Is mHealth at the Peak of Inflated Expectations?

By: Brian Dolan | Sep 2, 2010        

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Brian Dolan, Editor, MobiHealthNewsAt the beginning of the summer, the American Telemedicine Association’s President Jon Linkous wrote a somewhat scathing critique of the hype that surrounded (and continues to surround) all things mHealth. This past week Eric Dishman, an Intel Fellow and director of health innovation and policy for Intel’s Digital Health Group, argued convincingly that right now mHealth is at the apex of the hype cycle:

“This well-intentioned but premature celebration of all things ‘mHealth’ may come back to bite us, if we’re not more careful,” Dishman wrote in his rant, entitled The Hype and Hope of mHealth. Dishman broke his primary concerns down into three buckets: The vaguity of the term “mHealth,” a clear failing to “manage expectations” for mHealth, and an inability to get beyond a few very specific mHealth baises.

Vaguity: “If ‘mHealth’ is all of these things and more….if ‘mHealth’ is everything…then it is nothing. The phrase has become so slippery, so ubiquitous as to become almost useless. We must be more careful in defining and aligning what we’re talking about, and I encourage these various workshops and organizers to spend some time clarifying and specifying what’s at play here,” Dishman wrote.

I sympathize with Dishman on this one, really: The semantics around mHealth and wireless health can be confusing or overly broad at times. Navel-gazing, however, is a bigger danger for such a new industry. Language is rarely precise. Debates over the etymology of mHealth vs. wireless health vs. the new term du jour seem much less important than the real issues: Efficacy, business model, regulatory environment, et al.

Expectations: “As we’re reaching a fevered pitch about mHealth, I fear that no technology solution could ever achieve the enormous claims and utopian breakthroughs so many are promising. We’re doing a terrible job with expectations management because consumers and clinicians are all likely to believe that these solutions and services are widely proven, affordable, and available. This is just not the case yet. The potential is there, but not yet the products and price points.”

While I can’t speak to the beliefs of consumers at large, I find it hard to believe many clinicians are under the impression mHealth services are widely “proven, affordable and available.” Most discussions I’ve had with clinicians have led me to the opposite conclusion: Clinicians are either fully aware of mHealth’s potential and prematurity or they are rife with skepticism about it.

Biases: Dishman was frustrated after a discussion with an organizer of an mHealth related event that showed the organizer had “all three of the biases of the mHealth movement that concern me: It’s supposed to be about cell phones, with cool gadgets, for young people,” Dishman wrote.

Does that ring true for you? All about the phone? Too cool? For the young? Or does it sound like an isolated incident?

In any case, I agree with both Dishman and Linkous about one thing at least: We are at the apex of the hype cycle for mHealth. It’s what Gartner Research calls the Peak of Inflated Expectations. So, hang on, because if Gartner’s hype cycle is correct, then our next maneuver is a steep descent into the Trough of Disillusionment.

  • healthythinker

    I couldn’t agree more: “If mHealth is everything, it is nothing.” So much has been subsumed under the mHealth umbrella, but defining the landscape in a more granular, practical way. Brian and Eric are correct. I’ll add one more issue to the list of “regulation, business models, and efficacy.” And that would be consumer/patient engagement: much of the hype is around peoples’ willingness to engage in health, and there’s a huge chasm between peoples’ good intentions and “doing.” JSK

  • David Doherty, mHealth Insight

    Hi Brian check out my detailed response to Eric’s:

    I think you’ll agree it’s easy to appreciate his perspectives when you consider the rather disappointing, expensive and already outdated products being marketed by Intel Health.

  • Chad Barker

    The response to Eric Dishman’s post whiffs a bit of “Yeah yeah whatever. I know we’re facing irrational exuberance but I don’t want to worry about the reasons why so let’s poke holes.” Dishman has been focusing on consumers in the digital health space for 15 years and has his finger on the pulse. That doesn’t make him all-knowing, but then show me a better way to break the hype down so we can take action.

    Also, I disagree w suggesting the youth/coolness/phone bias might be an isolated incident. Besides, Mr. Dishman himself says in the very next sentence (not quoted above): “I know there are many out there who don’t share these biases, but that phone call, like so many other conversations I have had around mHealth recently, underscores real issues I think we need to tackle.” A huge challenge is that the youth/coolness/phone factors have merit, but they also tend to leave out the segment of our population who, on average, needs these solutions most: the elderly.

    We don’t have to crash into the trough of disillusionment. We can willingly raise our own consciousness around the factors of the mHealth hype (in this case) and course-correct rather than being forced to do so by disregarding the specific reasons for the hype and getting clobbered. It’s not enough to say there’s hype without understanding the reasons or doing anything about it.

  • Paul Sonnier

    Excellent commentary, Brian!
    It’s worth noting that in Gartner’s 2009 Hype Cycle report, Home Health Monitoring was plotted near the Trough of Disillusionment, well beyond the apex of the Peak of Inflated Expectations. Arguably, HHM is a subset of wireless and mobile health since many products in that segment are featuring wireless technology for enhanced mobility of users.
    Perhaps this is a perfect example illustrating the highly fragmented composition of products falling under the category of wireless and mobile health, which is comprised of both consumer and clinical application sub-markets? As such, I think more value will be provided in these types of analyses and discussions if we first first break it up into its constituent parts, rather than hype — or anti-hype — what is an incredibly broad and diverse set of what are usually wirelessly-enabled products.

    Paul Sonnier
    Founder, Wireless Health group on LinkedIn

  • Brian Dolan

    Thanks, Paul. In Gartner’s 2010 Telemedicine Hype Cycle they have mHealth and mobile health monitoring listed among the “At the Peak” while HHM, as you said, is sliding into the trough. (not the graphic but the tablet of contents lists out different subsets of telemedicine)

    And, I agree with you — a more focused discussion on particular subsets of wireless health would make these discussions more productive.


  • Brian Dolan

    Chad – Thanks for the comments.

    My intent was to call attention to Dishman’s column so that readers could raise their consciousness of the factors surrounding mHealth hype, as you phrased it above. The post received top billing in our weekly newsletter this morning because I believe that Dishman’s was the most worthwhile blog about mobile health that came out this week.

    His quote: “Try to… focus all of this attention and investment on the care models and use cases we’re trying to enable first and foremost, with the technologies taking a distant second place.” Was also our quote of the week in the newsletter.

    Dishman’s piece was clearly the beginning of the discussion — he made that clear.

    In any case, I had no intent to dismiss Dishman’s blog post with a “whatever” response. I agree with David Doherty’s comment in his post (linked to below) that Dishman deserves high praise for openly sharing his opinions and inviting debate.

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  • bart collet

    Most excellent discussion!
    Am I the only one making a difference between ‘popular mhealth’ and ‘medical-clinical mhealth’?
    The latter being the topic of this discussion and indeed may be victim to some inflated expectations (and also being buried by legal obstructions by the competition!).
    But the first still has very strong growth potential for health aware people, fitness and wellness, the elderly, …

  • Guest

    bart, pls define “popular” mHealth?

  • bart collet

    popular mhealth (everything on the mhealth shelf of your local supermarket or available at an affordable price in local webshops): bluetooth weighing scales, fitness monitoring apps, location based review apps, patient controlled EHR, …
    Can someone find a better naming than ‘popular mhealth’? consumer mhealth, fisher price mhealth, easy mhealth, … ?

  • David Doherty, mHealth Insight

    I find that using the “fisher price” term (which I first heard you using) gets everyone on the same page very quickly…

  • David Inns

    “Take time to deliberate; but when the time for action arrives, stop thinking and go in.”- Bonaparte; at GreatCall we are just focusing on what the aging consumer needs and delivering it, that’s not hype

  • Laurie Orlov

    In terms of terms for mHealth — the list of conferences posted on the right side of this page offers a telling illustration: mHealth, Consumer Healthcare & Wireless technologies, Mobile healthcare, body computing, medical device connectivity, remote healthcare management, wireless health, and connected health.

    So not only is there no clarity on terms and definitions, but clearly the very ambiguity has spawned a thriving event (funded by exhibitor) industry. That certainly characterizes a hype cycle, but not one that is anywhere near the apex. Disillusionment only happens when there is enough adoption to spur complaints about the inadequacy of the technology. Right now, general complaints are only about the degree of adoption — of…(your term substituted here).

  • Brian Dolan

    Laurie, I fully agree with the events comment. “Disillusionment only happens when there is enough adoption to spur complaints about the inadequacy of the technology” seems to me to be what follows after reaching the hype apex, but maybe that’s your point — if we haven’t yet hit disillusionment on that front then we haven’t yet reached the top.

  • Brian Dolan

    David, to date, that Napoleon quote certainly fits GreatCall’s mHealth moves with Jitterbug — moving faster than any other mobile service provider in the US, hands down. Seems like by early next year, however, a couple more operators are moving from the “thinking” to “going in” phase…

  • David Inns

    just trying to stay two steps ahead…not easy…but we are trying!