Interview: Mayo Clinic forges its mobile strategy

By: Brian Dolan | May 31, 2009        

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mobihealthnews recently caught up with Scott Eising, director of product management for Mayo Clinic Internet Services, to discuss his group’s strategy and pain points for moving Mayo Clinic’s online offerings to the mobile platform. Every major provider of health services and information is trying to figure out how best to go mobile. Eising offered a peek behind the curtain at Mayo to discuss how the not-for-profit, integrated medical practice is planning to do just that.

Mayo Clinic employs 3,300 physicians, scientists and researchers as well as 46,000 allied health staff at its three sites in Rochester, MN, Jacksonville, FL, and Phoenix, AZ. Mayo treats more than 500,000 people each year.

mobihealthnews: In general, what kind of opportunity does Mayo Clinic have to capitalize on mobile platforms?

Eising: It depends on the audience. Our group serves a number of audiences. On the consumer side, we have a presence MayoClinic.com on the Web, we certainly think providing a mobile experience for accessing health information is going to be paramount. We really don’t do that today at all. How we optimize our content for mobile is kind of a question for us. Do we do the m.mayoclinic.com approach and offer a narrow subset of content that we share with that audience? We have so much content so that could be challenging. I think in the near term we will probably go in the consumer app direction, just because with the browser capabilities on these newer smartphones the experience isn’t too bad when you can pinch and expand and get at the content you want. First on the mobile side, we will look at smartphones for consumers and some apps. We are a user-centric design shop though, and we need to do more research about what are the mobile needs and habits of our customer base on the consumer side. We have a lot of data about the Web and their habits there, but our user research group isn’t convinced that those habits will transfer over. From a general standpoint, that seems to be a real gap out there in the health area, anyway, about what things do consumers want to do from a health perspective on mobile. Beyond the obvious — symptoms, first aid or find-a-doctor. We are going to do some fundamental user research with several audiences to get a sense of how they are using their mobile phone today in general — calls, text messaging, mobile browsing. Then get to what are the potential opportunities or pain points from either an information or health management standpoint that would be better served via mobile versus tethered to a desk.

Can you highlight any of those pain points about moving to a mobile platform?

Certainly the fact that there are multiple mobile platforms is a challenge. Even if you just narrow it to the smartphone platforms, certainly from a consumer perspective the iPhone and iTouch and the AppStore currently is really dominant. Hard not to point to it and say that’s been really successful. We have a lot of clinicians here and other medical professionals who are more attuned to the BlackBerry/RIM platform. We have a relationship with Microsoft around HealthManager, which causes us to want to look at the Windows Mobile platform. That challenge, of course, isn’t unique to healthcare, it’s just a challenge that from a technical perspective to gather the expertise needed to develop for each of these platforms and what can you reuse or not reuse for each of those scenarios is tricky. Lots just generalize with an example — if I am going to build a symptom checker app, because I can tell you when people come to MayoClinic.com via a mobile device they are usually looking for symptom content, so I build that, but the question is where do I build it the first time? How do I build it in a way that it works for Palm OS but I’ve done it in a smart way so it works on other platforms. That’s different from what we are accustomed to in the online world where we build, host and manage all of these applications and while we may have to worry about which version of [Internet Explorer] a visitor has or how it looks in Safari, but it’s still a heck of a lot easier than from a mobile perspective.

I’d imagine there could also be some hesitance as to which platform to start with in general. For example, you’d kind of be making a statement if you launched your first apps with Apple’s iPhone right? How do you choose? Is there a need to go after all platforms at once?

Right, and I left out a big one — the Google Android platform is going to be coming out on a lot more devices in the coming year and you have to wonder what the relationship is between Android and Google Health. I think partially our thinking is that it’s such a new area that you can spend a lot of time trying to wrestle with all of these questions and never actually build anything. I think we are going to do the best we can to put a strategy in place based on what we know and then get engaged in learning and building some knowledge and core competency and evolve as we go. If we don’t, I don’t think in this space you’re ever going to say “OK, I got it.” Because as soon as you say, “OK, I got it,” the next day somebody is going to come out with something else that makes you say, “Oh, man, need to start over.” There are some things we know and some safe bets we can make about how to proceed in this space for determining what the user experience should be and what’s best practice here. We are creating content for this space or repurposing content for this space. I find that product teams do a much better job solving problems when they are actually building something instead of just hypothesizing — especially technical folks and designers.

So what about supporting clinicians and other physicians and their interaction with Mayo. What role does your group play in supporting them and what’s the mobile strategy there?

The group that I am in doesn’t support our internal docs, but I can say that certainly there is a movement afoot. Our own doctors are just like doctors outside of Mayo, they are probably using the same medical apps on their iPhone or BlackBerry that there colleagues do elsewhere. I can say that, because they ask me when is Mayo going to have a presence on this device? So I know they are using it. Our group won’t try and meet their needs because there is an internal IT group that will look at what part of our clinical systems or tools might we want to give our practitioners more mobile access too, for instance.

One audience my group does handle is external physicians or referring physicians. There are two strategies there — we have a referring physician portal today that is a secure portal where a physician who wants to refer a patient to Mayo logs in, fill out a profile on that patient, submit it and upload things like medical records that may be necessary for the referral. The patient may or may not end up coming to Mayo, but if they do, then the portal is where we refer back to that referring physician the status of the visit and the opinion or the outcome of it. So we are doing some user research right now and asking that group which aspects of that referring physician portal might be of more value if they were accessible via mobile devices. Certainly, you could imagine an alert or a reminder sent to the referring physician when new information was pushed to their portal. Maybe we could provide them some sort of preview into that information via mobile device or a way to put in a simple request for a referral from their device. So, we have a user survey out to that group so we can find out how we can better optimize that experience for those users. Obvioulsy being a tertiary destination medical center, referrals are a big part of where our patient base comes from. They are looking for that specialty expertise that Mayo provides and that they can’t get in their community. Referring physicians are an important partner for bringing patients to Mayo or for patients finding their way to Mayo.

The other audience on the external physicians side that we know we probably have assets that could be made available via mobile is the audience for continuing medical education. We have a whole medical school and CME schools here at Mayo in Rochester and other campuses. We know from looking at the marketplace for other apps that CME is one of those areas we definitely want to explore because we have seen some others doing that. We also have some knowledge assets that may be of interest to that audience as well and that’s about as deep as I can explain that one right now. There are some great models out there for CME via mobiles so it’s definitely another strategy for that audience that we are exploring.

One other audience that I didn’t mention is the corporate market. We have a big corporate business unit that sells a health and wellness portal, which includes health assessments and behavior change programs. The offerings include health coaching, tobacco quit lines, nurse lines and other services around wellness that large, often self-insured, employers use to make their worker populations healthier. That’s another group where we think mobile will be a great way to engage them and keep these types of services top of mind. Ties between telephonic-style health coaching programs with mobile apps or even developing mobile apps that tie back to the Embody Health platform. The ability to maybe track or log some metrics from my mobile and have it networked back to the Embody Health online portal. That makes too much sense not to do. These smartphone devices as a workforce tool are also very prevalent so it may be another way to help out clients engage their population in managing their health and wellness.

The idea that health is mobile — I heard it first from John Moore from Chilmark Research — has really stuck with me. Health is mobile: People are engaged in these health activities throughout the day and week whether at home, at the gym or at a kid’s soccer game. The expectation that you are going to reach these people where they are when they want it — we talk about wanting to do that now via the Web or telephonically, but as you really dig into the mobile platform or platforms you just see how well-suited they are to better meet that expectation. It’s really exciting from the health and wellness management perspective. As smartphones get more prevalent or ubiquitous it’s going to have a huge impact. I have to say, I’m much deeper into this space now than I ever was before and the further you get into it the potential seems enormous. It’s a ways out but the key is not to wait until it gets here.

On that note, what was your “aha” moment for the opportunity mobile presents for health and wellness?

Well, this is just personally my realization — not Mayo’s. It was seeing the impact of the iPhone and the mass appeal that the device and AppStore seemed to have. Where this is being strategically driven from is less from our consumers and our patients and more so at this stage from the leadership, stakeholders and industry or government. Certainly consumers have embraced mobile devices, including the iPhone and AppStore, but I don’t have patients calling me up regularly on the phone asking if a Mayo app is coming yet. I do have clincial leadership and administrative leadership calling me and saying, “Hey, we need to get engaged in this now.” I attribute that to they, themselves going out and having a personal experience with a smartphone, probably not with a health app, but the user experience is so much different from the cell phone they used to carry that I think a light bulb went off.

In the fall last year, we started to get more inquiries from physician leaders and groups about mobile health. I think it’s all the awareness in the industry that comes from seeing it in the news and the leadership here has looked around and decided Mayo needs to be doing more here.

Do you see that as a problem that consumers aren’t demanding more mobile health solutions or does it need to start with stakeholders getting interested first before they help consumers become aware of the opportunity?

I have enough confidence in looking at the platforms and trends and these smartphones are turning into more of a life management tool. Health is going to be a part of that. Consumers may not yet know who to ask for what from a health perspective when it comes to mobile, but if we go out and understand what their needs our and deliver good, simple apps that meet those needs, I am confident that people will embrace them. It is all so new right now, though, so very few consumers can articulate what they want.

I spent some time talking to one of our corporate customers about mobile and it’s very new for them too. They are still reacting to it from a consumer perspective because it hasn’t trickled down enough professionally to figure out what it means.

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  • Roberto Pflaumer

    It should not be a surprise that the Mayo Clinic is a leader and is looking for what they have to do, before the customers are presenting their “needs”. No one of us had the need for the functionalities that the mobile phone has nowadays. I really enjoy the definition that was given: “Life management tool”. Great way to look ahead, conceptualized what is already going on. The smart phones are already being used by individuals of all the ages and all the socioeconomic levels. The speed of the change and the adoption of this “essential” device should make it the perfect vehicle for the patients and their physicians to interact. What should be included and what should not be part of the mobile life is an entirely different discussion. But for sure that we can already envision some of the benefits: Educational snapshots for chronic conditions, follow up of different sorts in order to increase the patient adherence to medical treatments and thus, reducing the cost of health care.

    Again, congratulations to the thinkers and conceptualizers of the Mayo Clinic, the future is here already.

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  • http://www.mobilestorm.com Elyse Rossler

    I don’t get it…..why not immediately start texting your Patients their appointment reminders. 98% of all cell phones in America can receive a simple Text reminder via SMS. These appointment reminders are personalized, transactional, and can greatly decrease the NO SHOW patient. They cost pennies to send (vs. the post card at .40 or the voice call at .50), and everyone is walking around with a cell phone on their hip! Even in their home (62% of Americas carry their cell phone from room to room while home!), AND, the average text message is read within 4 minutes!! mobileStorm has what Mayo Clinic needs today!

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  • J Applebaum, MD

    Mayo needs to work with companies that already provide quality information to physicians and other healthcare providers on mobile platforms. The idea is not to create yet another App for the iPhone. Companies like Skyscape have been publishing quality information for the healthcare. Android, iPhone, BlackBerry, Windows Mobile, Palm Pre…all of these platforms need to be covered. Also you need to consider the full healthcare provider spectrum along with the patients. I like what Skyscape has been doing with publishers, societies – why couldn’t they partner with Mayo, Cleveland Clinic, UCSF, etc.?

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