The next big app

Mobile healthcare apps are multiplying fast and putting a vast array of new tools in the hands of patients and the providers who deliver their care. The pace and scope of innovation makes it hard to imagine what app developers will create next. So we put the question to some of the thinkers in the best position to know what's needed and what's possible.

The recent Healthcare Information and Management Systems Society convention in New Orleans brought together many of the brightest minds in the healthcare information technology field, and we asked them to describe the next big healthcare applications. Here are some of their edited responses.

Dr. Farzad Mostashari, head of the Office of the National Coordinator for Health Information Technology at HHS:

“The patient. We are going to be in an era where everyone is going to be looking to improve health and healthcare at lower cost. And we are going to be looking at every underutilized resource in healthcare. And the greatest, the most underutilized resource in healthcare is the patient and their family members—the uncompensated caregivers. I have been one. I suspect most of us at one time or another become one. And the power of the patient—if the patient is a partner in the healthcare system—is enormous, and I believe that health IT can help tap into that.

“Someone just told me the term 'behavioral informatics.' I love it. To me it's, how do we understand behavior change? And how do we use the tools of information, not just giving people knowledge, but actually helping people tap into … sometimes their irrationality. … Text messages (can) double smoking quit rates. That's pharmaceutical-level effectiveness. Think about that.”

Dr. Karen DeSalvo, New Orleans health commissioner:

“One of the exciting applications that I have heard about—and I believe it exists now—is attaching a (geographic information) tracking system to inhalers that children use who have asthma so that … the provider or the doc will know how many times the kids use the inhaler. And they might care where they are. I, as a health commissioner, really care where the kid is when they are using the inhaler, because if I see concentrations of kids using an inhaler at a certain school or in a certain housing development, that triggers to me there may be a problem in that building, environmentally with mold or something else.”

Dr. Eric Topol, health IT futurist and director of the Scripps Translational Science Institute:

“I think the one that makes the dashboard for your phone or alternative tablet, that pulls things together that are relevant for you. That would be important and there are a lot of these aggregating entities out there. So, I think that the ones that can pull all that data together, make it useful, that is going to be a real nice contribution.”

George Hickman, executive vice president and chief information officer at Albany (N.Y.) Medical Center and chairman of the College of Healthcare Information Management Executives:

“I don't know how imminent it is, but what I am seeing going on with certain biotechnologies in nanoscale happens to be pretty interesting stuff. And so I think while even today we may be able to put a pacemaker inside of you and monitor a lot of things about what's going on with you from that pacemaker externally, you are going to see more and more implantables and other things happening at that scale that are going to shape how healthcare is rendered and in very different ways.”

Dr. Charles Jaffe, CEO of the standards development organization Health Level Seven:

“I think the critical factor as we move ahead with evidence-based medicine and accountable care is finding a way to identify the signals that come out of the healthcare delivery system. This has been cleverly identified as big data, but it is always big data and now it will be ultra big data. In the past, we have always demanded that this data be codified and highly structured, and I believe that the next innovation will come from those organizations that are capable of mining data that we view as unstructured today. … We are working with a number of organizations hand-in-glove to make analytics of big data a reality.”

Dr. Deborah Peel, founder of Patient Privacy Rights Foundation, a privacy advocacy organization:

“People want control of their information. They want to be able to decide who sees it and make it go away. And so I think that the next big thing in healthcare is going to be that kind of control for patients over their information.”

H. Stephen Lieber, president and CEO, HIMSS:

“I think the thing that is going to drive healthcare next is Medicare is going to finally get a handle on payment issues. So the applications that help provider organizations and physician practices deal with, 'We are not going to pay for that duplicate test,' the things we have been talking about for years—we are going to have to have the technology in place to manage that challenge.”