services and advocating for their adoption.  I think they can and will play a central role in helping us live healthier lives and helping the health care system deliver better care.  And I agree with your point that the personal nature of mobile phones make them particularly powerful in health.  Perhaps I am hoping we will soon get to the point when we can just take for granted that any effort to improve health will incorporate mobile tools and then we can stop having conferences about them.    
    BTW – regarding your comment about me contradicting myself, the quote on “Enough with the grants…” was Tennessee Gov. Phil Bredesen’s, not mine.

  • http://twitter.com/Paul_Sonnier Paul Sonnier

    Great commentary, Neil! I appreciate the mention of the Digital Health group on LinkedIn, too. As a technologist, I have always been fascinated by the way technology impacts and transforms our lives for the better. This was why I first got excited about the impact wireless technology is having in terms of empowering consumers vis-a-vis their health (sports, fitness, wellness, etc.) and the way in which wireless is also improving the delivery of healthcare and practice of medicine.

    When Dr. Eric Topol came out with his book, “The Creative Destruction of Medicine: How the Digital Revolution will Create Better Healthcare”, I was delighted, because he cogently described the higher level impact (beyond wireless) that digital technology is having on medicine. For me, Dr. Topol perfectly described the underlying, technological groundswell of disruptive change (overdue in many cases) that we’re seeing in the areas that all of the commentators below (and I) focus on.

    So, I didn’t change my group name/focus from wireless to digital because I thought wireless was not impactful, but because it’s part of the technology “stack” (as Rob McCray has described it) that includes the eight macro, digital technology trends converging with – and transforming – health and healthcare. These comprise the super-convergence Dr. Topol describes in his book:    
    - Wireless Sensors and Devices
    - Genomics
    - Social Networking
    - Mobile Connectivity and Bandwidth
    - Imaging
    - Health Information Systems
    - The Internet
    - Computing Power and the Data Universe (Big Data)      

    Thanks again for all that you’re doing, Neil. You were the first reporter to mention my group and, as I’ve seen, still willing to tell the unvarnished story about every topic you cover.

    Best regards,
    Paul Sonnier

    Founder, 12,000+ member Digital Health group on LinkedIn
    Head of Digital Health Strategy, Popper and Company
    Mentor, Blueprint Health

  • Jon Pearce

    An excellent observation and one that needs to be embraced
    by any mHealth/Health entrepreneur who really wants to achieve disruption.  Telemedicine as a technology started with
    NASA 50 years ago with “video” visits with astronauts. In 1973 a pilot an
    Arizona reservation linked up Native Americans with a hospital 200 miles away
    via a semi-trailer packed full of video equipment.  In 2009 UHG and Cisco launched another “state-of-the-art
    pilot with higher-def cameras and screens – and a bigger trailer.

     

    So, if the fundamental technology has been around for 50
    years, why don’t we all do video visits with our doctors?

     

    Because it’s not about the technology – it’s about how that
    technology enables the business and health needs of healthcare stakeholders.  It sounds painfully obvious, but it’s
    subtle.  And healthcare is a ruthless executioner
    for even multi-billion dollar companies that do not grasp that reality.     

     

    Neil/Matt – please continue preaching the Gospel.

     

    Cheers,

    Jon

    CEO/Founder, Zipnosis

  • Bill Prenovitz

    I completely agree that the “m” in mHealth is a distraction. It reminds me of when CD-ROM technology moved beyond the music industry and there were innumerable CD-ROM conferences as potential users (publishers) and enabling technology providers tried to understand how the new technology would evolve into a mainstream tool. For years, no one made money in the CD-ROM except the companies writing the research and holding the conferences.

    Perhaps the best way to think of these conferences is that they are really SIG meetings, allowing the pioneers to learn from each and encourage each other. The important point is that no one expect the tail (technology) to wag the dog (user benefit). 

  • John Bennett MD

    Yes, this is a lively current, relevant topic, to what I see are two problems with the, shall we say, digital revolution that Mr. Sonnier refers to, a la Dr. Topol.
    The main problem, once I investigated using videochat to do housecalls for my small practice, was that this digital revolution needs two thing:
    1) A common language

    2) A Home

    I was frustrated by the inconsistent language I saw, that, I think, hinders communication, as it does with this topic.

    What do you call all the great things that are going on?  mHealth? iHealth?
    Wireless Medicine?  eHealth?

    So, I searched for a “Home” group that one went to, when one wanted answers in any field.

    I could not find one.

    So I am setting out to rectifiy what I feel to address to two problems of comon language and home.

    I am creating a website,

    http://www.internetmedicine.com

    Speaking of convergence, I stumbled upon a great program, Word Press, that allows me to post the latest development in the, what I now propose to call, the field of “Internet Medicine”.

    As I research furtner, this field is more than “widgets”.  Internet Medicine permeates, and will further permeates, the entire healthcare system, for EMT’s to Hospital Billing.  It is going to radically change EVERYTHING in medicine.

    The doctors office in ten years will be completely different, as will the hospital.

    Put your seat belt on, Mr. Moore’s prediction applies to Internte Medince too!

    John Bennett MD

  • Dr George Margelis

    Hallelujah

    Adding a prefix to health limits it, and silos it from the real healthcare world.

    http://www.youtube.com/watch?v=g7RVTMryi48&sns=em

  • David Brooks

    Having worked in the mobile health space for the past 12 years – yes, mobile health did, in fact, exist before the iPhone – I am amazed how little has changed.  Mobility is not about devices or gadgets or 99 cent apps.  It’s about the free flow of information.  The challenge has always been, and remains, gaining access to meaningful information stores.  With this information, applications can: (1) deliver the information when and where it is needed most, and (2) mash-up information from disparate systems to generate new insights.  Unfortunately, HIE or not, key stakeholders will continue to restrict the flow of this information by hook or by crook.  AT&T (https://mhealth.att.com/) and some others are doing some work to simplify access to health information in direct support of mobile health application developers, but until meaningful information flows freely (and yes, securely), “mHealth” will by stymied.  I think Paul is completely correct in his statement, in so far that most conversation about mHealth revolves around devices and disconnected applications.  In just about every case, transformational solutions will be those that interconnect with the larger healthcare IT ecosystem.  In fact, we’d all be a lot better off if the focus shifted from mobility to data access and interoperability.

  • Natasha Gajewski

    As an mHealth entrepreneur, I too have wearied of the label, especially as the mHealth ecosystem drifts towards the technology of cost-cutting and away from improving health outcomes.  Just take a look at the various health accelerators and count the number of startups that directly serve the patient community.  Shamefully few. 

    Look, if we want to improve health, m or otherwise, shouldn’t we focus on solutions that empower and enable patients? 

  • http://twitter.com/ersiemens ersiemens

    Jody Ranck’s states in the e-book, “Connected Health”: “The important point here is to move beyond the mere facination with the mobile device, and connect the device with people and data flows, so the right person gets the right care at the right time – a realization of anytime, anyplace health.”

    That is the promise, but it remains only a promise and not a reality.  The hard truth of Paul Meyer’s comments are that we all should be frustrated by the slow growth of such a promising enabler of better health… “Mobile” holds great prmoise.  We all know intuitively know it is the right way to go…  I applaude all those that contiue to work at building mHealth sensors and solutions.  This is not an easy road, but it is the right one!  

  • Derek Newell

    thanks for the clarification on the misquote. I think we are more in agreement than not. Couldn’t imaging you would have devoted so much of your life to a topic with out the deep understanding of how transformative it is. I know your products and services have affected many, many people in positive ways! Great  work!

  • Derek Newell

    Agree, it’s not about the label, it’s about the power of the technology. These categorizations are useful during early stages of adoption. Some fade and some stick. I am not sure mHealth will stick, but connected health (than you Dr. .edar)  or something that differentiates the new way we use information, data and connectivity from the old health will probably stick in the lexicon of health/