Widely diffused, health information technology (health IT) provides the infrastructure to spur innovations in health care delivery. Health IT is an essential component of health care reform efforts aimed at expanding measurement and reporting, new care delivery models, and improving access to care. Over the last ten years, use of mobile technology has increased and is becoming more prevalent in health care. Health care delivery is no longer limited to face-to-face encounters. Mobile health (mHealth) is the use of communications devices, such as tablets and smartphones, for the delivery of health services, information, and education. mHealth has the potential to strengthen care delivery through improved access to information. Emerging mHealth applications enable providers and patients to manage and monitor health information more efficiently. mHealth offers the potential to increase patient engagement in their own health and lifestyle management to achieve better care and improved outcomes.
mHealth vs. Telehealth
mHealth encompasses the public health, social, and behavior aspects of a patient’s life that affect health outcomes. mHealth encourages patients to be engaged in managing their health care and improving their health outcomes by leveraging widespread use of mobile communication devices to deliver health services, information, and education. Examples of mHealth include use of mobile applications to track medication compliance, provide self-management support, create peer networks to manage health conditions, or sync with wearable devices to track and monitor activity, among other things. Telehealth uses two-way audio, video, and other forms of telecommunication technology, such as remote monitoring devices. Telehealth focuses on increasing access to health care services to improve a patient’s health status. Examples of telehealth include patient consultations and encounters via video conferencing, remote monitoring of vital signs, case management support, and continuing medical education.
Mobile communication carriers have been successful in connecting to populations typically considered underserved by the health care and public health communities due to the lack of resources available, such as health care providers, services, and facilities. mHealth can leverage the widespread technological infrastructure that is already connected to these communities in a way that traditional health services are unable by using mobile communication devices to deliver health services remotely.
Users of mHealth are not only shown to be more engaged in their health, but are found to be more compliant with physician’s health care recommendations. Evidence also suggests that consumers prefer using mHealth interventions to manage their health conditions over prescription medications when recommended by a physician.
mHealth users are able to receive daily support from a physician or extended support network through information and goals sharing and the ability to track, report, and review health data in a more timely manner. mHealth also facilitates information sharing and communication between patients and health care providers by enabling communication outside the clinical setting on a more routine basis.
Payor reimbursements for mHealth services are lagging behind other forms of health IT reimbursement . Costs associated with some mHealth applications, such as wearable devices, can further limit adoption of mHealth and are often cited as a barrier to adoption. In order for mHealth to be successfully implemented, delivered, and sustained, providers must receive reimbursements to cover the costs of providing mHealth.
As the use of health IT continues to expand, so do concerns around the privacy and security of electronic health information. Health care professionals who use mHealth should become familiar with the privacy and security requirements of the Health Insurance Portability and Accountability act of 1996 (HIPAA) and Federal Information Security Management Act (FISMA). In addition, review the Health and Human Services Tips to Protect Secure Health Information When Using a Mobile Device. Health care professionals are encouraged to develop organizational mobile device management policies to safeguard health information when engaging in mHealth .
At the federal level, agencies have taken various positions on mHealth. The Federal Trade Commission (FTC) is continuously monitoring confidentiality of mHealth devices in accordance with Section 5 of the FTC Act. The FTC offers advice on building security protocols when using Internet connected devices in the publication Careful Connections: Building Security in the Internet of Things  the FTC also offers advice on best practices and an Interactive Tool for app developers. The Federal Drug Administration (FDA) has taken a hands-off approach to most medical device data systems, unless they are deemed to pose a health threat to the user if they malfunction.
MHCC mHealth Grants
Improving Patient Outcomes using mHealth Technology Projects – Awarded December 2016
Awardee - John Hopkins Pediatrics at Home
The MHCC awarded grant funding to Johns Hopkins Pediatrics at Home (JH PAH) to demonstrate the impact of using mHealth to manage pediatric asthma in patients served by East Baltimore Medical Center. The project is for 18 months and will utilize a mobile application to conduct regular health assessments, track the patient’s Asthma Action Plan, provide real time-time clinical and educational feedback, and facilitate secure communication between the patient and a JH PAH nurse. A 2:1 financial match and demonstrated sustainability of the pilot is required. In addition, a performance report at the end of the project is required. Lessons learned from the projects will be used to inform future mHealth initiatives across the State.
Mobile Health IT in the States: A Policy Perspective using the HiMSS mHealth Roadmap
Mobile Health App Developers: FTC Best Practices
HHS: Examining Oversight of the Privacy & Security of Health Data Collected by Entities Not Regulated by HIPAA
HealthIT.gov: Mobile Device Privacy and Security
Managing Mobile Devices in Your Health Care Organization
HiMSS Mobile Security Toolkit
K4Health Toolkits: The mHealth Planning Guide
WHO mHealth MAPS toolkit
1.Anderson, M. Technology Device Ownership: 2015. Pew Research Center: Internet, Science, and Tech. October 29, 2015. Available at: http://www.pewinternet.org/2015/10/29/technology-device-ownership-2015/.
2. Mcaskill, R. Multiple mHealth Martets set to Experience Growth. mHealth Intelligence. March 2015. Available at: http://mhealthintelligence.com/news/multiple-mhealth-markets-set-to-experience-growth
3. American Telemedicine Association. About Telemedicine. Available at: http://www.americantelemed.org/main/about/about-telemedicine
4. K4Health Toolkits. The mHealth Planning Guide: Key Considerations for Integrating Mobile Technology in Health Programs. Available at: https://www.k4health.org/toolkits/mhealth-planning-guide
5. HiMSS. mHealth App Essentials: Patient Engagement, Considerations, and Implementation, February 20, 2015. Available at: http://www.himss.org/mhealth-app-essentials-patient-engagement-considerations-and-implementation
6. Ibid 5.
7. Ibid 5.
8. HiMSS. 5 Questions About Mobile Health (mHealth) and Defining What It Is, April 26, 2013. Available at: http://www.himss.org/5-questions-about-mobile-heath-mhealth-and-defining-what-it
9. MobiHealthNews. Deloitt’s four P’s for mobile health best practices, January 15, 2014. Available at: http://www.mobihealthnews.com/28844/deloittes-four-ps-for-mobile-health-best-practices
10. Ibid 5.
11. HiMSS. Mobile Security Toolkit, Regulatory & Legal Information. Available at: http://www.himss.org/library/healthcare-privacy-security/mobile-security-toolkit/legal
12. HealthIT.gov. Mobile Device Privacy and Security, Five steps organizations can take to manage mobile devices used by health care providers and professionals. Available at: https://www.healthit.gov/providers-professionals/five-steps-organizations-can-take-manage-mobile-devices-used-health-care-pro
13. Ibid 5.
14. Federal Trade Commission Act, Section 5: Unfair or Deceptive Acts or Practices. Available at: https://www.federalreserve.gov/boarddocs/supmanual/cch/ftca.pdf
15. Ibid 5.
16. The FDA defines medical device data systems as devices that are intended to provide one or
more of the following uses, without controlling or altering the functions or parameters of any connected medical devices: (i) The electronic transfer of medical device data; (ii) the electronic storage of medical device data; (iii) he electronic conversion of medical device data from one format to another format in accordance with a preset specification; or (iv) the electronic display of medical device data. An MDDS may include software, electronic or electrical hardware such as a physical communications medium (including wireless hardware), modems, interfaces, and a communications protocol. This identification does not include devices intended to be used in connection with active patient monitoring
17. VentureBeat. FDA makes official its hands-off approach to regulating health apps and medical software, February 6, 2015. Available at: http://venturebeat.com/2015/02/06/fda-makes-official-its-hands-off-approach-to-regulating-health-apps-and-medical-software/