Mobile Monitoring Devices Grow but Link to Clinical Workflow Lacking

A panel of experts at the Hospital Cloud Forum in New York noted progress in developing health and fitness tracking devices, yet the industry requires links to clinical care.

NEW YORK—As health and fitness tracking devices hit the market that allow consumers to keep track of their personal health data, doctors need to find a way to integrate mobile devices and the data they provide into clinical care.

A panel of health IT experts addressed this question at a session on mobile health at Information Management Networks' Hospital Cloud Forum here on April 16.

Mobile devices connected to the cloud will be important in linking patient data with physicians' workflows, according to Dr. Steven J. Davidson, senior vice president and chief medical informatics officer of Maimonides Medical Center in Brooklyn, N.Y.

"I'd like to offer a vision as a longtime clinician that has talked to lots of patients over the years that the cloud is where patients and physicians are going to meet," Davidson said.

He mentioned as an example the Statewide Health Information Exchange of New York (SHINY-NY) and how patients will be able to view the same health data as doctors through the cloud.

"I believe they're going to get that access on these," Davidson said, referring to smartphones and tablets.

Mobile is the platform that allows health care providers to monitor chronic conditions, said Matthew Taylor, senior information and communications technology (ICT) strategist and architect for Intel.

"From an Intel perspective, we probably look at m-health more broadly to look at smartphones, tablets, laptops, the whole gamut," Taylor said. "Our interest is certainly being able to make these platforms effective for the provider community to be able to deliver virtualized services to enable chronic disease management, to do patient education, all with an eye toward outcomes," he said.

By allowing doctors to access virtualized services on mobile devices, the health care industry will be able to reduce readmissions or avoid admissions from the start, Taylor noted.

Still, John Moore, an analyst at Chilmark Research and moderator of the panel, noted that electronic health record (EHR) adoption is still the first priority in health care before getting doctors to use tablets such as the iPad.

Concerns about privacy and data breaches as well as adherence to the Health Insurance Portability and Accountability Act (HIPAA) weigh on doctors as they incorporate mobility into their practices.

As organizations implement bring-your-own-device (BYOD) programs, tablets with security features such as remote wipe could help accelerate mobile adoption in health care, Intel's Taylor suggested.

It's been difficult for health organizations to understand how to connect mobile devices to clinical care, said Keith Toussaint, executive director of business development, global business solutions, at the Mayo Clinic.

"The gap is significant in regard to the large population of patients who are finding a way to seamlessly integrate data coming out of the m-health experience into clinical care, and that's one of the things we're attacking directly," Toussaint said. "If we get to the point where we're able to marry the applications with effective biometric data capture that is well integrated with clinical workflow, that could change the story, but we're not there yet."

Several mobile devices are hitting the market to track patient biometric data, as Moore noted.

These include the BodyMedia Core2 armband that monitors temperature, acceleration, calories burned and sleep patterns; the wrist-worn Misfit Wearables Shine that tracks bike pedal strokes and distance traveled; and the Fitbug Orb pedometer that connects to a cloud platform to allow users to track their sleep and fitness routines.

The ability for doctors to validate data coming from mobile monitoring devices will be an important consideration in incorporating them into clinical care, Moore said.

"How do you validate that this came from a blood pressure cuff and not some kid fooling around with a dad's blood pressure cuff outside?" Moore asked.

Meanwhile, to be implemented into a clinical environment, mobile medical devices and apps will require approval by the U.S. Food and Drug Administration, but the smartphones and tablets they connect to will not, Christy L. Foreman, director of the FDA's Office of Device Evaluation at the Center for Devices and Radiological Health, told a congressional panel on March 21.