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Healthcare IT struggles to keep up with mobile health demands

Brian Eastwood | Aug. 28, 2013
Healthcare, like most industries, finds its hard to meet the mobility desires of employees (caregivers) and customers (patients). But while healthcare struggles with unique legal and regulatory impediments that other fields don't face, it's also poised to gain much more from what some call a 'mobile revolution.'

As Dunbrack puts it, the industry is still in a "look up, receive alerts" mode where the use of mHealth is largely limited to consuming data from EHR, imaging and e-prescribing systems - as opposed to creating that data on a smartphone or tablet - and engaging in asynchronous communication that's little different than waiting for a physician to answer a page or return a phone call.

Getting there won't be easy, of course. To adapt to a "mobile-first" culture, as Dunbrack and Hand suggest, healthcare IT departments very well may have to reinvent the wheel - they'll need to place added emphasis on everything from BYOD policies and mobile enterprise management to security infrastructure to mobile app development and application lifecycle management.

Make Mobile Health Apps Easy to Develop, Use, Replicate
For the Cleveland Clinic, the key to mobile health success has been making architecture, infrastructure and governance priorities, says William Morris, vice chairman of clinical informatics. (Morris, along with Ruppar and others, spoke at last month's mHealth World Congress in Boston.)

Focusing on architecture makes it easier to repurpose code and develop modules, Morris says. This reduces the likelihood that developers will have to build one-off mobile apps that come from fragmented, non-standardized requests. For the Cleveland Clinic, this meant developing a Web-based clinical services layer to manage a whole host of needs, including request routing, EHR access management, data validation and security, says Director of Technology and Innovation Brent Hicks.

It's also imperative to understand how new mobile apps will fit into clinical workflows, says Beth Reese, manager of the institution's Clinical Solutions Center. To do this, Hicks accompanies nurses on rounds to get to the root of the problem and develop an app that meets nurses' needs, not their own perceived needs. Plus, when nurses help develop the app, they don't need to be trained on it once it goes live.

Undergoing such a mobile application development process mirrors ICD Health Insights' short- and long-term recommendations for healthcare organizations aiming to embrace mobile health. Now is the time to be defining clinical mobility strategies, governance policies, usability criteria and the key performance indicators for determining a project's return on investment.

It will also help to align IT with line-of-business departments - as Cleveland Clinic did with nursing - and assess the top healthcare IT skills your organization needs.

Only once that has happened, Dunbrack says, should organizations start to plan for more "opportunistic" clinical mobile health deployments such as remote monitoring, telehealth and robotics.

Use Healthcare IT Challenges As Opportunities to Use 'Virtual Care'
In that sense, then, some may say that healthcare organizations are almost lucky that mobile health faces numerous growth barriers. These obstacles exist in the form of a looming deadline to implement EHR systems, the omnipresent challenge of health information exchange, the various technical and administrative hurdles of participating in an accountable care organization and trying to realize the potential of big data in healthcare. Oh, and then there's healthcare reform, which aims to do nothing less than change the payment model of what will likely be a $3 trillion industry in 2013.


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