Technologists have worked for years to break down data silos in healthcare. Then, just as it seemed they were starting to figure out interoperability, along comes a flood of mobile health apps that simply don't connect to anything.
A recent report from MedData Group, a market research firm based in Topsfield, Mass., found that many doctors doubt the promise of connected health, even though two-thirds use mobile apps professionally.
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Only 1 percent of the 532 physicians queried this past winter thought the U.S. healthcare system would be fully connected within a year, while 57 percent indicated that it would take more than five years to get there. The doctors cited lack of interoperability more than any other barrier except issues with data security.
While about six in 10 physicians surveyed said they would be interested in mobile access to EHRs, doctors tend to doubt that vendors will be able to create a "fully connected healthcare system in the short run, or that their local hospitals are prepared to implement it," the report says.
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Physicians also expressed concern that new technology will cost them more than it will save them. One respondent suggested that a well-connected healthcare system is "good for patients but nobody will want to ever become a doctor."
"Until [mobile health] information is intelligently managed, which requires high-intensity human oversight, which to date we have been unwilling to program or to pay for, we will continue to have only what our current technology provides: a vast and unmanageable amount of uncontrolled, non-vetted and non-meaningful information," MedData concludes.
That is precisely what Mark Blatt, MD, worldwide medical director for Intel, has noticed. Blatt believes there is a "fundamental problem" in healthcare: "The service that we produce is unaffordable," he says. "Anything that can't really be looked at as lowering the cost of care is already a non-starter."
The mobile apps physicians have flocked to mostly are reference tools, which is fine, but not ideal, according to Blatt. "The real fundamental value in mobile is not data lookup," he says. Mobile technology "allows us to collaborate in cyberspace in real time."
In other words, connectivity will come from platforms that help people work collaboratively, according to Blatt. For example, mobile technology is particularly well-suited to home care, Blatt says, as low-cost videoconferencing and streaming telemetry can easily enable what he calls care virtualization.
"Collaboration is where I want to head, even if I don't start there," he says.
That leaves plenty of opportunity for technology developers large and small, according to Unity Stoakes, co-founder and partner of New York-based entrepreneurship academy StartUp Health.
"What's clear is what's needed, which is a connectivity layer," Stoakes says. "There really is not a connectivity layer at this point, nothing that makes it easy for a developer to plug and play."
Certainly, such platforms are in the works, like the "ecosystems" some telecommunications companies and industry consortiums claim to be building, says Stoakes. "But nothing is mature enough that there is a dominant connectivity platform," he adds.
That may be OK, according to Stoakes. "Everyone's trying to have a winner-take-all scenario," he says. But it does not have to be that way; in the smartphone and tablet markets, Apple's iOS and Google's Android both are strong platforms, but neither dominates, and the competing operating systems can talk to each other via the Internet.
In an immature market like mobile health, it is typical for silos to develop. Stoakes says there is plenty of room for an industry consortium to come together and make rules for developers to follow, though he believes it is more likely that an entrepreneur rather than an association will drive standardization.