While the Veterans Health Administration bets heavily on mobile health and telemedicine, another major federally run healthcare organization, the Military Health System, is treading more carefully.
"If people don't see us running out as fast, it's because we have to manage a global environment in a mobile, secure manner," Military Health System CTO Mark Goodge writes in a guest column for Federal News Radio (Washington, D.C.).
The MHS wants to go mobile – and has, in many ways, with 10 apps now available for free on iTunes and Google Play through the Department of Defense's National Center for Telehealth and Technology (T2), including one that tracks anxiety, depression and other symptoms of post-traumatic stress disorder. The U.S. Army is nearly halfway into a five-year deal to use Diversinet's mCare platform for communicating with wounded soldiers and also tracks the health of some special forces with Zephyr Technologies monitoring gear.
But the MHS does not want to do too much without being confident that there are adequate levels of privacy, security and interoperability. After all, American troops are deployed around the globe, and protecting their health data could be a matter of national security. "For DoD, the biggest issue is security," Goodge says.
"At MHS, we have to get the policies and frameworks right, and we are working on a lot of these issues right now. These will allow us to guide the enterprise to a better way forward for mobile and mobile technologies," he notes.
"We want to ensure that any personal health information or personally identifiable information that could be presented on these devices and applications is protected. We also want to ensure that we have conformity of standards for mobile devices and mobile selections, and that we offer interoperability across the enterprise."
That enterprise is enormous, supporting care for 9.6 million people with more than 1 million inpatient admissions and 130 million outpatient visits in 2011, according to Goodge. "For the Department of Defense, the scope of effort is so large and so varied that defining where we need to go and where we want to be means many different things," he says.
"It's important to remember that we are dealing with very young technologies. Five years ago, they mostly didn't exist. Ten years from now, we'll probably be wearing devices," Goodge continues. "You're already starting to see some of that trend with stuff embedded into clothing that allows for you to broadcast. In a few years, we could be wearing biosensors that take various readings from the wearer and send that information to another application, so providers and patients can be more proactive in care.
"But, for now, the technological challenges are to ensure that we have trusted and secure communications between devices, that we have contingency plans already put in place in case that device falls into the wrong hands and that we have the proper encryption."