One of the hottest topics for speculation in healthcare today is the unrealized potential for mobile health -- defined as technologies that use mobile devices, apps or telehealth to connect patients and physicians -- to transform the way healthcare is sought and delivered. Two-thirds of Americans own a smartphone, and companies are eager to tap this widespread technology for the benefit of patients, doctors and hospitals. But expert say it's not yet obvious how exactly mobile services might be leveraged in the bureucratic world of healthcare with its highly sensitive privacy issues.
"The fact is that consumers are mobile so healthcare has to respond to that,” Shira D'Erasmo, a communications director at the insurance company Humana, said at a panel discussion on mobile health held on Thursday as part of the Third New York Health Forum at the Explorer’s Club in Manhattan.
Already, some companies have launched mobile services focused on easing the inconvenience for patients of dealing with the healthcare system. ZocDoc, Inc. is an online doctor-booking service that has been adapted for mobile. Kevin Kumler, the company's vice president, points out that it takes 18 days on average for a patient to book a primary health care appointment in the U.S. The service grants patients access to a physician's calendar to schedule their appointment right away-- much like consumers can use Seamless to order food online or Uber to call a driver.
Unity Stoakes, founder of StartUp Health, which provides consultation to healthcare entrepreneurs, said he is most excited by the notion that mobile health can apply elegant solutions to everyday problems for both patients and their caregivers. “Sensors can be embedded into and onto and around everything to understand really important and simple things like, 'Did Grandma get out of bed today?'” he said.
The nation’s largest companies are just as eager as its smallest to explore these possibilities -- D'Erasmo says Humana’s home care division, which provides at-home health services for elderly patients, has experimented with placing sensors in patients’ homes and using Skype or other virtual services to enable remote caregivers to attend doctors visits with a loved one.
Pharmaceutical companies have also begun to use mobile tech such as Fitbits or Garmin activity trackers to measure patient data during clinical trials. These tools and other such devices might allow researchers to constantly track vital signs, log a patients’ heartbeat pattern or trace the effects of a medicine, rather than only collecting this information during a check-up.
Even though some companies have begun to use trackers in their trials, the Food and Drug Administration has not yet approved any drug based on a result measured by a mobile health device. Kara Dennis, managing director of Medidata, which provides software support for pharmaceutical companies conducting trials, predicts this could soon change.
While she is optimistic about the future, Dennis said that there is still a ways to go to get there. "Mobile technology is still very new in the clinical research space," she said.
Additionally, a pharmaceutical company has a far more rigorous standard for data collection than a consumer who is planning their workout -- a device must be worn almost constantly in a clinical trial and measure data with extreme precision. It’s also recommended that a device can be worn in the shower -- which is not recommended for Fitbit -- and has a long battery life. "Those considerations become very serious when you're considering using it in clinical trials," said Dennis.
A recent lawsuit from a Florida man alleging Fitbit gadgets overestimate the amount of sleep that wearers receive by 67 minutes per night are also problematic. "If you’re overestimating sleep duration, we can't use that in a trial,” Dennis said. “We need to know how much the patient actually slept."
Les Funtleyder, a portfolio manager at Esquared Asset Management, said investors would be wise to keep a clear head when considering the potential of each new mobile health application. He sees five or six mobile health companies seeking investment a week and worries that many are overvalued. "I think mobile health is reminiscent of a bubble,” he said. But “I don't think they're in a bubble yet."
One of the current limitations, as Stoakes of Startup Health sees it, is that each mobile health company is independently trying to build its own hardware and software to deliver its services. The arrival of platform tools such as Apple’s ResearchKit, which developers may leverage to collect health data or conduct experiments, could absolve companies of this need and allow them to focus on perfecting their product or service.
Paula Wilson, president of Joint Commission International, which provides accreditation for hospitals, says that while mobile health could lead to great advances in healthcare, it will inevitably bring new risks. The vast majority of major healthcare data breaches that have occurred in recent years took place through electronic networks.
Still, Stoakes at StartUp Health believes that these technologies will soon become an essential part of all healthcare services. "Very soon, there won't be a separate category called mobile health,” he said. Instead, Stoakes said mobile devices will be fully integrated into the way that healthcare is designed and delivered.