Mobile Health Reaches Its Tipping Point

Mobile health is becoming a promising arrow in healthcare’s quiver to bend the cost curve.

Irving-based Christus Health gave 80 hospital-discharged patients in Texarkana age 65 and older a toolkit that included a pulse oximeter, weight scale, tablet, and blood pressure cuff in July 2012. The kit was designed to feed health information wirelessly back to care coordinator nurses at St. Michael Health System.

After one year, the 44 patients who completed the program reflected a $2.44 return on investment for every $1 spent. Before the 44 enrolled in the program to reduce hospital readmissions, the average cost of care was nearly $13,000 per patient. After participation, the cost dropped to $1,231 each.

Christus plans to expand the remote monitoring system throughout its hospital system for congestive heart failure, diabetics, and other patients.

“Whether in a hospital, clinic or patient home, Christus Health will use telehealth to expand and improve healthcare for populations served,” said Christus Health chief medical information officer Luke Webster, MD.

Mobile health includes smartphones, tablets, and other mobile and wireless devices. It also encompasses software apps to allow users to monitor their own health. Physicians and other providers also use the apps to engage patients in their health. Apps especially can be useful in remote areas without access to traditional healthcare.

In 2011, U.S. Secretary of Health and Human Services Kathleen Sebelius referred to mobile health as “the biggest technology breakthrough of our time” and maintained that its use would address skyrocketing healthcare costs and access scarcity.

A recent report by Dallas-based Markets and Markets estimated the global mobile healthcare market at $6.3 billion in 2013 and is expected to reach $20.7 billion by 2018, a compounded annual growth rate of more than 27 percent.

Forecasters predict that the number of apps will continue to grow at a rate of 25 percent annually for the near future. Industry experts say that 500 million consumers and healthcare providers will use a mobile health app by 2015. By 2018, the industry expects half of the 3.4 billion mobile device users worldwide will download a health app.

The digital health footprint at International 2014 Consumer Electronics Show in Las Vegas earlier this month was 40 percent larger than it was in 2013. The growth from 2012 to 2013 was 25 percent.

More people worldwide will have greater access to mobile devices than they will have to toilets and running water in 2014, said Nasrin Dayani, executive director of AT&T mHealth and telehealth solutions, at a recent Dallas conference. She said baby boomers comprise a huge mobile health market, with more than half of people 50 and older using or wanting to use mobile technology. She said 88 percent of those 50 and over have cell phones.

“Patient engagement [with mobile health] is not the issue,” Dayani said. “They’re ready. The desire to live at home as they age will push the technology to enable independent living.”

More than 1 out of 3 employers use mobile technology to engage wellness-program participants in healthy behavior, according to the 2013 Aon Hewitt employer survey. Nine out of 10 employers say they plan to do so within five years.

There is ample room for growth. A 2012 PwC survey of medical device executives found that only about 1 out of 8 healthcare companies were maximizing the use of smartphone apps to integrate patient data into clinical workflows. Only about 1 out of 4 physicians encouraged patients to use mobile health apps, but more than half said they believed the widespread adoption of apps was inevitable.

However, mobile health requires behavior change and that is not easy for providers or patients. A recent survey found that only 10 percent of medication adherence programs used mobile platforms. And Pew Research Project’s latest data showed that most people still track their health in their heads rather than digitally.

There generally are two main types of mobile health apps: consumer-operated apps and healthcare-operated apps.

The Food and Drug Administration decided in September to limit its oversight of mobile health apps to those used by medical professionals. The agency plans to stay away from consumer-operated apps, such as those that track personal fitness, prompt doctor appointment reminders, or provide drug-dosing schedules. In its ruling, the FDA was attempting to strike a balance between patient safety and not stifling innovation.

Dayani said the new guidelines would make it easier for designers “to push the envelope” for content-rich apps.

The big challenges in healthcare information technology, Dayani said, are to harness the explosion of digital data to make it useful for providers and patients, and to engage patients through mobile technology. This “infobesity” threatens to overwhelm providers with too much data if not harnessed properly.

Steve Jacob is editor-at-large of D Healthcare Daily and author of the book Health Care in 2020: Where Uncertain Reform, Bad Habits, Too Few Doctors and Skyrocketing Costs Are Taking Us. He can be reached at

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