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Why are mobile apps lacking for hospitals, inpatient care?

By Kyle Murphy, PhD

- The market for mobile health (mHealth) applications is tremendous insofar as recent reports and projections are concerned. However, a closer examination of these apps show a serious bias toward the consumer (i.e., the patient) and much less concern for health IT solutions developed to benefit those responsible for monitoring and managing patients, healthcare organizations and providers.

“Eighty percent of the health apps being released are for the consumer,” Naomi Fried, PhD, Chief Innovation Officer at Boston Children’s Hospital, told the audience at the 5th Annual mHealth World Congress.  “Of the remaining percent of health apps that actually are clinical in nature, what we’re primarily seeing are existing websites and tools beings turned into mobile apps.”

According to Fried, the current offering of mHealth apps for healthcare organizations and providers has done little more than present existing tools in a friendlier (i.e., web- or mobile-optimized) format:

But all of these are examples of just changing the delivery mechanism of existing tools and content. Within healthcare, there’s actually a dearth of mobile apps being created in certain areas. I’m thinking in particular of the hospital inpatient environment. Relatively speaking, there are very few truly innovative mobile apps being created.

That prevailing focus of mHealth apps is on the consumer does make sense. Working directly with consumers allows mobile app developers to avoid working in an environment that is heavily regulated and therefore difficult to thrive in.

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“Issues of HIPAA privacy and security can be daunting to the uninitiated,” explained Fried. “Healthcare is a heavily regulated industry, and anyone thinking about developing a mobile app needs to respect these regulations if they’re developing in the clinical environments.”

As Fried noted in her presentation, the challenge of developing innovative mobile apps for healthcare is further complicated by the specter of the Food and Drug Administration (FDA) considering upping its role in regulating mHealth apps in a way akin to its regulation of medical devices. “This will certainly give most developers pause when thinking about building a mobile app for this environment,” she added.

Despite the seemingly perilous adventure that is developing mobile apps for healthcare organizations and providers, Fried stressed the untapped potential dormant within healthcare, an industry whose reliance on paper points to the need for serious innovation:

Hospitals are often still using paper, which takes up space and can get lost. And taking care of patients usually involves accessing a great deal of data that you want to have available on the fly. Mobile apps that could provide busy clinicians with access to data, replace paper, and give this to them all on the fly is an ideal solution.

The million- (perhaps billion-) dollar question facing mHealth developers in the hospital space is: What is preventing them from capitalizing on this opportunity?

According to Fried, there are several obstacles in the way, the first of which is the complexity (i.e., diversity) of health IT systems already in place within the inpatient settings.

“The hospital environment is usually running a variety of clinical solutions that a mobile app might need to connect to,” she observed. “It’s pretty complicated. Most clinical IT environments are very complex, hard to learn, and not one that most mobile app developers know much about.”

And that’s just one side of the coin. The other deals with the privacy and security issues which play a major role in how patients and their information is treated. This recognition, claimed Fried, would seem to point to the need for healthcare organizations and providers to develop their own solutions given their familiarity with the environment. That, however, is beyond the reach of many hospitals and clinical settings struggling to allocate resources appropriately.

Why don’t hospital IT departments develop mobile apps for the hospital environment? After all, they understand the clinical IT ecosystem. They certainly are aware of issues of HIPAA privacy and security. But I think you’ll find most hospital IT departments are extremely busy. Most of their workers are overworked, if not exhausted. They are busy supporting all those existing clinical IT systems, dealing with upgrades, complying with security, preparing for meaningful use and ICD-10.

The awareness of these challenges has led Boston Children’s Hospital to use an innovative approach toward innovative health IT, which has taken the form of the FastTrack Innovation in Technology (FIT). This program offers creative individuals and resource groups the opportunity to engage with developers to work through the many stages that mobile app development requires and hopefully bridge the gap between development and adoption.

Obviously, not all institutions can copy this model, but at the very least it shows that many of the great transformative ideas for reforming healthcare delivery already reside in the minds and workflows of those currently doing the work.

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