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The Mobile Patient: How mHealth Tools are Paving the Way for Better Care Management

May 27, 2015
by Rajiv Leventhal
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With a sweeping shift to patient-centered and value-based care, mobile health technologies are increasingly being used to improve care in unprecedented ways.

In the new healthcare, one which emphasizes comprehensive, team-based and accessible care, provider organizations will need to make concerted efforts to become more patient-centered.  For many providers, patient engagement is no easy task, but it’s certainly at the top of mind for healthcare CIOs.

Indeed, according to findings of the 26th Annual HIMSS Leadership Survey, sponsored by the Chicago-based Healthcare Information and Management Systems Society (HIMSS) and released at the annual HIMSS conference this past April, patient satisfaction, patient engagement, and quality of care improvement have raced to the top of healthcare CIOs’ and senior IT executives’ agendas in the past year, a stark change from previous years which found that health IT leaders were more focused on business and financial goals. Nonetheless, it’s been a struggle for physicians to truly engage their patients, especially the 45 percent of U.S. adults with at least one chronic condition.

Enter the world of mobile health (mHealth) to help with care management and patient engagement, a growing trend in healthcare. In fact, another recent survey from HIMSS found that more than 90 percent of survey respondents are utilizing mobile devices within their organizations to engage patients in their care. The fourth annual HIMSS mobile survey, which included more than 200 healthcare provider employees, revealed that 73 percent of respondents believe the use of app-enabled patient portals has been the most effective tool in patient engagement to date.

Further, when asked about patient-generated health data (PGHD), 14 percent reported that all or most data generated by mobile devices is integrated into the electronic health record (EHR), while 52 percent reported that some data has been integrated into the medical record. “mHealth continues to evolve as a tool to drive healthcare efficiencies. The proposed meaningful use Stage 3 rule realizes this with the concept of application program interfaces (APIs) and patient-generated health data, and this year’s survey showed that the wide spread availability of mobile technology has had a positive impact on the coordination of patient care,” said David Collins, senior director of the HIMSS mHealth community.

Analysts do predict that the wearables market will grow tenfold to $50 billion over the next three to five years. So undoubtedly, putting personal devices in the hands of patients has begun to change the way patients and physicians communicate with each other. And for each of the major smartphone operating systems, there is now an app for almost every conceivable healthcare need.

What’s more, there are policy implications to consider as well. As HIMSS’ Collins mentioned, the recent meaningful use Stage 3 proposal that calls for more that 15 percent of patients to contribute PGHD or data from a non-clinical setting into the certified EHR technology during the EHR reporting period, will put the onus on providers to collect information from patients, often captured from exercise or fitness devices or recorded on mobile apps.

What does all this mean? For forward-thinking providers, it’s about getting patients to use mHealth tools for more effective care management. Mobile health tools have the potential to create a low-cost stream of highly actionable clinical data, using readily available cloud-connected sensors, ranging from glucose meters to heart monitors to asthma tools. To this end, all sorts of vendors in the market place are working on using mobile devices to get first get patients to track their own data, with the eventual goal to get said data into the EHR. For most vendors and provider organizations though, as noted in the HIMSS mHealth survey, this concept is a novel one.


According to Ken Kleinberg, director of health IT membership service at the Washington, D.C.-based The Advisory Board Company, mHealth vendors are now making it easier on patients to track and share their data than ever before. “These apps are now designed for a small device. You’re no longer trying to open a browser on a tiny screen, but instead you’re looking at an app designed just for that platform, so the data entry and reminders are pretty straight forward,” Kleinberg says. “You may get text message reminders, for example, and these are simple mechanisms that don’t require complex hardware,” he says. Kleinberg adds that there is also a trend involving smartphones with medical devices, where asthma patients, for instance, can have their inhaler with an attachment to it that keeps track of every time the inhaler is used. “This way you can sit down with your provider or look at the data yourself, and sit down and figure out trends,” he says.

Ken Kleinberg

To this end, at this year’s HIMSS conference, the Durham, N.C.-based Duke Medicine shared the experience it has had thus far with Apple’s HealthKit, a framework designed to house healthcare and fitness apps, allowing them to work together and gather their data under the Health app. Since HealthKit’s launch, many notable healthcare organizations, including Stanford Medicine, Cleveland Clinic, and EHR vendors like Epic, have all partnered with Apple to work in their own patient-generated data applications.