Electronic Health Records

Adoption & Implementation News

When will mHealth become part of clinical workflows, EHRs?

By Kyle Murphy, PhD

While the adoption of smartphones and proliferation of mobile application have increased over the past few years, many healthcare organizations and providers are not ready to integrate mobile health (mHealth) data into their clinical workflows, according to the penultimate panel at the Information Management Network (IMN) Hospital Cloud Forum in New York City.

So what’s keeping providers from accepting information (i.e., biometric data) from patients’ devices and applications via the cloud? That was the precisely the question that the session’s moderator, Chilmark Research Founder and CEO John Moore, posed to the panelists of “mHealth — Balancing the Benefits and the Risks.” “When is this going to come into healthcare? When are providers going to start using this in the context of care?” asked Moore.

“We really found limited evidence that mHealth in and of itself has shown its effectiveness. We still believe there is a pony in there, but the truth is we’re still looking for the definitive approaches that give us those definitively-improved outcomes,” claimed Keith Toussaint, Executive Director of Business Development, Global Health Solutions, at Mayo Clinic. “If we get to the point where we’re able to marry the applications with effective biometric data capture that is well integrated with clinical workflow, that could change the story but we’re not there yet.”

While at present this integration is still its infancy or experimental phase, it is inevitable according to a fellow member of the panel. “I’d like to offer a vision as a longtime clinician who talked to lots of patients over the years that the cloud is where patients and physicians are going to meet,” observed Steven J. Davidson, MD, MBA, FACEP, FACP, who serves as Senior Vice President and CMIO at Maimonides Medical Center. “I believe they’re going to get that access on these [points to smartphone].”

According to Dr. Davidson, EHR-mHealth integration — the confluence of provider and consumer data — has much to do with generational perceptions of the practice of medicine:

The folks recently out of medical school totally get this and they’re just waiting for it. Those who are in primary care practice or those who are involved in innovative models of practice are looking for the information, and somewhat sadly (though it’s not universal based on age) there are more than a fair number of physicians hoping to age out of the practice of medicine before they feel even more besieged by patient information. I don’t know when it’s going to come. It’s like everything else. There are extremes in belief and most of us have to find some place in the center to cope: Be either the first to pick up the new or the last to put the old aside.

The experience of Maimonides encapsulates the impact that mobile devices and applications are having on the delivery of healthcare. By this upcoming summer, the medical center will be tripling its internet bandwidth and using no less than two internet service providers to ensure that its wireless network can support the increasing number of authentications and connections to the hospital’s network after less than two years of offering support for BYOD (bring your own device) and online access to visitors and clinicians.

What remains for the healthcare industry to resolve, therefore, is the means for validating data from multiple sources, not just from providers, and ensuring that these mHealth devices and applications are properly vetted. At stake are issues of trust both in terms of the sources of data and the integrity of the information flowing into a central record. With healthcare organizations and providers already mired in the adoption and meaningful use of EHR systems as well as improvements to data capture and clinical documentation, the added burden of mHealth is one they are unlikely to shoulder until the former are mastered.




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