Expanding on our thoughts, I wanted to discuss some issues surrounding the Telemedicine/mHealth/Wireless Health Solutions. Here is a brief list:
1) “HIgh Definition Living” – This term has been used to describe a typical Health Gateway where the consumers keep close tabs on their healthcare/illness and supplement their physicians care regimen. This poses an important question, “Who will take responsibility of your healthcare, if you won’t ?” Patient accountability is critical in healthcare, but do we have the necessary tools to equip our patients and have them engaged? I would rather argue that their is a strong trend suggesting a rise in such tools and this will be the future of medicine. Today, “we are living in low-definition health system –Dr. Brigitte Piniewski“, and we must continue our march towards the high-definition living. The big premise is that one should not be waiting until one becomes sick to use healthcare infrastructure, rather the “high-definition healthcare” tools guide you regularly on your lifestyle choices and specific needs.
2) Health Vs Illness – In keeping up with the above trends, do we have a good measure of health (direct or indirect)? Shouldn’t this be factored in technological developments? It is normal to measure illness and prevent illness, but I would argue it would be optimum to measure and stay healthy. Perhaps, this would be addressed as we get a buy in from the users of mHealth technologies. For instance, a large chunk of health problems can be linked to lifestyle. Engaging folks in their own well being through technologies that modulate and measure mobility/activity may help improve health and stave off illness.
3) Pink Ribbons Vs Community Health Drives – Pink Ribbon march for fundraising, is it advancing science? May be, but only marginally. Adoption of science and mHealth technologies/tools may provide a better route to engage folks, inspire each other and generate data to lead us into our future, staving off illness and improving the quality of life. The key question is, are we prepared to give up a bit (perhaps a large bit) off our privacy to achieve this goal? This space is not well regulated, but it does not mean it cannot be. The data needs to be simple, de-identified and mobile (cloud based). It needs to be activity status Vs HIV status; it needs to modulate patient behavior. One may also argue the costs and scalability of mHealth solutions, and rightfully so. Ideally, these mHealth solutions should be cost-effective and scalable (or modular) to fit in every household.
4) Islands of Data Vs Conglomerates of Data – Data storage from most mHealth/Telemedicine/Wireless Healthcare Solutions are Islands of data. But shouldn’t we rather be looking at co-occurrences of events (Conglomerates of Data). This choice should always be guided by, “is your choice of measurand(s) promoting health ?” For example, measuring weight Vs workout status with calorie intake & nutritional status. Another example, measuring infection status Vs measuring basal temperature with ulcer trajectory & pain in a foot ulcer patient with a wound imaging technology.
We lack a standard unit of measuring health. This gap cannot be filled instantly. their needs to be a paradigm shift from a episodic/sick-care health model to a futuristic predictive health model.
5) Fee for Service Model Vs Self/Community Subscription Model – It is rather obvious that the biggest barrier in advancing this paradigm shift is reimbursement. Perhaps, we have to overlook the conventional fee for service model, and consider a self/community subscription model. We all subscribe to wall street journal for our investment needs, we subscribe to ADT/Brinks for our home security, Comcast for our cable, Vonage for our telephony, AT&T/Verizon for our phone service. Can’t we subscribe to mHealth for our own healthcare, to advance healthy living.
I hope we can advance this interesting discussion!