I’m utterly hopeful about all the attention mobile health has been receiving in the news lately, I really am. The latest to grab my attention was this Fast Company article, “As Smartphones Get Smarter, You May Get Healthier: How mHealth Can Bring Cheaper Health Care To All” by Adam Bluesmen.
Note: See other things I’ve been reading on my tumblr blog here: As if your life depends on it.
This FC article is an optimistic account of success stories and major players shaking up the healthcare industry, including an eye test iPhone attachment that reduces the cost of $10,000 equipment to just $30, in what they call “the thrilling, disruptive potential of mHealth.”
Optimism and celebration are well and good, but we also need a realistic look at the challenges faced in mHealth. In every app’s design and development, there are still some very big issues to tackle.
1. How do we laud an app effectively for what it does without over-exaggerating its capabilities?
The Eatery is a classic example of an app tackling a healthcare challenge (the way we eat) in a different way (through photo capture rather than calorie counting), but its UI is not perfect despite the app’s great press. Moreover, what their collected data means is oversold, proclaiming more relevancy than is realistic given the lack of an unbiased, scientific study.
Similarly, the above Fast Company article quotes Raja Rajamannar, chief innovation officer at Humana, as saying that by utilizing mobile phones in healthcare:
“It’s like the human body has developed a new organ.”
If only it were that simple! For one thing, the body is complex and we don’t fully understand it, so a statement like that is clear-cut hyperbole. There is a glorification here of multi-billion dollar possibilities.
How do we get the attention we need to make effective change without going the way of the pharmaceutical hyperbole, ie. convincing an entire generation of people that pills (or phones) can cure anything? Should mHealth app teams have a code of responsibility similar to the Hippocratic oath?
A responsibility to users should be built into mHealth application development as the consequences of not doing so are very real. If the app you design and build for patients to track their diabetes, for example, is misleading or unusable, it’s quite possible to not only increase physical pain and suffering but even to become an inadvertent cause of death.
2. How do we provide healthcare innovation in equal measure for the underprivileged, those without access to smartphones and expensive data plans?
We need to be cognizant of providing minimum access points for people of less privileged backgrounds. Not everyone can afford an iPhone. Disease, however, is not discerning; illness strikes everywhere, and those with less available resources may be less equipped to manage their illness. Everyone deserves access to the best care available, and this issue is unfortunately not well-addressed within existing mHealth solutions.
Also, while teams that build healthcare apps may never be able to keep up with the fast pace of commerce, and while the mobile industry continues to settle on operating system and hardware consistencies, we need to continue to consider building web-based apps that can be accessed by any device with a browser. While not the sexiest solution, we also still need to consider SMS options.
Twitter is an example of how its creators have deliberated attempted to broaden their reach by allowing functionality through the use of SMS. In September 2011, a Twitter blog post revealed that “almost four billion SMS messages are sent and received on Twitter every month.” Even though smartphones are set to overtake features phones in 2012, the old classics are still a force to be reckoned with.
3. FDA regulation of mHealth apps and devices: Will it make us stronger or slow us down?
FDA approval of mHealth apps is like any kind of government regulation – cumbersome, fastidious, regimented, a pain. And it can certainly be a stumbling block for progress, but what it does do is protect against the sort of hyper-inflation of value I talked about above. Fast Company says the FDA plans to streamline their process to be fast and effective. I’ll believe it when I see it, but until then it is worth questioning whether we are better with it or without it.
4. Data collection = data overload?
How do we present the results of better monitoring, faster tests and greater access to more precise information in a way that is digestible and ultimately useful? Maybe users will dive deep into their own healthcare analytics, but then again, maybe they won’t. Fast Company quotes John Moore, a lead researcher in the New Media Medicine group at the MIT Media Lab:
“Whether these tools actually make us any healthier, however, will depend on how we use them. Given the ability to record our snacks, thoughts, naps, movements, and more, “we will be overwhelmed with data.”
Our challenge will be to present digestible chunks of information that retain their accuracy and relevancy.
5. How do we get all the players on the save wavelenth?
Communication, as ever, is one of the biggest determinants of an app’s success. How do we achieve buy-in from all the stakeholders, not only from patients and the public but from doctors, nurses, and others behind the scenes? How do we fully integrate the “disruptive potential of mHealth” into the complicated workflows that exist within hospitals and other care settings?
Some decisions about the crafting of an app’s architecture greatly depend on how subgroups of these people will interact with each other and their environments. Considerations need to include and pinpoint where common interests overlap. You’d think this would be simple: We all care about health, safety and saving lives. But nothing is ever that simple that involves transferring knowledge and expectations between collaborators.
These are just a few of the more complicated challenges I’ve encountered since starting work with the centre two months ago. These are biggies. And they are issues designers need to be aware of as we imagine the future of mobile health.
What challenges do you think are important facing the mHealth industry? Leave a note below. I’d love to hear other opinions.