1. Keys to Building a Successful Mobile
Health Strategy
David Lee Scher, MD
DLS Healthcare Consulting, LLC
digitalhealthconsultants.com
blog: davidleescher.com

2. “The most valuable commodity that I know of is
information”. –Gordon Gekko, “Wall Street”

3. What is mHealth?
Diverse application of wireless and mobile
technologies designed to improve health
research, health care services and health
outcomes .

5. Pew Internet/CHCG Surveys

6. Developments Supporting mHealth
Adoption
• Implementation of electronic health records
• Release of FDA Guidance on Mobile Medical
Apps
• Growth of Patient advocacy (Health 2.0,
Quantified Self movement), Social Media
• Wearable sensor and remote monitoring
technology development

7. Why is mHealth Good for Patients?
• SOMETHING MUST BE DONE to IMPROVE HEALTHCARE
• Promotes patient engagement (self-management)
• Provides educational resources and content development
• Improves doctor-patient relationship
• Creates personalization of healthcare -> ?better outcome
• Convergence of many technologies -> simplification,
convenience
• Supports caregivers’ mission

9. Which Mobile Apps Patients Want Their
Doctor to Have
• 42%: An app to see their test results.
• 33%: App connected to remote monitoring
devices.
• 30%: Access to patient health records via
mobile device.
• 13%: Didn’t think apps would help improve
care at all.
Source: 2012 Ruder Finn mHealth Report

10. • GENERAL HEALTHCARE AND FITNESS
– Fitness & nutrition
– Health tracking tools
– Managing medical conditions
– Medical compliance
– Wellness (traditional and corporate)
• MEDICAL INFORMATION
– Reference
– Diagnostic Tools
– Continuing Medical Education (CME)
– Alerts and Awareness
• REMOTE MONITORING, COLLABORATION, AND
CONSULTATION
– Remote monitoring (safety)
– Remote Consultation
– Remote Collaboration
• HEALTHCARE MANAGEMENT
– Logistical & payment support
– Patient health records

11. Facts About Health Apps*
• 97,000 mHealth applications are listed on 62 full
catalog app stores.
• 15% are designed for healthcare professionals
(CME, RPM, healthcare management).
• 42% of apps: Paid business model.
• Top 10 mHealth apps generate 4 million free and
300,000 paid downloads per day
*Research2guidance, 3/13

12. Barriers to Adoption of mHealth
• Incomplete regulatory guidance
• Lack of reliability, security/privacy
• Lack of mobile strategy by providers (BYOD, M2M
integration), payers
• Lack of smart phones by older, chronically ill pts
• Lack of business models
• Lack of proven reimbursement, return on
investment
• Physicians’ fear of high volume useless data

13. >90,000
medical
apps/programs
Clinicians:
“Not
medically
sound”
Consumers:
<1/10 of
apps used
more than
once
Business:
“Doesn’t
make me
money”
From Megan Ranney, MD

14. Remote Patient Monitoring

15. Attributes of Ideal RPM
• Provide continuous surveillance with
only actionable, trending data
• Unobtrusive
• Interoperable with other devices and
EHR/portals
• Have associated robust analytics with
clinical decision support

16. Mobile Cardiac Monitoring

17. Diabetes

18. Transdermal Patch w/Continuous
Glucose Monitoring

19. Blood Pressure Monitoring

20. Pulmonary Monitoring

21. Complete Vital Sign/GPS Monitoring

23. Sensors: MEMS
• Implantable Sensors
• Wearable Sensors
• Biochemical sensors: glucose, pulse ox
• Positioning sensors

24. Wearable Physiologic Monitoring

25. Footwear Sensors

26. mHealth: Smart Phone Capabilities

28. Medication Adherence Apps
• MyMedSchedule
• Mymeds
• RxMindMe
• GloCaps

29. Proteus Digital: The Ultimate Adherence App

30. Role of Social Media in mHealth
• SoMe is mobile
• Patients use smartphones for health
information
• Patient-centered companies emerging
• New market/business model for Pharma and
med device companies

31. Social Media: Critical Role inmHealth
Strategy

32. 4/6 Most Used Mobile Apps are SoMe-Based*
*GlobalWebIndex, 2013

33. SoMe and Healthcare
Online patient support groups
– Clinical trial recruitment
– Peer and caregiver support
– Disease specific education
– Healthcare navigation
– Convenience
– Anonymity

34. mHealth and Clinical Trials

35. Advantages of Mobile Clinical Trials
• Recruitment of patients via social media
• Real-time adverse event reporting
• Bidirectional patient-provider interactions
eliminate visits
• Easier communications among all trial
stakeholders (regulators, sponsors, investigators)
• Facilitates medication adherence (reminders, pill
sensors)
• More efficient data collection, reporting, auditing
• NO MORE FAXES!

36. Healthcare is still working in silos in
many European countries
Hospital Care Physician Care Emergency Care Outpatient Care
No cross-border workflows, processes, no data exchange and access
Absence of legal and regulatory frameworks, e.g. for liability
Missing health-economic validation and bench-marks
No incentives for providers, payers and patients to use mHealth
Rainer Herzog, HealthActiveConsulting©

37. Regulatory agencies and policy makers
• National / international standard protocols for e-/m-Health
• Security and privacy of data
• Data integrity, availabilty and auditability
• Risk management
Food & Drug
Administration
(FDA)
USA
Medical
Device
Directive
(MDD)
EU
Office of the
National
Coordinator
(ONC)
USA
CE Quality
Mark
EU

38. A Strategic Framework for Hospitals and Health Systems
Present and Future State of mHealth
New Care Models
Technology
ROI and Payments
Policy
Privacy and
Security
Standards and
Interoperability
www.himss.org/mobilehealthit/roadmap

39. New Care Models: Healthcare in
Transition
• Acute care  Chronic Disease Management
• Aging at Home
• Hospital Readmission Prevention
• Caregiver Involvement

40. mHIMSS Roadmap
• ROI/Payment: Addresses financial aspects of mobile tech
adoption
• Legal & Policy: FDA mobile medical app Guidance
• Standards & Interoperability: Types of
networks, communication patterns, standards above and
below the network layers, network/storage
tradeoffs, syntax and data, app standards, Blue Button
Interface
• Technology: Factors to consider in app development
• Privacy & Safety: Current state and future considerations

41. What is the Best Measure of the State of
Adoption?
The HIMSS Mobile Technology Member Survey,
2013
Released February 26, 2014

42. HIMSS Survey: Respondent Profile
• 62%: IT professionals
• 27%: Responsible for developing the
organization’s mobile tech policy
• 38%: Member of committee responsible for
developing the organization’s policy on mobile
tech
• 22%: Responsible for implementation and
operation of mobile tech

43. Highlights of 2013 HIMSS Mobile Tech
Survey
• Prioritization of Mobile Technology:
Average score: 5.25 (range=0-7)
• Maturity of Mobile Technology Environment:
Characterized at 3.95, increased from 3.33 in
2012
• Impact of Mobile Technology on Patient Care:
33%: will substantially or dramatically impact
patient care, decreased from 2/3 in 2012

44. Takeaways From HIMSS Survey
Mobile Technology Policy:
59% have mobile tech policy, 29% in
development.
App Development:
Apps within their organization likely to be developed
by third party.
½ plan to expand app usage.
Barriers to Mobile Technology Use:
#1= Funding

45. Significance of the Survey
• Identifies the decision-makers
• Identifies market penetration more
accurately than industry analysts
• Identifies pain points of mobile tech
adoption
• Useful for
developers, analysts, healthcare
enterprises, IT vendors

46. Challenges
• Increase awareness and mobile tech by older
consumer/patients
• Need filtered actionable data/alerts
• Full connectivity with EHRs
• Clinical efficacy studies
• Interoperability among apps and platforms
• Complete, reasonable and appropriate regulatory
requirements
• Funding for mobile strategies (private, public)

47. Questions?