The federal government will pay about $27 billion in subsidies to induce hospitals and office-based physicians to adopt EHR systems. Meanwhile, providers, payers, the sick and the well are all snapping up mobile-health tools, such as smartphones and a variety of wireless devices, with no federal incentive payments required. These mobile-health users are ushering in a new era in medicine and wellness, mobile-health mavens say, while the government needs to do little more than take notes and get out of the way.
“There is an explosion of apps available to help docs, for all kinds of things,” says former health IT entrepreneur Todd Park, now chief technology officer at HHS. “The thing that would be important for us to do is to keep abreast of what's happening and, to the extent that we can, to unblock potential barriers.”
While the U.S. market is “saturated” with 234 million mobile-phone subscribers age 13 and older, according to researcher Stephanie Flosi, existing customers are rapidly swapping basic cell phones for smartphones. Flosi is a senior analyst with the market research firm comScore.
As of February, there were more than 69.5 million smartphone users in the U.S., compared with 25.5 million two years earlier, the comScore data show. And while text messaging, social networking and playing games remain much more popular uses than, say, perusing the Internet for healthcare tips, about 7 million smartphone users look up healthcare information on the devices at least once a month, according to comScore. At least 1.3 million people use them for health-related purposes nearly every day. And those numbers are growing.
The annual consumer market for remote/mobile-health monitoring devices, meanwhile, is estimated at between $7.7 billion and $43 billion, based on the range of what consumers told analysts at the PricewaterhouseCoopers Health Research Institute. The institute published a white paper in September titled Healthcare unwired: New business models delivering care anywhere, leveraging its survey and other research.
PwC analysts found three distinct business cases for mobile-health applications. One is as a lookup and communications tool for clinicians to improve workflow and decision-making. Another is as a pure-play consumer health support device. And a third is as a hybrid linking clinician and patient.
According to PwC, 40% of physicians surveyed said they could eliminate between 11% and 30% of office visits by using mobile health devices and applications to e-mail, text or monitor patients. But the greatest benefit seen by clinicians, according to the PwC survey, is in data access and decision-making (see chart).
About half of consumers surveyed, meanwhile, say they would buy mobile health technology, and 40% would pay a monthly service fee for systems that could send information to their doctors. For now, though, consumers don't want to pay very much for these connections. The preferred prices were $10 a month for the service and $75 for the device, according to the institute.
At Holy Name, the mHealth future arrived earlier this year when it hitched MicroHIS, its suite of mobile-health applications, to an existing Web-based connectivity platform, WebHIS. Now both systems link clinicians to the hospital's largely self-developed EHR.
Skvarenina, the hospital's point man on the home-grown mobile app project, recalls he was out to dinner with a pediatrician when she got a call from the hospital. “She called back, she had a hard time trying to reach a nurse and then had data read back to her, and I thought, ‘Wouldn't it be great if you could do this on a phone?' ”
Development on the mobile application began last December. It was piloted in February and rolled out in March. In two weeks, 77 physicians were using the system. Doctors can use their smartphones to obtain new lab, radiology and cardiology results, basic patient demographics, admission information, diagnoses, and the latest vital signs, and can call the mobile phones carried by on-duty nurses with the touch of an icon.
Physicians are now asking for access to progress notes and medication lists, and surgeons want their surgical schedules, apps that are under development and should be ready in a couple of weeks, Skvarenina says.