Is mHealth at a crossroads? A visit with the NIH Public-Private Partnership Program

A little over two years ago, I wrote a cheerlead-y piece on mHealth entitled “6 Reasons why mHealth is different than eHealth” (most of the stuff I write on here is cheerlead-y, everything except keeping secrets from patients, I don’t cheearlead that). I just reviewed it again, and the 6 reasons weren’t all reasons why mHealth is “easier,” just different. Several aspects of mHealth are more difficult than eHealth.

It’s now two years later and what has changed? I was graciously invited to a dialogue organized by the National Institutes of Health Public-Private Partnership Program on mHealth. Thank goodness this program has a web site so I don’t have to describe what they do, and thank goodness Barbara Mittleman, MD said, “Of course” and set up a hashtag immediately when I asked if I could tweet (it’s #nihmhealth).

If the definition of innovation is “a good idea executed well“, then maybe mHealth is at a crossroads, just because all the good ideas out there are not fully actualized across the health space.

The NIH Public-Private Partnership Program is having a 2 day meeting that brings together government/public and private entities to dialogue on the ways that the benefits of mHealth could reach more people, in the United States and globally.

A theme I heard today was that some of the applications are not based on the best science, and some of the scientists are not as good at creating applications, so this is an area for collaboration. Another theme was about perceived usefulness and usability. And then there was this one:

I’ve been checking in on mHealth now and then over the past two years and it’s undeniable that it is being woven into health care. Maybe not as fast as people would like, but it is happening. In 2010, you couldn’t e-mail your physician at Group Health Cooperative or Kaiser Permanente from your mobile phone. Now over 9,500,000 people can (see: The mHealth app from @GroupHealth promotes what people want : A relationship with their doctor” and “Siri, email my doctor“) , as easily as they would access their doctor via the web. I don’t have data on the Kaiser Permanente experience yet, but as soon as I do, I’ll post it here.

Vanity data or actionable data?

Actionable and/or Vanity

Emailing your doctor, making appointments, and reviewing lab test results make common tasks much easier. Then there is this. On the left is the device I use to quantify myself, on the right is the device+software that an awesome colleague of mine uses to quantify themselves. As I am reading Eric Ries The Lean Startup (more on that soon), I am reminded by the difference between “vanity metrics” and “actionable metrics.” I don’t which is which for whom and I don’t know what the population breakdown is for people who need what.

Individual behavior or social determinants or both?

My other sojourn since 2010 has been to understand social determinants of health better, the “causes of the causes” of poor health. If the impacts of those are far greater than individual behavior choices, what are the apps yet to be written that take this into account? What apps could be created to give the voiceless a voice, and/or impact community conditions in addition to/instead of individual behavior.

As I have said here many times (and I will repeat), “I am not that smart and my ideas are not that unique,” which means these desires are shared by many people I have spoken to, which also means we are going to get there.

I liked the reframe of my comment “Is mHealth at a crossroads,” as “Is medicine at a crossroads,” which I think is a fair way to look at things. As I have said here many times I am not that smart and my ideas are not that unique, which means these desires are shared by many people I have spoken to, which also means we are going to get there – to good ideas executed across social strata, to influence individual behavior as well as to reduce health inequalities.

Which stakeholders should be included? Guess…

I recommend following the work of the National Institutes of Health Public Private Partnership, who plan to continue this dialogue and invite more stakeholders to participate. I learned that they are very committed to success in this space and are willing to help connect the best research to the best use for Americans. Oh, and they will invite patients/consumers/people to be part of the conversation. I wrote this for you, Regina Holliday!


Ted Eytan, MD