mHealth Task Force issues recommendations

Within five years, mobile health technology should be fully integrated into the ideal model for healthcare delivery. To accomplish this, however, leadership and collaboration is required.

That's the easy conclusion drawn from the mHealth Task Force Findings and Recommendations, a 26-page report released Tuesday by a committee convened by the Federal Communications Commission to chart the course of mHealth. The harder part will be overcoming some of the barriers listed in the report and getting many different and disparate groups – ranging from overstressed doctors to territorial federal and state agencies – to buy into the philosophy.

The report leads with sobering statistics: The United States ranks 37th in the world in healthcare system performance, yet spends more on healthcare as a percentage of its Gross Domestic Product than any other nation. In addition, the Institute of Medicine has estimated that the nation is wasting as much as $765 billion a year in healthcare and seeing more than 750,000 people die each year to causes that could have been prevented by proper medical practices.

"mHealth can inprove patient care and create cost savings by capturing information for providers and allow(ing) them to rapidly analyze large amounts of information to better understand a person's health trends over time," the report states. "mHealth also offers the promise of giving patients easier access to their health information, and it allows the mining of data to improve cost transparency, increasing efficiencies across the continuum of care and enabling more accurate diagnosis and treatment."

The report, introduced at a Sept. 24 news conference by FCC Chairman Julius Genachowsky, comes with five recommendations, each of which breaks down into a number of even-more-specific directives, including the recommendation that the FCC fill the open position of FCC Healthcare Director. The recommendations are:

1. The FCC should continue to play a leadership role in advancing mobile health adoption. This would include hiring a healthcare director, improving educational outreach activities, launching a healthcare website and furthering the work of the mHealth Task Force.
2. Federal agencies should collaborate more often to promote innovation, improve product safety protocols and eliminate duplicate regulations. This would include the creation of a formal working group convened by the Secretary of Health and Human Services; more collaboration between the FCC and Food and Drug Administration on regulatory issues; more collaboration by the FCC, the Office of the National Coordinator for Health IT and the Centers for Medicare and Medicaid Services on health information exchange efforts; continued work by the FCC and CMS on broadband needs of healthcare providers; more work on the sharing of health data between agencies to improve population health; the development of a standard health technology nomenclature; and the development of health messaging and communication standards by the ONC with input from the FCC
3. The FCC should continue to work on expanding broadband access for healthcare. This would include expanding the Rural Health Care Program and determining if it can support wireless technology; allowing the FCC to permit consortium applications in that program; allowing the Lifeline program to support fixed and mobile broadband services and giving that program a goal of promoting healthcare delivery.
4. The FCC should continue to increase capacity, reliability and interoperability of mHealth technologies. This would include adding to the available licensed spectrum for mobile broadband and working with international partners to set aside and harmonize that wavelength; creating environments for the development of new wireless services and products; modifying SAR testing requirements to account for intermittent data transfer from medical devices; and addressing the issues of affordable connectivity and compatibility to simplify telehealth service to home environments.
5. The industry as a whole should support investment, innovation and job creation in mHealth. This would include supporting innovative, cost-effective and clinically relevant technologies; the adoption of standards-based technologies to transmit and encrypt health data; the development of and access to secure and trusted application interfaces for health data services such as electronic health records and health information exchanges; and support for collaborative opportunities, including public-private partnerships.

The road ahead isn't without potholes, according to the task force. Listed in the recommendations are several barriers that will have to be overcome, including a lack of access to fixed and mobile broadband coverage, particularly in rural areas; bandwidth issues caused by overuse and data-intensive medical apps; patient safety, privacy and interoperability issues; reimbursement questions; a "broadband adoption gap;" and a lack of secure messaging between health information systems.

Along with the barriers, the report also cited some positives. According to recent studies, 40 percent of physicians surveyed said they could switch as much as 30 percent of their office visits over to mHealth interactions, thereby improving physician supply and shortage forecasts for the next decade and beyond. The report also cited the Veterans' Administration, which has said that using telehealth to coordinate patient care could reduce the number of bed days of care by 25 percent and hospital admissions by 19 percent, while leading to improved patient satisfaction and "substantially" less expenses per patient per year.

The task force is co-chaired by Julian Goldman, medical director of biomedical engineering for Partners Healthcare, an attending physician at Massachusetts General Hospital and director of the CIMIT Program on Interoperability; Robert Jarrin, senior director of government affairs for Qualcomm; and Douglas Trauner, CEO of Health Analytic Services (TheCarrot.com).

It consists of representatives from Partners Healthcare, Qualcomm, Health Analytic Services, AT&T, the Medical Imaging & Technology Alliance, CHRISTUS Health, Medtronic, the U.S. Department of Health and Human Services, the Alfred Mann Foundation, WellDoc, Telcare, the George Washington University School of Medicine, West Health, Verizon, iMedicalApps and mHIMSS.
 

Eric Wicklund

Editor of mHIMSS.org

Follow Eric on Twitter @eriwick