This week, I had the privilege to present at the Energy and Commerce Subcommittee on Commerce, Manufacturing and Trade Hearing that took place in Washington, DC. As part of the “Disrupter Series: Health Care Apps” hearing, leaders in the healthcare industry discussed how mobile applications are disrupting the ways in which doctors and patients engage in the health care system and impact the affordability, accessibility, and delivery of care.
Non-stress tests (NSTs) are the current standard of care for monitoring high-risk pregnancies. Intended to reduce the risk of stillbirths, these tests are for those who have one or more risk factors, whether they be maternal, fetal or obstetric complications.
Currently, these tests can be very time-consuming for patients. NSTs involve attaching the mother to fetal and contraction monitors to watch the fetal heart rate tracing and uterine activity. However, many rural and remote areas don’t have ready access to NSTs. Consequently, mothers sometimes travel up to several hours each way to get to our facility for their NST appointments once or twice a week. Once they arrive, there’s the usual wait time, the 30-60 minute testing process, plus an additional wait time for the test to be interpreted by a staff member and a clinician. These appointments, on top of any additional prenatal visits the mothers have scheduled, can therefore add up to a considerable amount of time, even for patients who live nearby.
Over the past year, the perception of mobile technology in healthcare has changed dramatically. mHealth is now being recognized as a tool that can help address the challenges our healthcare system is facing, including a shortage of caregivers, an influx of newly insured patients, decreased reimbursements and readmission penalties. Historically, there have always been barriers that kept hospitals from making the leap to mobility – lack of infrastructure, costs, or the fear of security breaches, among other reasons. Yet as mobile technology becomes deeply ingrained in our day-to-day work and social lives, healthcare is following suit and migrating toward mobility as a component of care delivery.
However, concerns about security remain at the forefront. According to data from the Department of Health and Human Services (HHS), more than 41 million people have had their protected health information compromised in a reportable HIPAA privacy or security breach. Additional data from the 2014 Healthcare Breach Report from Bitglass suggests that 68 percent of all healthcare data breaches are due to device theft or loss and 48 percent of breaches involve a laptop, desktop or mobile device.
The pace of mHealth innovation shows no signs of slowing down. New technologies are not only improving the lives of patients, but also empowering clinicians. However, healthcare is a highly regulated space dominated by major vendors, and it is vital that the regulatory environment keep up with the changing world. Specifically, it’s time for the Department of Health and Human Services (HHS) to take a fresh look at the Health Insurance Portability and Accountability Act (HIPAA) to ensure it better fits today’s mobile world.
Current HIPAA guidelines – while critical – need to be revised to support smaller companies that can transform the space. Leading app developers across the industry are working together to seek clearer guidelines that will encourage innovation. The App Association recently joined with AirStrip, CareSync, and other mHealth companies urging government representatives to look at this issue so we can better align our practices with theirs and together work towards the goal of improved patient care.
There are more mobile devices than there are people on the planet. Many of us look at our phones more than 70 times a day. We bring them with us everywhere we go – to the movies, to our children’s soccer games and to work.
Many of us even have work environments that allow us to ‘bring your own device.’ If that is not an option, our work devices (thankfully!) are looking more and more like our personal devices. And in healthcare, we are now successfully addressing challenges to building mobile healthcare solutions that support our natural use and knowledge of these devices in our life flow.
Since patient care and well-being is at the center of Rockdale’s mission, attracting the best and brightest clinicians in the region is an important effort for us. Part of distinguishing ourselves from our competitors is providing the resources and advanced technological support clinicians want. In fact, to support this shift, we formed the Information Technology Physician Engagement Group in 2013 to identify exactly what were the technology priorities for our physicians:
- Improved cellular service
- Improved physician Wi-Fi
- Single sign-on access
- Mobile technology for better efficiency
The House Energy and Commerce Committee’s recent questions to FDA are seeking much-needed clarification of the agency’s policy of regulating certain mobile medical apps as medical devices. I’m very pleased to see the FDA responding to attempts to clarify the “gray area” of the guidance it issued in July 2011. Following three days of hearings last week on rules for these products – including the impact of FDA oversight and the potential for new taxes – I hope the FDA will take the following patient safety issues into consideration: Continue reading