Mobile health: US doctors skeptical, at high risk of disruption


International management consulting firm Accenture released findings about different attitudes around the world regarding mobile and connected health. Doctors in the United States were found by the company to be the least enthusiastic among eight countries surveyed and U.S. preparedness for a future of connected health received a mixed review. Given the potential for consumer and market-driven innovation, though, any ill-prepared skepticism may end up being an indicator of susceptibility to disruption more than a forecast of slow market adoption of new technologies.

The top 10 most common benefits of connected health were cited on average by 47.7% of U.S. doctors surveyed by Accenture. All seven other countries’ percentages were above 50%, Spain’s highest at 71%.

Doctors surveyed in all eight countries agreed that the biggest benefit of connected health technology will be increased access to data for clinical research; in other words, that medical treatment will be instrumented, tracked and used to inform the evolution of medicine. Doctors in most other countries believed that the reduction of medical errors would be the next-biggest benefit. U.S. doctors were more likely to site collaboration across organizations as a benefit.

When it came to relative preparedness for connected health, Accenture judged the United States to be weakest in strategic and clinical change management. Vision and leadership on the topic in the US trailed farthest behind Singapore, Spain and Canada but was ahead of Germany. No country surveyed had as robust an technology infrastructure to support connected health as did Spain, the company said.

Attitudes may not remain where they are today for long, says healthcare IT writer Brian Ahier. “I think two areas that bear mentioning EHRs (electronic health records) and HIE (health information exchange),” Ahier told RCR Wireless. “The [United States] is playing catch up with other developed nations regarding digitizing health records into an interoperable sytem. This will be a key infrastructure necessary to support new payment models. This why you have seen health insurers buying health IT companies. I think we will see the skepticism recede as the business model changes and providers are able to get paid for providing connected health care.”

Matthew Holt, co-chair of the Health 2.0 Conference, isn’t sure the contrast between countries surveyed is really that substantial.  “If there is a difference it’s probably because US doctors overall have been operating independently more than in teams and have tended not to have the care coordination and team work that some (think UK, Scandinavian, Dutch) doctors have been working on for the last 15 years or so,” Holt told RCR.  “All the connected health and groupware tools make that coordination easier. But if you haven’t had the institutional bias towards care coordination and teamwork, its probably harder to see where these tools make much of a difference.  And of course as they didn’t look at the most interesting countries (Denmark, Norway, New Zealand, Netherlands) with the highest use of EMRs and greatest history, so the contrast is a little weak.”

Mobile and connected health isn’t just about electronic records, hospital beds and medical equipment chock-full of wireless sensors either, though. There’s a lot more potential than that. Even if a large portion of doctors are skeptical of mobile and connected health, that doesn’t mean consumers, insurance companies or highly competitive healthcare providers will be. InformationWeek’s Marianne Kolbasuk McGee today profiled a mobile app called Castlight, which uses aggregated insurance data to help employees of large corporations discretely access price and quality information about their doctors’ services.

Jennifer Thew writes today on the medical technology corporate-sponsored site HL7 Standards about the rise of the Chief Nursing Informatics Officer.

Tom Lewis at reviewed this week a $5 smartphone app called MyMedicalTutor, which helps doctors do roll-playing exercises and make audio recordings of themselves delivering various hypothetical but common diagnoses.

U.S. doctors may find themselves standing aside skeptically while their robust technological infrastructure is taken advantage of by newly empowered patients, nurse informaticians and high-touch doctors that emphasize communication with their patients and use their mobile devices to make it happen.

Those skeptical doctors could face patients armed with Yelp-like apps on their phone, which they’ll use in deciding what treatment recommendations to accept, and competitors who have used their mobile devices as learning tools to develop the kind of personability in communication that will win the hearts of patients. If Accenture is correct and the US medical industry has robust technology infrastructure to support connected health, and the market is filled with smartphones, but the medical establishment’s biggest challenge is in change management – that sounds like a recipe for disruption to me.

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