A call for collaboration

Lawmakers and industry groups are urging federal agencies to collaborate on efforts that will accelerate the adoption of mobile health technologies among healthcare providers and patients.

A mobile health task force convened by the Federal Communications Commission set a goal last week for what's considered mHealth—mobile health, wireless health and e-care technologies—to become a routine best practice for medical care within the next five years.

However, barriers remain to that level of adoption in the healthcare industry, both in the development of the technology and infrastructure as well as with the federal agencies that are responsible for regulating wireless and medical devices.

Some organizations have been concerned that “there is a policy curve and a technology curve that are spatially disconnected,” said Tom Martin, a manager at mHIMSS and a task force member. mHIMSS is a mobile initiative of the Healthcare Information and Management Systems Society.

The task force recommended that the FCC continue to play a leadership role in advancing the adoption of mobile health, which includes a wide range of technologies from remote patient monitors and mobile medical and health software applications to medical body area network devices.

“We've seen, over the last several years, a steady stream of new examples of the ways that broadband technology, particularly wireless technology, can transform medicine,” FCC Chairman Julius Genachowski said last week during a panel discussion.

The task force also said federal agencies, including the CMS, the Food and Drug Administration, and the Office of the National Coordinator for Health Information Technology, should increase collaboration on mHealth to “promote innovation, protect patient safety and avoid regulatory duplication.”

“Modernizing the healthcare ecosystem is a national priority that requires close collaboration and prioritization among all stakeholders,” the task force said in the report.

In April, six lawmakers sent a letter to Genachowski and FDA Commissioner Dr. Margaret Hamburg requesting an update on coordinated FCC and FDA activities over concerns that momentum for shared collaboration on mHealth issues had slowed since the two agencies signed a memorandum of understanding in 2010.

“We are concerned that applying a complex regulatory framework could inhibit future growth and innovation in this promising market and could preclude tools that help patients better manage their care and allow the health system, as a whole, to reduce costs and improve quality,” the lawmakers wrote.

Meanwhile, the office of Rep. Mike Honda (D-Calif.), who represents Silicon Valley, said he plans to introduce legislation in November that would create an office of mobile health at the FDA in an effort to ensure that the agency is better equipped to work with companies developing consumer health technology, such as diagnostic tools that attach to a smartphone.

The FCC had announced plans in May to allocate spectrum for medical body area networks, which will use a wireless sensor to transmit a patient's physiological data to a nearby hub. The technology is expected to limit the number of wires tethering a patient to a hospital bed.

Attention to mobile health has increased among other government agencies. The FDA said last week that it will address information security risks for software in medical equipment after a Government Accountability Office report questioned how devices using wireless technology are protected.

“Examining the information security risks of certain active medical devices, especially with respect to intentional threats, is a relatively new field for federal regulators and information security researchers,” according to the GAO.

Security and privacy, reimbursement, interoperability, affordability, patient access to broadband and the impact of new technology on a hospital's workflow are mobile health issues that have raised questions.

Reimbursement, in particular, concerns providers and industry groups.

Increased interest in new payment models may better align reimbursement for new mobile or wireless technology that aims to improve communication between providers or between a provider and a patient, said Hank Fanberg, a task force member and director of technology advocacy for Christus Health, which operates hospitals in Texas, Louisiana and New Mexico.

“If you look at where healthcare is going, it's around coordinating care,” Fanberg said.

While some states have laws for reimbursing telehealth services, other technology that can improve the quality of care or prevent readmissions may not be reimbursed under a fee-for-service model. The task force recommended that the FCC coordinate with the CMS and the CMS Innovation Center to test reimbursement mechanisms for mobile health technologies.