Donna J. Slovensky

mHealth Products, Markets, and Trends

While much is being written in the popular press and online about the growing consumer interest in mHealth apps and the increasing availability of free and low-cost apps, the reality is that mHealth app usage has been relatively flat over the past couple of years. The general assumption is that well-designed, useful, and cost-effective apps will help consumers become more engaged in their health-care decisions and engage in healthier behaviors to achieve improved health outcomes. The mHealth product market is expected to grow in number, types, and sophistication of available devices and apps well into 2017, when sales are expected to reach US

A model for mHealth skills training for clinicians: meeting the future now

26 million, with the greater portion of revenue coming from accessory devices and associated services. While many apps and devices with good functionality are available, the challenge for developers and investors is sustainability. Seemingly, the product life cycle in mHealth is short—technology capability enables fast development and fast replacement—and consumers are fickle, especially when apps are available at little to no cost to them. A key business approach for developers is to use freebie apps to provide easy access to more lucrative products and services for a sustainable consumer market base. The conundrum for players in the mHealth market is whether providers and consumers truly want virtual health care, or whether developers and marketers are creating a perception that virtual care is to be preferred over traditional delivery models.

Mobile Means Global

We describe the current state of mHealth skills acquisition, education, and training available to clinical professionals in educational programs. We discuss how telemedicine experienced exponential growth due in large part to the ubiquity of the mobile phone. An outcome of this unprecedented growth has been the emergence of the need for technology skills training programs for clinicians that address extant curricula gaps. We propose a model to guide the development of future training programs that incorporate effective training strategies across five domains: (I) digital communication skills; (II) technology literacy and usage skills; (III) deploying telehealth products and services; (VI) regulatory and compliance issues; and (V) telehealth business case. These domains are discussed within the context of interprofessional teams and broader organizational factors.

From Telemedicine to Telehealth to eHealth: Where Does mHealth Fit?

mHealth is rapidly expanding globally, in both volume and scope. One of the most important questions developers and users must ask is whether mHealth can be scaled and sustained for the foreseeable future. Without cost-effectiveness and outcomes research, there is no way to know what works and what does not, particularly with regard to large-scale deployment. There is little to no evidence to show governments, foundations, entrepreneurs, and businesses that mHealth is worthy of investment. Consequently, stronger evidence is necessary to distinguish reality from hype and to encourage investor and entrepreneur participation.

The Possible Future of mHealth: Likely Trends and Speculation

The field of telemedicine, which emerged more than 40 years ago, has evolved from one-way transmission of information primarily for the purpose of diagnosis and treatment monitoring to robust telecommunications systems that enable virtual engagement between patients and providers. The technology evolution was made possible by the advent of high-speed processing and broadband transmission innovations. A forthcoming driver, changes in reimbursement practices associated with the Affordable Care Act, may impel the implementation of applications to a level more closely aligned with what we can and should do via remote health care, than what we have been financially motivated to do in past years.

TEAMusic: A New Exercise for Demonstrating Teamwork Principles

Seemingly, the most certain component of mHealth’s likely future is uncertainty. As a concept, mHealth has been addressed in the literature for many years. As a reality, its past is more recent. While mHealth is recognized as a disruptive innovation, one that promises to provide needed health care access at lower cost than face-to-face encounters, many expected benefits remain unrealized. Among the remaining challenges to achieving more of the potential for improved access and lower cost in health care are information privacy and security concerns, inability to vet applications and assure efficacy, uncertainty in product regulation, adequate business models for product development, and third-party payment for provider services delivered using mHealth. Currently, the market is dominated by a few large suppliers, notably Apple, but new players are entering a competitive landscape replete with relatively short product life cycles. Long-term viability and sustainability of mHealth as a health care delivery option will depend largely on the ability to meet stakeholder needs and to establish payment mechanisms that motivate providers to adopt mobile technologies as effective alternatives to many in-person interactions.

Introduction to Focused Issue on mHealth Infrastructure: issues and solutions that challenge optimal deployment of mHealth products and services

Games and group exercises can be used effectively to teach key principles of quality management. This paper presents a new game, TEAMusic, which has been found effective for teaching teamwork principles. The game has been used successfully in many types of class formats and with groups of different sizes. Points experientially obtained from field tests are provided to enhance the instructor/leaders review of game results and lessons learned following the demonstration. TEAMusic is also compared to a popular alternative, Lost at Sea.

Design of Health Information Systems

In 2013, when we began researching mHealth as a disruptive innovation in healthcare (1), we traced the origin of the term back more than two decades to a data communications professor, Dr. Robert Istepanian, now a visiting professor at the Imperial College, London, Institute of Global Health Innovation. Our conclusion at that time, and which currently holds, is that mHealth has yet to achieve industry-wide deployment of functional, sustainable products and services that consistently meet financial, quality, and patient satisfaction benchmarks. Although some impressive clinical and financial outcomes have been achieved, and many individuals have benefitted from access to healthcare made possible by mHealth applications, the scope of deployment across the industry and globally has not reached a ‘tipping point’ where mHealth is a ubiquitous component of the overall healthcare delivery system. We recognize that many factors contribute to this current state of unrealized potential, and many highly intelligent and skilled researchers, clinicians, innovators, and other professional groups continue their work to advance mHealth adoption.

mHealth Stakeholders: Follow the Money

This special issue is intended to generate new knowledge as well as provocative research questions. Application is showcased in several articles. This collection of papers permits researchers throughout the world to gain insight and understanding of what others are doing in their fields and possibilities for future study. In the past, multidisciplinary research teams often came together by pure chance. A biologist, an engineer, and a medical doctor might run into one another at the local sandwich shop at a university. Over time, they came to discuss their work. After more time, they might see possibilities for combining their disciplines to solve a complex problem. Evolving rom the chance luncheon encounters came a new discovery or means of applying new knowledge. However, we can no longer depend on such opportunistic encounters. Researchers need more determined methods of coming together, such as special issue journals in order to assure occasions for multidisciplinary scholarship. The world seems to be constantly changing. We cannot follow the leader and do more of the same. We have to seek knowledge and identify scholars and pathways to discovery. In today’s world, doing more of the same is a recipe for failure. We must challenge ourselves and others to collaborate with those who think broadly and differently about the world. The research landscape for STEM fields is undergoing especially dramatic and rapid change. Universities, governments, and private sector enterprises are funding research endeavors to capitalize on existing knowledge and new developments. Furthermore, applied research is coming under the spotlight. Increasingly our technological developments are enabling research to move quickly beyond the theoretical into real-world applications. Mobile phones have enhanced our communication and most certainly our research capabilities, including opportunities to work with scholars round the world. 3-D printers offer the potential to produce cars that cost less and can be produced rapidly without the need for a factory of skilled workers (Malvey & Slovensky, 2014). 3-D printers have already grabbed news headlines for the production of bionic arms. The “Internet of Things” has been a guiding force demonstrating the many possibilities enhanced connectivity beyond our individual lives. The complexity involved in designing health information systems (Plsek & Greenhalgh, 2001) has many facets. Some of the most challenging facets include: a) designing the human-machine interface between the system and the user, b) assuring the system’s ability to capture and enhance the relevant body or bodies of knowledge, c) designing the system to adapt to new methodologies or discoveries in biomedical informatics, and d) designing for compliance with standards, trends in technology, and statutory regulations. The articles selected for this special issue explore current knowledge and research corresponding to these facets.

Research Evidence and Other Information Sources

No business or service organization exists without stakeholders, individuals, or groups with the ability to affect the operations and success of an organization. mHealth developers, investors, and those responsible for commercializing innovative products are well-advised to identify the stakeholders most likely to support or threaten their segment of the industry or their particular product. The Affordable Care Act’s focus on engaging patients in their own health care has placed consumers at the top of the mHealth stakeholder list, but providers such as health systems and physicians are important as well, although their interests (and power) differ from consumers and from each other. Other key players are insurers, investors, and big pharma and biotech companies. And, the US military and the Veteran’s Administration must be considered in light of the scope of their health-care system. The direct and indirect influence of these and other stakeholders, whether they are supportive or non-supportive, the sources of their power, and the likelihood of that power being used are all important considerations in planning tactics for managing the various stakeholders and maximizing their potential benefit or minimizing their potential for harm. Market factors such as the availability of inexpensive technology, partnership opportunities across industry segments, and the growing interest of investors in digital health technologies create a supportive environment for the advancement of mHealth products—if business models can be sustained.