3 Guiding Principles for mHealth

by Patrick Quirk

mHealthmHealth seems to be a topic at almost every healthcare conference and webinar these days. It is a rising buzzword and by most accounts refers to eHealth via mobile platforms such as smartphones and wearables. Interestingly, some common concepts are already emerging as guiding principles for those working with mHealth.

1. Ownership of health records belongs with individuals
You may own the EHR, the claims system and the medical device, but the data stored within those systems belongs to the individuals they represent. Owners of these data systems have responsibility as data stewards to protect the privacy and confidentiality of the individuals to which the data belongs, and thus the data itself.

As more data enters traditional healthcare data systems, this concept will become clearer and increasingly important. Fitness tracker data is a great example of data which is not only owned by the individual, but also generated by a system owned by the individual. When this data is loaded into a provider's EHR, the ownership of the data does not change. The provider is simply trusted to care for the data.

Regardless of the source system, ownership of an individual's health data belongs with the individual.

2. Sharing of health information should not be limited to medical professionals, but available to everyone involved in the individual's health
Consider everyone involved in your health. MDs, PAs, RNs, pharmacists and insurers are on the list. How about your parents, spouse, children, friends, etc.? Do you have a health coach, dietician or a fitness trainer? What about a lawyer, psychologist or social worker?

Health factors, including personal behaviors and environment, have a much bigger impact on individual health than just the health care provided by medical professionals. Behaviors and lifestyle are much more likely to be impacted due to the influence and actions of family and friends than the advice of a medical professional. As such, an individual's ability to share select health information with anyone they choose may have more significant impacts to their health outcomes.

In short, mHealth provides an opportunity to see health data shared at unprecedented levels. Designers of mHealth systems and interoperability standards should keep a broad perspective in regards to when and with whom information may be shared.

3. Present actionable data to users
Would you like to sit down and review all of your individual medical records from your health care providers, your fitness tracker data, your insurance claims data, your pharmacy, etc.? The pure volume of health data for an individual can be overwhelming. To be effective, systems must identify the right data to present to the user and do so in a meaningful way in order to assist the user's decision making. This is true whether the user is a medical professional providing care or an individual.

By far, this is the most challenging of the three principles to execute. The heart of this principle is this question: Can individuals use the data available to make decisions which will improve health outcomes?

Guidance from medical professional will always be appropriate. However, imagine the positive impact to health outcomes if providers can include guidance based upon data from devices such as a fitness tracker. Such guidance could even be along the lines of "Send me a report from your fitness tracker if it indicates your resting heart rate goes outside of this range ## - ##." Such personal devices could be configured by the individual to send alerts to anyone they designate when such criteria are met.

Alerts are just one way of presenting just the right information at the right time. Rather than presenting a set of tabular data, graphically presenting data in the form of charts visualizing trends, percentages, patterns, etc. may often allow the user to come to a particular decision.

Healthcare will be transformed when systems are able to present:
○ The right data
○ To the right individual
○ At the right time and
○ In a meaningful way

mHealth presents truly exciting opportunities for advances in health outcomes, but it is just beginning to gain traction as a functional tool for health care. In order to fully realize the impact of these advances, individuals and medical professionals will need to make fundamental changes in how they interact. As mHealth matures, it is important to discuss principles such as these. They help health care professionals, individuals and system designers reach consensus on how to embrace the changes, keeping in mind that the end goal is to improve health outcomes.

Healthcare has always been about the patient. Healthcare processes and data systems should thus revolve around each individual and the unique factors of their health.

Special thanks to all those who have presented on mHealth recently and especially to those organizations who make such events possible including Central & Southern Ohio HIMSS, KY HIMSS, the Health Enterprise Network and the KY eHealth Summitt.