Health workers around the world are using mobile devices and wireless technologies to track infectious diseases, conduct research, treat patients, and bring access to modern healthcare to patients in developing nations, remote regions, and rural villages in ways never before possible. So what's keeping the U.S. from doing the same?
Bureaucrats who won't invest in unproven programs, policy wonks who fret about lack of regulation, and a widespread skepticism and lack of understanding of the benefits of mHealth, for starters, according to an international panel of experts and government officials at the mHealth Summit in Washington, DC, this week.
"American doctors don't know anything about mHealth," said K. Ganapathy, PhD, president of the Apollo Telemedicine Networking Foundation in India. And while that might be a bit of an overstatement, the general consensus among panel members is that if the U.S. wants to catch up with the rest of the world, it had better start paying better attention to mHealth—and building upon some of the many pilot programs taking place in other countries.
"To some extent it's true that scaling up is an important part but I think we've got a long way to go," said David Gustafson, PhD, director of the center for Health Enhancement Systems Studies at the University of Wisconsin Madison.
Like search results on the Internet, there are still an overwhelming number of health applications for patients and clinicians to choose from with no good way to determine which ones are helpful—and no guarantee they won't actually be harmful. Interfaces and devices are not always user-friendly, especially for older patients who might have trouble seeing small cell phone screens or punching tiny cell phone buttons, he added.
And he agrees that the U.S. healthcare system and healthcare consumers still haven't embraced mHealth and don't necessarily understand its potential benefits. "Right now there is skepticism except for a few enthusiasts like us," he said.
The world doesn't have time for large, randomized control trials that could take years to show whether mHealth can improve outcomes and further stall implementation, panelists said.
But governments will be reluctant to invest in mHealth technologies without that kind of data. The problem is compounded by the lack of awareness of potential for mHealth among bureaucrats and other stakeholders, said Ganapathy.
Public-private partnerships and commercial ventures could help speed things along. "In my country we are in a position to make mHealth private," said Mwendwa Mwenesi, MD, who coordinates the Phones for Health program for Tanzania's Ministry of Health and Social Welfare. "We are seeing that is the only way we can move forward."
"India is very open to public-private partnerships and this is a reality—not just a slogan," said Ganapathy. But Gustafson said the U.S., at least, should proceed with caution. "I don't think we can just turn it over to the private sectors and say 'Go for it,'" he said.
Another solution is to publicize the many mHealth success stories, said Allen Wade Hightower, chief of data management activity at the Centers for Disease Control's Center for Global Health. The task ahead, he said, is to win the confidence of senior management at agencies such as CDC. "Once they see that this technology is working and helping them do more with fewer resources, they'll buy into it," he said.
And, he added, forums such as this one, which organizers said attracted about 2,400 registered attendees from nearly 50 countries, is one way to do just that.