Uncategorized

The Second to Last Mile

flying cadeuciiThanks to the ubiquity of cable, fiber and wireless internet, the “last mile” telecommunications gap that has long separated the consumer from the wide world web is finally being bridged. According to Pew Research, 84% of Americans now regularly use the internet, and 68% use smartphones to access increasingly available broadband services.

The impact on healthcare has been considerable. More than half of all Americans have already uploaded their vital signs, benchmarked their fitness levels, co-managed their medications, communicated with their providers or researched health-related information.  No wonder the “mHealth” market could grow to $60 billion by the end of the decade

Yet, as more and more patients have rushed into this growing ecosystem of apps, wearables, home devices and other gadgets, a considerable body of research suggests that U.S. health care providers are not keeping up.  The poor second-to-last mile fit between consumers’ personal health technology and the providers’ incumbent information systems is turning out to be an important barrier to fully realizing the full potential of mHealth.

How should mHealth leaders respond?

Everyone agrees that healthcare technology is beset by unfriendly interfaces, poor clinical fit and opaque “black-box” programming logic.  In addition to this, physicians are also well aware of the perils of inbox data overload.

Resolving these technical challenges is well within reach.  Yet, healthcare leaders who are sponsoring mHealth initiatives should also consider three lessons that address the very human dimensions of connecting the second-to-last mile:

Less is more:  While the PowerPoint allure of large and multi-faceted mHealth solutions is considerable, their real-world implementation should be easy. Before connecting the second mile, health system leaders and mHealth providers should ask 1) why any mHealth initiative should take multiple days or require the assistance of legions of “super-users”, and 2) why patients shouldn’t be able to navigate within a user interface with the “Yahoo” standard of just “two-taps.”

Additive work vs. substitutive innovation.  As that second mile is bridged with increasingly efficient mHealth technology, the inevitable additions to existing provider workloads should prompt a collaborative search for any incumbent low-value processes or tasks that can be modified or discarded.  If the result is ultimately increased work for the providers, that downside cost needs to be explicitly vetted against any tangible patient benefit.

Unintended consequences:  While there may be a natural preference to deploy mHealth for everyone who qualifies, second-mile link-ups should be initially limited to the patients who have the greatest potential for benefit.  This is not only a time-honored way to grow expertise, but allow other known and unknown dimensions of the provider-patient relationship to catch up with the technology.  Limiting the scope of a first-time mHealth initiative will also diminish the prospect of unanticipated consequences while also facilitating the disciplined measure of a limited set of key outcomes.

Livongo’s Post Ad Banner 728*90

Categories: Uncategorized

5
Leave a Reply

3 Comment threads
2 Thread replies
0 Followers
 
Most reacted comment
Hottest comment thread
5 Comment authors
ronenmaxdJaan SidorovPerryBobbyGvegasLeoHolmMD Recent comment authors
newest oldest most voted
ronenmaxd
Member

Its amazing how the world changes….the internet has evolved significantly in the last years, which has brought major changes to the world (the “arab” spring)

LeoHolmMD
Member
LeoHolmMD

US Healthcare providers have not “kept up” because they see no point. Although I’m sure after tacking on another 60 billion onto an already bloated health system, things should get better. These are the same unfulfilled promises that industries like home health and electronic medical records have already made. Mhealth will be no different. Lots of data, mostly useless and self serving, increasing episodes of care while taking their cut of the action. Mhealth has contributed mostly to health noise. You can upload your vitals constantly: what good is it going to do you? The compulsive jogger and the slob… Read more »

BobbyGvegas
Member

“Information is overrated.”
– Taleb

Perry
Member
Perry

Most providers are just having a hard enough time keeping up with the multitude of acronyms being thrown at us daily.
Margalit called it “death by a thousand acronyms”.