For mHealth to succeed, we'll need standards

From the mHealthNews archive

Do you FitBit? It’s a question that’s on the lips of millions of consumers, given that the device manufacturer captured a whopping 67 percent of total wearable fitness trackers sold in 2013. Once the domain of limited-functionality products like hearing aids and traditional pedometers that merely counted steps and mileage, the mobile health devices market is maturing and transforming into a much more sophisticated, feature-rich environment.

There are now commercially available consumer applications that can turn a smartphone into a thermometer, pulse oximeter, blood pressure monitor, glucose meter and more. Then there’s the clinical mHealth market – projected to surge past the consumer mHealth market to reach a high of $16B by 2023 – with its array of mobile ultrasounds, virus and nano-particle imagers, blood analyzers and other clinical functionalities. Opportunities for development and adoption of new labor-, time- and money-saving mHealth devices is virtually unlimited, but the challenges posed by integrating new mHealth technologies into a busy clinical practice can be daunting, and even become a barrier to adoption.

Is mHealth a cure worse than the disease?
mHealth technologies offer a bounty of benefits and advantages, including improved monitoring, faster diagnostics, greater flexibility and measurable cost-savings, for physicians and patients alike. However, with great promise also come great challenges, particularly for healthcare organizations and clinical practices. What’s the best way to work these new devices and applications into an organization’s daily workflow? How much is too much when it comes to data? And how should that information be safeguarded to prevent costly security breaches or HIPAA violations? What happens when mHealth devices aren’t interoperable with either one another or network infrastructures?

These are only a few of the urgent questions that the mHealth ecosystem must address if technology innovation and adoption is to continue, yet there are no simple answers. Take the question of cost; mHealth devices have ancillary costs beyond just the purchase price that must be taken into account – training, integration, operation and security, for example. One factor that can cause these costs to spiral is a lack of interoperability between mHealth devices. Many times, integrating mHealth technologies into an existing network means implementing a patchwork solution that cobbles disparate hardware and software together into something that mostly works. Or it might require considerable manual intervention to ensure the system functions adequately in an environment where devices can’t communicate with each other. Neither circumstance is optimal in situations where the quality of patient care is on the line.

Data accuracy, privacy and security represent additional hurdles that can stymie mHealth technology adoption. Is essential information being captured and recorded correctly? Who can or should be able to access sensitive medical data? How secure is the data transfer process between the device and the network?

It’s not surprising that some physicians are wary of using mobile or wireless mHealth devices, especially given today’s increasingly rigid policy and regulatory landscape where even minor HIPAA violations can result in major headaches and significant penalties. To achieve maximum efficacy, mHealth devices and systems need to be interoperable, reliable, accurate and secure – a tall order, to be sure. Ensuring data is not being routed over or being stored on a vulnerable network, that all fail points along the way are accounted for, and HIPAA compliance is being maintained aren’t responsibilities that physicians and healthcare organizations can take lightly. Rather, these are vitally important considerations for anyone considering adding mHealth technologies to their daily routine.

Just what the doctor ordered
With the growing convergence of embedded, medical and telecommunications technologies, mHealth devices have the opportunity to become increasingly powerful weapons in the fight against disease. However, with each new innovation in mHealth devices and systems also comes a corresponding rise in the level of technological complexity. Thankfully, efforts are underway to overcome these challenges, ensuring better interoperability and paving the way for mHealth’s greater acceptance in both clinical environments and the consumer market.

Organizations such as IEEE and the International Organization for Standardization (ISO) are working to develop and foster the adoption of much-needed mHealth technology standards and frameworks. One such example is ISO/IEEE 11073, a group of standards that addresses personal health devices (PHDs) interoperability, connectivity and data transport. There is also strong policy and regulatory support through vehicles like the American Recovery and Reinvestment Act (ARRA). ARRA’s nearly $20 billion in funding to promote the adoption of healthcare information technologies and electronic health records is helping to improve patient diagnosis and treatment by allowing data to be accurately captured, recorded and secured at the point of care.

Despite these concerted efforts and support, the transition from devices that are proprietary and specialized to those that are standardized and open remains a slow one. So how can physicians help spur device manufacturers and system integrators into delivering mHealth products that actually improve the caliber, speed and cost of patient care? Just like patients must be their own best advocate, so must physicians and healthcare organizations be willing to do the same when it comes to mHealth.

Physicians and healthcare organizations wield much more leverage in the mHealth arena than they realize. One key avenue of influence is the purchase agreement, wherein stipulations that any new in-home monitoring device or clinical system must meet global interoperability and security standards can be added. Another tactic is for healthcare professionals to become better educated. As the old saying goes, forewarned is forearmed; having a better understanding of the critical role that interoperability and data security play will help ensure mHealth technologies can be more easily integrated into daily clinical routines.

A prescription for mHealth success
With the rise of the Internet of Things, mHealth devices – like the aforementioned FitBit – and systems are becoming a de facto part of our healthcare landscape. And despite some ongoing challenges, these innovative technologies continue to break new ground, and integration and adoption rates are accelerating.

With open global interoperability and security standards and frameworks in place, the promise and benefits mHealth offers will be magnified to the point where we’ll wonder, “Why we haven’t been doing it this way all along?”

Bill Ash is strategic program director for the IEEE Standards Association, currently overseeing the eHealth, smart grid and smart city for the IEEE-SA. Kathryn Bennett is senior program manager for the IEEE-SA, involved in the strategic advancement of eHealth initiatives for IEEE.