Mobile technology is the epitome of cool. We’re walking around with powerful computers in our pockets that magically send and receive messages from thin air. These phones and tablets provide the answer to any question we don’t know, making everyone a “genius,” and the party’s really just getting started.
But there’s a big problem with mHealth, and that problem is the same one that gets in the way with everything aimed at improving health in our country: Us.
I’m a fan of comedian Louis CK. Don’t look him up if you’re easily offended, but he was dead on when he talked on Late Night With Conan O’Brien in 2009 about how our expectations and demands change so quickly when it comes to technology.
“How quickly the world owes him something, he knew only existed 10 seconds ago.”
Mobile technology is that shiny, accessible new toy. It follows in the footsteps of VHS, personal computers, Atari 2600, and too many others to name. Although mobile technology continues to evolve, people have embraced it into their lives, leaving no debate that it’s here to stay. The portability of mobile – the ability to reach people where they are at all times – has everyone imagining the possibilities of what can be accomplished, what problems can be solved and how much money they can make, and justifiably so.
Just last week, Darrell West published an article in The Brooking Institutions’ Issues in Technology Innovation, titled “How Mobile Devices are Transforming Healthcare (PDF).” In his in-depth article, West explores some very exciting ways mHealth technology is extending access to healthcare in rural communities and the potential it has in preventing or predicting outbreaks, such as Dengue Fever in India and Sri Lanka.
Giving access to healthcare to those desperate for help is the area I think mobile technology has the greatest promise for success.
A majority of the paper is spent describing mobile applications designed to help patients monitor existing conditions, such as Type II Diabetes and high blood pressure, and others designed to encourage healthy behaviors, such medication adherence, maternal care and smoking cessation – each areas of critical importance, no doubt. But isn’t there already plenty of literature and assistance freely accessible that addresses these conditions?
Several years ago I had the pleasure of working alongside Fernando Guerra, MD, the former director of health at the San Antonio Metropolitan Health District, on a public health project designed to educate residents about the city’s very real obesity epidemic. The project, as part of the city’s FitCity campaign, would distribute body mass index charts – then a somewhat new idea – to every physician’s office in town. Literature would accompany the charts asking the physician and his or her medical staffs to educate their patients about BMI and where they rate on system’s measurement scale of healthy, overweight or obese.
My hope was that these patients would have an epiphany and begin to work at improving their health, and the negative label of “fat city” would soon be removed from outsiders’ thoughts when they were asked to describe the residents of San Antonio.
After the charts were printed and mailed, I asked the physician members of the public health committee if they thought the initiative had been a success. Most thought that the initiative was a step in the right direction and that only time will tell if the outcomes would be positive. Dr. Guerra, one of the most genuinely compassionate and thoughtful physicians I have ever met, agreed, but offered a glimpse of reality when he said something to this effect: “Go to the bus station downtown and ask people waiting outside about BMI. If more than one person there is able to tell you what it is, then I’ll say it has been a success.”
That, to me, that illustrates a key problem with the American mHealth discussion: Supporters believe that digital access to mobile health apps will magically improve their health. The trouble is that mobile health can only provide access and greater information, it cannot provide the personal willpower needed to make difficult choices that may lead to healthy outcomes.
Is my positive contribution to this discussion simply: Everyone needs a swift kick in the pants? Is the real problem laziness?
No, but I do believe that personal responsibility is missing from the dialogue on mHealth, and it’s something that public health professionals have been preaching to no avail for decades. A shift in thinking and action is the X factor: converting personal motivation into community transformation. Maybe my thoughts are best summed up by something Louis CK said in the aforementioned video, “Give it a minute! It’s going to space!”
It is an awesome time in healthcare when so many smart, motivated people are all thinking about innovative ways to improve our national’s health care problems with these powerful, mini computers that we carry with us everywhere. Before, public health professionals were the lone voices of encouragement for the masses.
I look forward to the day in the not too distant future when I’m pumping gas and I hear someone complain as they’re looking down at their smartphone, “Oh, crap! My doctor just texted to remind me that it’s time for a checkup.”
Chad Johnson blogs regularly at Health Standards Blog.
