Donna Malvey

Developing a measure of engagement with telehealth systems: The mHealth Technology Engagement Index.

Introduction Telehealth systems and mobile health (mHealth) devices allow for the exchange of both physical and mental healthcare data, as well as information from a patient to a practitioner, or care recipient to caregiver; but there has been little research on why users are motivated to engage with telehealth systems. Given this, we sought to create a measure that satisfactorily assesses human motivation to use telehealth devices. Methods 532 survey responses were used in an exploratory factor analysis and confirmatory factor analysis, which tested and retested the feasibility of this new measure. Convergent and divergent validity analyses indicated that the mHealth Technology Engagement Index (mTEI) is a unique measure of motivation. Results The results indicated that autonomy, competence, relatedness, goal attainment, and goal setting underpin motivation to use telehealth systems. Discussion The mTEI shows promise in indexing human motivation to use telehealth technologies. We also discuss the importance of developing measurement tools based on theory and how practitioners can best utilize the mTEI.

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

RESPONDING TO BIOTERRORISM: A LESSON IN HUMILITY FOR MANAGEMENT SCHOLARS

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.

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

Although we have yet to experience a major bioterrorism event in the U.S., we are nevertheless preparing for such an event. In this paper, we consider the nature of bioterrorism and the threats and challenges it brings to managing health care organizations. Because existing managerial theory may be inadequate in responding to bioterrorism events, management scholars are advised to approach their research with a great deal of humility and openness. Inasmuch as emerging theoretical frameworks based on complexity science and chaos theory are not fully developed, we propose that stakeholder management theory may be the best approach at this juncture.

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.

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

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.

Testing the Reliability of a Measure of Motivation to Engage With Telehealth Technology

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

Telehealth systems and devices allow for the exchange of important healthcare data between users and practitioners (Malvey & Slovensky, 2014). To date, there has been little research on the motivation underlying engagement and adoption of telehealth systems. Given this, the present study tested a new measure, the mHealth Technology Engagement Index (mTEI), across two student samples (N = 191). Participants interacted with two types of telehealth devices or two types of telehealth interfaces, then reported their motivation to engage with these devices or interfaces. The purpose of this research was to establish the reliability of the mTEI and validate its usefulness across differing devices and interfaces. We also discuss the importance of developing a measure based on strong theoretical support.