Chanin Wendling, MBA, is director of eHealth in the Division of Applied Research and Clinical Informatics at Pennsylvania's Geisinger Health System. She has developed key strategies that leverage mobile and portal technologies to drive digital patient engagement and facilitate the provider's ability to deliver quality patient care, including smartphones for providers, text message appointment reminders, iPads to collect patient data and drive patient engagement and mobile apps for colonoscopy and lumbar spine surgery.
Editor's note: She will present a session at the HIMSS15 Conference and Exhibition titled "Active Patient Engagement: mHealth as a Tool for Interaction." Part of the Mobile Health Symposium, the session takes place from 10:45-11:45 a.m. Sunday, April 12, in Room S102 at the McCormick Center.
Q. What's the one promise of mHealth that will drive the most adoption over the coming year?
A. I think mobile health is about meeting patients where they are. They don’t have to be in a clinical setting and they don’t have to be sitting at home. These devices are part of how patients are living their lives. If we make taking care of your health consistent with how you keep track of your family calendar, organize your to do’s, etc., then patient engagement should be natural.
Q. What mHealth technology will become ubiquitous in the next 5 years? Why?
A. I would flip the question. It’s not about what mHealth technology will become ubiquitous in the next five years - it’s about what consumer technology will be ubiquitous and how do we in healthcare take advantage of it? We don’t need to be a company like Facebook or Apple, creating the vision for the future. We just need to ride the wave that they create. We see mobile devices and all the apps, electronic books and tracking features that continue to expand on these devices worth the investment for healthcare.
Q. What's the most cutting-edge application you're seeing now? What other innovations might we see in the near future?
A. At HIMSS14, I saw a portal tool that allowed patients to create their own health view. A patient with hypertension can create a graph that has at its base blood pressure, and then overlay it with the weather, sleeping patterns or eating. The patient could then see if there is any correlation between high blood pressure and other factors important in his/her life. It made health very personal. It wasn’t about a patient portal where the health organization decides the design for everyone or a mobile app that meets a clinical need. It was a series of widgets where the patient was the focus. It was incredibly powerful and I said to myself, “That’s where we need to be.”
In terms of other innovations, we are investing in a patient “bring your own device” model. Supplying mobile devices to patients is costly, and CMS restricts loaning these devices to their patients. And many patients already have devices and aren’t interested in having to carry around two. With mobile device vendors coming out with interesting features such as eBooks and publicly available sites where content can be downloaded, we can equip patients with the needed tools to manage their health on their own devices. As an example, we developed an eBook for lumbar spine surgery. Its ability to combine text, video, pop-ups and questionnaires is a staggering difference from the traditional clinical pamphlet. It will lead to better patient engagement.
Q. What mHealth tool or trend will likely die out or fail?
A. I wonder about all the “attachments” that are available for a smartphone - there are glucometers and pulse oximeters and blood pressure monitors. You just get the app and sync with Bluetooth technology to upload your results. Some of these will certainly survive because of the complexity of certain readings, but mobile devices are getting so sophisticated (see below) that I expect a number of health readings to just be available natively on the phone. Consumers don’t want to carry the phone and the attachment if they can avoid it.
Q. What mHealth tool or trend has surprised you the most, either with its success or its failure?
A. I am most impressed by what gets built into the device itself. For example, I now use my fingerprint as my passcode. I don’t have to add any apps to track basic health data, and that is expected to grow over time. I used to have a flashlight app but I don’t even have to go to an app store to get that anymore. The vendors in this space really have a good handle on user design and what users want as standard on the device. And the devices are so intuitive, across all ages, even the elderly. We currently have a project where the potential app for barcode scanning requires a special device called a “sled” to be attached to the smartphone to do the actual scanning. But we’re pretty sure that is a temporary solution; one of the vendors is sure to build that functionality into the base of the mobile device. It seems that if we keep asking, the vendors will keep providing.
Q. What's your biggest fear about mHealth? Why?
A. My biggest fear is that organizations are pursuing mHealth technology because it is sexy rather than because it actually improves care. I absolutely admit that the technology is catchy and intriguing and we are definitely in the pack of organizations looking at how to use it. But fundamentally, mHealth needs to advance healthcare goals. Getting a bunch of activity tracker data from the guy who runs marathons is not really the target. We need engagement from the patients (and their caregivers) with chronic conditions and frequent ED/hospital visits. mHealth needs to stand up to the same return on investment test as any other technology. It needs to drive patient engagement, improve outcomes and/or decrease cost to be worth the effort.
Q. Who's going to push mHealth "to the next level" – consumers, providers or some other party?
A. My vote is on the patients, and I hope they rise up and demand a better way to manage their health. I have enormous respect for the job that the clinical teams have to do. The rules, the time constraints, the new technology – it’s overwhelming. But a healthy patient is ultimately up to the patient. Fifteen minutes at a primary care visit with a provider isn’t going to transform how patients live their lives. Patients need to work with their clinical teams to take the expert advice and find a way to work their care plans into their work schedule and family schedule and every day stress. I just don’t see how someone else deciding that for the patient is going to have the best results.
Q. What are you working on now?
A. A key focus over the next three to six months is the overall patient experience – how do we take the human touch elements, which are so critical, and combine them with all this advanced technology to create the right approach to healthcare? And how do we not let the current payment models stop us from doing what we know is the right approach? mHealth opens the door to fabulous new options. But talking to your doctor one-on-one, human-to-human, is still incredibly valuable. We want to find a place where that all fits in, and where we have a flexible, patient-driven model that allows for different approaches depending on patients’ preferences.
