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.
When it comes to mHealth, most industrialised nations such as the U.S. and Europe have a head start. Money for healthcare technology investments is available, the infrastructure is in place, and most of the population is already engaged in the healthcare system.
As a country of about 52 million people, South Africa shares many characteristics with its larger brethren. There is a mix of public and private healthcare providers and health insurance plans, physician shortages in key areas, and South Africa is beset by many of the same chronic diseases that industrialised countries face (cardiovascular and obesity-related diseases, diabetes, etc.).
It is no secret that health systems are under intense pressure to deliver better outcomes at lower costs, and standardizing acute care workflow will only carry providers so far. Truly moving the needle on cost and outcomes will require a fundamental redesign in care delivery; otherwise, health systems may well find themselves left out. Care keeps shifting to environments in which hospitals have less influence: what was once critical care can now be managed in an in-patient unit; what was once in the hospital is now in an office; what was once in the office is now at home.
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
Many of my fellow clinicians see the ongoing health IT movement as a hindrance to the quality of care they are able to provide their patients. When they hear all this talk about “automation,” “streamlining efficiency,” and “mobilizing data,” it can seem that technology is replacing the human side of compassionate patient care with an assembly line that churns out procedures. Some clinicians see mobile technologies pulling them away from the bedside and turning patients into data points. But, if a hospital takes the right approach to this process change, that’s simply not the case. In fact, clinicians should find the exact opposite to be true as these solutions fulfill the promise of becoming a true mobile assistant – always there to improve workflow anytime, anywhere.