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Dr Layla McCay

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Why mHealth Is Caught Between Vision and Reality

Posted: 12/10/2013 8:36 pm

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This morning I braved snow and a two-hour, three-forms-of-public-transport expedition to the Gaylord National Conference Center to prepare for the future. In its fifth year, the mHealth Summit is the place for mHealth aficionados from the clinical, policy, tech, business, and academic worlds to come together, show and tell, learn, and imagine how health and health care can be transformed by wireless technology. With over 4,000 delegates this year, many brandishing their company or organization's latest shiny innovation, the Summit certainly has no shortage of vision.

And yet today, as people's PowerPoint clickers inevitably failed to advance slides, as wireless microphones remained stubbornly silent, as people struggled to connect to wifi, as random computer admin alerts popped onscreen mid-presentation mere minutes after a joke had been made about this happening in the earlier days of digital health care, nobody seemed particularly surprised. At work, teleconferences are routinely beset by people not being able to connect/see/hear/speak. At airports, stations, conferences, people cluster around phone sockets, desperately pouring life back into the mobile devices that let them down only hours after they were fully charged. A lot of variables need to come together to deliver the seamless wireless experience we hope for but don't yet absolutely expect. I'm struck by an apt comment made at the opening session of the Summit today: "mHealth is caught between vision and reality."

With two full days of sessions ahead of us, this conference is only just picking up steam, but amidst the inevitable-yet-compelling "look at my sexy device/app" presentations and "behold the glorious mHealth future," I was intrigued by a certain measured tone abutting the expected heady whirl of possibility. The speakers today spoke of the juxtaposition between, on the one hand, all the cool emerging tech that could deliver various whizzy health improvement services in spades and, on the other, the practicalities of scaling it up. This isn't the happy blue sky thinking in which we indulge during events like TEDMED.

At the mHealth Summit the less giddy but extremely important message of the day seems to be that innovation is outpacing legacy infrastructure. Hospitals have huge, expensive, unwieldy IT infrastructure designed to digitize 1950s-'80s processes. They can't just drop it or easily adapt this complex infrastructure to accommodate some upstart 21st-century mobile gadgets. They're not even sure yet if they should try. We are hovering on a cusp.

Interestingly, an Atlantic Council event on harnessing disruptive technology today (which I was following simultaneously via Twitter) was delivering a similar message. Essentially, cool disruptive idea, impactful idea, even transformative tech/digital-based idea... we get it... we sort of agree... we wish we could help... But sorry, at the institutional level we're not currently quite ready to be disrupted.

Back at the mHealth Summit Steve Case defined the three stages of entrepreneurship as hype, hope, and happiness. The collective imaginations of Summit delegates have have been inspired by "hype" -- we believe in the potential of mHealth as a health service improvement tool. That's why we showed up. This conference seems to be planting us firmly in the "hope" phase -- we recognize the significant barriers, the practical challenges to implementation. These are still early days in mHealth. But what's clear is that while mHealth may be caught between vision and reality, it's not stuck there. It's going to be amazing. Eventually. And when it is we'll move into the "happiness" phase, where the potential is realized: the infrastructure's in place, and mHealth is just a conventional, effective tool that everyone's using in health care as a matter of course. The specifics of what this success will look like is impossible to predict as the field is moving so fast. What can be easier predicted is that at this point the entrepreneurs will circle to the next hype.

In the meantime I look forward to my snowy expedition to the Summit tomorrow to for another dose of vision, pragmatism and hopeful determination to make mHealth work to improve health care. And live tweet... if I can connect to the wifi!

 

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