mHealth Isn’t an EHR

Secretary of Health and Human Services Kathleen Sebelius addressed the mHeath Summit Monday telling an audience of mobile operators, device and technology vendors and entrepreneurs that the Obama administration can help them accelerate the adoption of their health technologies, just like it helped electronic health record vendors.

The mHealth Summit is an annual forum that discusses the use of mobile technology to improve health outcomes in the United States and abroad. The three day forum, going on now, is taking place in National Harbor, Md., and is expected to draw more than 3,500 people.

Sebelius’ speech was a call for all of the parties in the room from both the private and public sectors to collaborate. She pointed to numbers released last week from the Centers for Disease Control and Prevention that show positive growth in EHR adoption as evidence of what can happen when the government creates policies that promote certain technologies. The CMS survey found that 34% of physicians using EHRs is up from 25% in 2010. That growth is largely due to the incentives the government has promised to pay practices that use electronic records according to government guidelines.

“Let me be clear: there is no more powerful force for innovation than American entrepreneurs. Government couldn’t replace the private sector as the primary force behind developing new products if it tried. And we don’t want to try,” Sebelius said.

“But government can play a limited but crucial role as a catalyst. And electronic health records are a perfect example.”

But mHealth is different. It isn’t one device but a category of many different technologies. And it isn’t nearly as clear as to how government policies can help promote the field as it was with EHRs.

Sebelius tried to outline a few ways health care reform could potentially steer the development of mHealth technologies.

“There are shared savings programs that allow doctors and nurses to benefit when they help patients manage their chronic conditions and stay out of the emergency room. Another new program will help them improve coordination during care transitions so that patients who leave the hospital don’t have to come back,” she said.

Both of these changes made by the Patient Protection and Affordable Care Act represent avenues that mHealth companies can pursue when designing their technologies. And contained within PPACA are many, many more.

This is different than the way the government promoted the use of EHRs. The Centers for Medicare and Medicaid Services clearly outline EHR incentive programs. EHR vendors had their work cut out for them; to be marketable they had to make sure their product qualified users for these programs. Also, these incentives were incorporated into the American Recovery and Reinvestment Act passed in 2009, not PPACA passed in 2010. EHR incentive payments began to take place in 2011, while some of PPACA’s biggest changes won’t go into effect until 2014.

Then for forward thinkers, there’s that nagging possibility that reform won’t even come and all efforts now to plan for the future will be meaningless. Several Republicans vying for the presidential nominee, including former Massachusetts Governor Mitt Romney and former Speaker of the House Newt Gingrich, have said they will repeal the health care law if elected in 2012.

So health care companies are trying to design technologies for the health care world of the future that they can’t clearly picture yet. Sebelius asked for support despite this.

“So today, my first challenge to you is to be supporters of all the innovations underway in our health care system, not just those that directly involve mobile tools,” she said, referring to new and never before seen changes that will come with the health care reform law as it currently stands.

It’s a request that involves a broad set of innovations, and it’s hard to pinpoint exactly how prepping for PPACA will benefit mHealth developers. But the uncertainty might not be a bad thing. These companies have a lot more room to explore compared to EHR vendors. We don’t know exactly what type of health care system we’ll find ourselves living in in a few years. Whether the government clearly defines new health care programs on paper or not, technology developers are going to shape them in unthinkable ways.

Sebelius left the audience with one last piece of general, but good advice. Design health technology with one main beneficiary in mind ― the patient.

“If you want mobile health technologies to succeed, the best thing you can do is help move us towards the kind of patient-centered health care system that allows those technologies to make the biggest impact,” she said.

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