Health Standards

Healthcare & Technology Resources

  • Blog
  • Podcasts
  • #HITsm Chat
  • About
  • Authors

The Problem With mHealth: You and Me

June 5, 2012 By Health Standards 2 Comments

Mobile technology is the epitome of cool. We’re walking around with powerful computers in our pockets that magically send and receive messages from thin air. These phones and tablets provide the answer to any question we don’t know, making everyone a “genius,” and the party’s really just getting started.

But there’s a big problem with mHealth, and that problem is the same one that gets in the way with everything aimed at improving health in our country: Us.

I’m a fan of comedian Louis CK. Don’t look him up if you’re easily offended, but he was dead on when he talked on Late Night With Conan O’Brien about how our expectations and demands change so quickly when it comes to technology. If you’re not one of the 6 million who have watched this 2009 clip on YouTube, it’s definitely worth your four minutes.

“How quickly the world owes him something, he knew only existed 10 seconds ago.”

Mobile technology is that shiny, accessible new toy. It follows in the footsteps of VHS, personal computers, Atari 2600, and too many others to name. Although mobile technology continues to evolve, people have embraced it into their lives, leaving no debate that it’s here to stay. The portability of mobile – the ability to reach people where they are at all times – has everyone imagining the possibilities of what can be accomplished, what problems can be solved and how much money they can make, and justifiably so.

Just last week, Darrell West published an article in The Brooking Institutions’ Issues in Technology Innovation, titled “How Mobile Devices are Transforming Healthcare (PDF).” In his in-depth article, West explores some very exciting ways mHealth technology is extending access to healthcare in rural communities and the potential it has in preventing or predicting outbreaks, such as Dengue Fever in India and Sri Lanka.

Giving access to healthcare to those desperate for help is the area I think mobile technology has the greatest promise for success.

A majority of the paper is spent describing mobile applications designed to help patients monitor existing conditions, such as Type II Diabetes and high blood pressure, and others designed to encourage healthy behaviors, such medication adherence, maternal care and smoking cessation – each areas of critical importance, no doubt. But isn’t there already plenty of literature and assistance freely accessible that addresses these conditions?

Several years ago I had the pleasure of working alongside Fernando Guerra, MD, the former director of health at the San Antonio Metropolitan Health District, on a public health project designed to educate residents about the city’s very real obesity epidemic. The project, as part of the city’s FitCity campaign, would distribute body mass index charts – then a somewhat new idea – to every physician’s office in town. Literature would accompany the charts asking the physician and his or her medical staffs to educate their patients about BMI and where they rate on system’s measurement scale of healthy, overweight or obese.

My hope was that these patients would have an epiphany and begin to work at improving their health, and the negative label of “fat city” would soon be removed from outsiders’ thoughts when they were asked to describe the residents of San Antonio.

After the charts were printed and mailed, I asked the physician members of the public health committee if they thought the initiative had been a success. Most thought that the initiative was a step in the right direction and that only time will tell if the outcomes would be positive. Dr. Guerra, one of the most genuinely compassionate and thoughtful physicians I have ever met, agreed, but offered a glimpse of reality when he said something to this effect: “Go to the bus station downtown and ask people waiting outside about BMI. If more than one person there is able to tell you what it is, then I’ll say it has been a success.”

That, to me, that illustrates a key problem with the American mHealth discussion: Supporters believe that digital access to mobile health apps will magically improve their health. The trouble is that mobile health can only provide access and greater information, it cannot provide the personal willpower needed to make difficult choices that may lead to healthy outcomes.

Is my positive contribution to this discussion simply: Everyone needs a swift kick in the pants? Is the real problem laziness?

No, but I do believe that personal responsibility is missing from the dialogue on mHealth, and it’s something that public health professionals have been preaching to no avail for decades. A shift in thinking and action is the X factor: converting personal motivation into community transformation. Maybe my thoughts are best summed up by something Louis CK said in the above video, “Give it a minute! It’s going to space!”

It is an awesome time in healthcare when so many smart, motivated people are all thinking about innovative ways to improve our national’s health care problems with these powerful, mini computers that we carry with us everywhere. Before, public health professionals were the lone voices of encouragement for the masses.

I look forward to the day in the not too distant future when I’m pumping gas and I hear someone complain as they’re looking down at their smartphone, “Oh, crap! My doctor just texted to remind me that it’s time for a checkup.”

For more information read:

  • Mobile: The health-care fix we’ve been waiting for? in The Washington Post
  • The Future is Quantified: Convergence of Trends, by Angela Dunn
The following two tabs change content below.
  • Bio
  • Latest Posts
My Twitter profileMy Facebook profileMy Google+ profile

Health Standards

Engaging conversations on healthcare and technology. Your source for health IT standards, healthcare interoperability, Meaningful Use, and health technology trends.
My Twitter profileMy Facebook profileMy Google+ profile

Latest posts by Health Standards (see all)

  • Will web APIs and HL7 FHIR change our views on data interoperability? - July 11, 2017
  • [#HITsm chat 11.18.16] Celebrate Passing the #HITsm Torch - November 15, 2016
  • Passing the #HITsm torch - November 10, 2016

Filed Under: Health care, mHealth Tagged With: apps, mHealth, mobile, responsibility, smart phones

  • georgemargelis

    Great post Chad. The goal of mHealth, actually all healthcare should be to improve health literacy, especially amongst the burgeoning chronic disease population. Whilst your point about personal responsibility is very pertinent,I think it is a multi step process. First they need to be able to diagnose their own situation, and enhancing their health literacy is an important aspect of that. Once they can recognise they have a problem, then they can start exploring how to manage or treat it. Then they can start sharing their experiences so that they can be properly evaluated, be it by crowd sourcing or other means, and finally we can build an evidence based knowledge base upon which to develop future policy and interventions. In that way we develop a high performance learning healthcare system.

  • wcjohnson

    Great comment. I agree with all of that, George. Enhancing and improving health literacy is an age-old problem and one I don’t think will ever go away. We love unhealthy behaviors and activities, otherwise we all would be models of great health. Self-knowledge is a powerful motivator for those who are in denial about how healthy they really are, or how healthy their behaviors may be. I think they are classified by public health professionals as “at risk.” I’m probably one of these individuals, and I would guess that a majority of Americans are as well. I see huge potential in mobile health technology and the quantified movement. When I wrote this, I was much more skeptical than I am today. Healthcare is rife with doubters and those who use negativity to stifle progress because it requires change. When dealing with such an important issue, and when the potential is so great, little is gained when wallowing in doubt. I do wish there was a way to increase consciousness in individuals who simply do not care nor possess the motivation to apply the effort required to become a better human. Let’s continue to collectively move the healthcare average in the right direction.

HL7 FHIR Resources

HL7 FHIR Resources

Connect

  • 
  • 
  • 
  • 
Tweets by @HealthStandards

#HITSM Chat

[#HITsm chat 11.18.16] Celebrate Passing the #HITsm Torch

November 15, 2016

Moderated by Chad Johnson, @OchoTex, HealthStandards.com Editor and Corepoint Health Senior Marketing Manager. November 18th will be the last #HITsm chat under @HealthStandards. Celebrate ‘Passing the #HITsm torch’ to @techguy @HealthcareScene.

Passing the #HITsm torch

November 10, 2016

The first #HITsm tweet chat was held almost six years ago on Jan 10, 2011. Since that time, we have hosted approximately 280 #HITsm chats. While some of you may have participated in that very first chat (only 15 actually participated), I’m proud to say that the chats and the community have continued to grow […]

View More #HITSM Chat >

Podcasts

‘Hactivist’ Fred Trotter on the Cancer Moonshot, open source data in healthcare, and more

August 3, 2016

Artificial intelligence is a topic that isn’t going away in the health IT and medical community. One reason it’s come as far as it has is thanks to open sourcing, or shared data. Today’s guest, Fred Trotter, has a lot to say about the Vice President’s Cancer Moonshot initiative – which he was recognized for […]

Sue Schade on gender equality, CIO challenges, and value-based healthcare

July 27, 2016

View More Podcasts >

Copyright © 2021 Health Standards. All Rights Reserved.