Stuart M. Hochron, MD, JD, co-founded and is the chief medical officer of Practice Unite, a platform for HIPAA-compliant mobile communication and collaboration applications. He is a practicing physician and healthcare attorney with more than 25 years of experience advising healthcare systems and physicians. He received his MD degree from New York Medical College and his JD degree from Rutgers Law School, and is a clinical professor in the Department of Medicine at UMDNJ-Rutgers medical school.
Q. What's the one promise of mHealth that will drive the most adoption over the coming year?
A. Adoption of mHealth, like adoption of all mobile technology, is related to how much value the technology adds and how easy it is to use. Clinicians frustrated with having to log in and navigate EHRs report high levels of satisfaction and ease of use when push notifications contain relevant clinical information. Mobile push notifications limited to critical labs, consults and diagnostic imaging are among the most highly rated. Clinical decision support using predictive analytics will be a major driver of clinician adoption as implementation broadens. Adoption will increase as the “network effect” (use is related to the square of the number of users in a network) drives greater collaboration and sharing of information.
Q. What mHealth technology will become ubiquitous in the next 5 years? Why?
A. As in other industries, and in our personal lives, several mobile technologies will become ubiquitous in healthcare over the next five years. Secure texting, now a commodity, will be widely deployed among acute care clinicians within the next two years. Secure video telemedicine between clinicians and patients will proliferate as population health initiatives gain importance and reimbursements for telemedicine improve. Technologies such as way-finding, mobile payment and social media networking will become ubiquitous in healthcare for the same reasons that they are now ubiquitous in our lives: convenience, speed, easy access to resources, social connections, educational potential, etc.
Q. What's the most cutting-edge application you're seeing now? What other innovations might we see in the near future?
A. There is so much innovation that it’s hard to choose one. An application we believe has real promise uses cutting-edge predictive analytics to deliver highly relevant critical notifications to non-notification-saturated care team members. The application, Process Proxy, reduces treatment errors, limits the number of notifications and speeds care delivery using algorithms that analyze a patient’s diagnosis, CPOE orders, medication delivery times, etc. In the near future, analytics that specifically improve the workflows involved in managing high-risk patients and connect patients to care coordinators and care team members will further improve workflow inefficiencies and patient/clinician satisfaction.
Q. What mHealth tool or trend will likely die out or fail?
A. Basic text solutions that do not integrate with analytics and/or with the EHR will be replaced by mobile communication and collaboration tools within the next two years.
Q. What mHealth tool or trend has surprised you the most, either with its success or its failure?
A. I am most surprised by the impact of both high-tech and low-tech/high-touch remote patient monitoring. High-tech home monitoring (e.g. Bluetooth enabled blood pressure, weight, oximetry, etc.) has consistently been shown to reduce the rate of preventable hospital readmissions. Similarly, the use of low-tech mobile solutions, (e.g. question sets sent to patients via secure messaging, mobile delivery of patient appointment and immunization reminders and mobile home care team coordination tools) have shown remarkable potential in the long-term care arena. Both findings suggest that communication is a significant barrier to improving care and lowering health costs in the U.S.
Q. What's your biggest fear about mHealth? Why?
A. Security, security, security. More personal health information is moving through the cloud to and from mobile devices every day. As with all electronic data transfer, organizations need to continuously monitor and address system security risks and enhance system security. Mobile user and device authentication by healthcare systems is a rarely identified but clearly at-risk behavior.
Q. Who's going to push mHealth "to the next level" – consumers, providers or some other party?
A. The empowerment of the patient and consumer demand for fast, easy access to healthcare will push mHealth to the next level. Within the next two years 40 percent of all primary care will be delivered by nurse practitioners located inside U.S. pharmacies. Care delivery mechanisms that take advantage of consumer-facing mobile apps will extend the mHealth envelope. Insurers and other managers of ACOs and care networks will increasingly market, monitor and control workflows using mobile apps.
Q. What are you working on now?
A. Our focus at Practice Unite is to mobile-enable healthcare organizations so they can use their existing systems to coordinate care effectively throughout the care continuum. We are deploying mobile apps that enable EHRs and other IT systems to seamlessly deliver communications and information to clinicians and patients when and how they want it.
We believe that mHealth users should have secure access to the same variety of mobile functions that they enjoy in their private lives (e.g. texting/photos, video telemedicine, synchronous and asynchronous voice communication and mobile document transfer). We’re including all of these forms in our apps. Users also want seamless connections between systems and users, so we’re linking users with the systems they need most in ways that deliver a seamless experience when accessing EHRs, patient portals, analytics and other databases. Lastly, security is a huge issue in mHealth. My team is about to deploy a unique tool that combines a high level of security, continuous fraud monitoring and improved usability.
Previous articles in our mHealth masters series:
Duke's Ricky Bloomfield, MD on the promise of HealthKit and SMART on FHIR
At Geisinger, mHealth begins with the patient
Why consumer engagement needs a makeover
