John Scott, MD, is an associate professor in the Division of Allergy and Infectious Diseases at University of Washington Medicine and the UW's medical director for telemedicine. A graduate of Stanford University and Georgetown University, he leads the Project ECHO clinician-to-clinician consultation program and was named 2014's "Top Doctor" by Seattle Met. He also has an active research program in viral hepatitis and has published in several locations.
Q. What's the one promise of mHealth that will drive the most adoption over the coming year?
A. Consumer-focused, easy-to-use platforms such as the iWatch and Samsung SimBand.
Q. What mHealth technology will become ubiquitous in the next 5 years? Why?
A. I think the technology from Theranos has the greatest potential and will be near ubiquitous. This chip-based technology allows a person to have any of 70 common lab tests for $2-$5 from just a drop of blood; it’s already being sold in Walgreens in California and Arizona. In the next five years, this technology will just be an app and technology run through your smartphone. Information will be uploaded to the cloud and routed to your clinician. This will be a major market disrupter for diagnostic companies like Quest, Labcorp and institutions that have large diagnostic laboratories.
Q. What's the most cutting-edge application you're seeing now? What other innovations might we see in the near future?
A. I like the above technology plus some really exciting work coming from Proteus (based in Redwood City, Calif.). This very small chip is wrapped around a patient’s oral medication and, after ingested, is activated with the stomach acid, sending a signal to one’s phone that medicine was taken and at what time. The patient can then add additional comments, such as how they felt. All of this goes to the clinician through a secure cloud connection, who can examine a patient’s adherence to medicines and symptoms and intervene if needed. Since conditions like hypertension and diabetes are so common and require daily medications, I think this technology could really revolutionize healthcare. I think applications that provide both subjective and objective data to clinicians are good, they just need to get that decision support in there somehow.
Q. What mHealth tool or trend will likely die out or fail?
A. Stand-alone apps that don’t integrate into the most common EMRs. That’s a show-stopper. As a provider and purchaser for a large health system, I want something that can scale and work seamlessly with our EMR.
Q. What mHealth tool or trend has surprised you the most, either with its success or its failure?
A. I haven’t seen the “killer app” for healthcare yet. With all the brains and creativity out there, I’d expected something like the iPhone by now. Maybe folks are not dreaming big enough. With that being said, I think we’ll see some ingenious, low-tech solutions coming from international, low-resource settings. There’s beauty in simplicity.
Q. What's your biggest fear about mHealth? Why?
A. Too much uncertainty or complexity about the regulation of mHealth. The statements from the FDA have been head-scratchers.
Q. Who's going to push mHealth "to the next level" – consumers, providers or some other party?
A. Definitely not providers. We are scared of an avalanche of information. We need some way to sort it and figure out which values are actionable. Payers are super-conservative and slow to innovate – just look at how long it’s taking to get telemedicine reimbursed in many states. So I think it’s going to be consumers driving this. What are now “gee whiz” features will be commonplace and expected in the next five years.
Q. What are you working on now?
A. I’m excited about work that my colleagues at UW are doing for post-surgical wound management and infection prevention, called mPOWEr. I also like Dr. Jim Stout’s app for neonatal jaundice, called BiliCam. His app could save thousands of lives in developing nations!
Previous installments in our mHealth masters series:
A call for EHR providers to catch up
Lifestyle monitoring on the rise
