“The main barriers are not the technology,” but rather the healthcare industry's “inherent resistance to change,” Dr. David Levy, PwC's global healthcare leader, says in a statement accompanying the firm's report. “Though many people think mobile health will be ancillary or bolted on to the healthcare industry, we look at it differently” as “the future of healthcare, deeply integrated into delivery that will be better, faster, less expensive and far more customer-focused.”
But for now, “It's kind of like a wild, wild West in the mobile health space,” says Lee Perlman, president of GNYHA Ventures, a for-profit subsidiary of the Greater New York Hospital Association, which serves 250 hospitals and other care organizations in the metropolitan New York region. “We've tried to put some rationale to it.”
The subsidiary has invested $2.5 million in creating Happtique, a mobile health services platform for hospitals, doctors, developers and provider organizations as well as patients. It includes a mobile app management software system that enables hospitals and other provider organizations to control access to their electronic health-record systems by users of mobile applications.
It also offers a catalog of apps, sorted into more than 300 healthcare categories for easier searching. This online market will allow hospitals and other healthcare organizations a place to brand and sell their in-house developed apps, serving as a gatekeeper for apps used by their patients. It has a program under way to vet and certify applications for operability, privacy, security and content. (The public-comment period for the first round of mobile application certification criteria ends Aug. 17.)
Happtique also plans to launch a service enabling physicians to write their patients “prescriptions” for pertinent mobile healthcare applications. Patients can then go to the site and download to their smartphones or tablet computers a specific application to fit their medical or preventive healthcare needs. “We're looking at apps in a similar vein as drugs,” Perlman says. “They are pills of information.”
Perlman already has plenty of competition. According to marketing information for Happtique, 63% of physicians are using mobile health solutions that are not connected to their practices or hospitals.
MobiHealthNews, a mobile health market research company based in Cambridge, Mass., reports that in April there were 13,600 consumer health apps and an estimated 5,200 medical professional apps now on Apple's App Store. According to Brian Dolan, the firm's co-founder and managing editor, developers of mobile health apps for Apple devices typically release counterparts for phones and tablets running on Google's Android mobile operating system, either simultaneously or soon thereafter. “And if it's in the Android store, it's almost certainly in the Apple store,” Dolan says.
Yet another competitor is Orlando Portale, chief innovation officer at the San Diego-based Palomar Health, who oversees development of the health system's own mobile application platform under the working name of MIAA, which stands for “medical information anytime, anywhere.”
When the new 288-bed Palomar Medical Center opens Aug. 19 in Escondido, Calif., plans call for fully leveraging mobile wireless technology throughout the hospital. In September, it will launch a new program “tying in the mobile platform with next generation mobile devices,” Portale says. “We're partnering with some companies that are reinventing the physiological monitoring space. You have sensors on the body that capture physiological indicators and connect them wirelessly.”
The MIAA will connect mobile devices to a hospital's EHR and “as well as information coming from medical devices, ECG wave forms, all that stuff coming from monitors from a hospital. We'll push all that stuff out and allow physicians to access it in real time.”
Palomar has licensed its intellectual property on MIAA to Airstrip Technologies for sale outside its system, Portale says.
From the physicians' side, demand for mobile apps has not yet peaked, says Dr. Jonathan Bertman, founder of Amazing Charts, North Kingston, R.I., a developer of EHR systems for smaller physician practices.
“Yes, slowly and surely, there is a push for more mobility apps, and I believe in the future that will be stronger,” says Bertman, who was named Physician Entrepreneur of the Year in 2010 by Modern Physician, a sister publication to Modern Healthcare.
His company has a dedicated mobile app to access its EHR, but “the interest of existing clients is not quite there yet.”
Privacy and security concerns are still an issue for his customers, Bertman says, “The whole question that gets asked is the privacy issue. So often we hear about the breaches of the scale you just can't imagine.”
Health insurer Aetna recently received approval from Apple for an iPad application that runs on the 4G network. Aetna plans to launch the app in a few weeks, says Dr. Charles Kennedy, CEO of its accountable care solutions unit.
The demand is already here from people who are integrating smart devices into their everyday activities, Kennedy says. “They're seeing what's coming out,” and then turning to healthcare and saying, “I can do this stuff, why can't I do this other stuff.”
The new devices have raised the bar for EHR vendors, who no longer will be able to rely on Web browsers to connect mobile device users to their clinical systems, he says. They must develop mobile-enabled versions of their systems.
“Web-based products make the customer frustrated,” Kennedy says “They say, 'Why can't my experience be like on an iPad?' ”
He recently led a round table of 80 customers to preview the new application with attendees representing about 10,000 doctors. “The feedback that I got, the minute you get the iPad out, I will make that a mandatory device and I'll get the doctors to use it. Call me in six months. But my gut tells me that this technology is going to have a shift in the use of EHRs. I don't think doctors want to use keyboards and machines plugged into the wall.”