One area of mobile that might need more thorough evaluation is wearables. Currently, the use of wearables by practices is much lower than average mHealth apps, with only 14.5 percent of respondents to the 2018 Mobile Health Survey saying they accept data from these devices. The most common reason why, according to 61.1 percent of respondents, is that the data doesn't integrate into the EHR.
Kuhnen says another factor in slowing down the adoption of wearables in a practice setting is the lack of financial incentives. "Physicians are seeing so much data currently, there is a bit of a data overload. You're going to have to see more of a move towards value-based payments to get them to use [wearable data]," he notes. Putting physicians on the hook for the cost of care in a fully capitated model, he notes, would give them more reason to ensure their patients are being more active. Kvedar agrees that compensation is a big question regarding tracking and using wearables data, as well as how it can be integrated into a physician's work flow.
Steve Ommen, associate dean and medical director of connected care at Mayo Clinic, says the data around the technology needs to develop as well. "The wearable devices have largely focused on simple biometrics to date, that we didn't previously have a large archive of data that we knew was a true signal of someone's health. Now that more people are using them and there are large databanks of biometric data, the big data [crowd] can develop algorithms to predict [health behaviors]," he says.
Ommen adds that the sensors that drive these wearable devices are evolving into more specific uses for the patients who need this kind of tracking the most. "I think wearables are coming, but there is a lot of work to be done."
Whether it's mobile apps, wearables, or something else, there are still practices afraid to take the plunge. For those who are airing on the side of caution, Girgis has some simple advice: "Don't be afraid to try new things." She adds that it's important to ask advice of those who have already gone ahead and adopted the technology.
It's important for mHealth novice practices to start small and make sure they understand an app's value before using it, advises Kuhnen. Another important piece of advice, he says, is to make sure you consider the patient's feelings.
"If you're not careful on how you roll [a mHealth app] out, there can be negative feelings on patient side. If a patient sees a staff member tapping on away at their phone, they may assume they're on Facebook or a social network. Having an explicit communication or marketing strategy on how you roll these things out is important," he says.
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