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The financial promise of mHealth

Although there’s little hardcore evidence to date that mobile health technology will dramatically reduce U.S. healthcare costs, several thought leaders are optimistic. 

Proponents like Eric Topol, MD, a cardiologist at Scripps Green Hospital in La Jolla, Calif., for instance, claims it will save billions.

In an interview published in MIT Technology Review, Topol pointed to inexpensive iPhone adds-ons that can serve as EKG monitors, and a mobile ultrasound device about the size of a smart phone that scans a patient’s heart chambers. This device, which resembles a flip phone and is made by GE, can be used for about 80 percent of U.S. scans, Topol claims. He charges nothing for such scans when done as part of a routine exam. Most doctors, he said, charge $600 to perform an ultrasound using a $350,000 machine.

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Topol is among many critics of the healthcare system who believe providers invest too heavily in expensive technologies such as $350,000 ultrasound machines when less expensive alternatives are available.

In addition to the boon of less expensive technologies, mHealth proponents are hoping that mHealth technologies can improve providers’ bottom lines by reducing hospital readmission rates. 

Now that the Centers for Medicare & Medicaid Services is penalizing hospitals for what they consider unnecessary 30-day readmissions, some are hoping that 2014 will bring a mHealth return on investment through remote patient monitoring. Others are looking to use video coaching to enable clinicians to “remotely push meal and activity plans in a prescriptive manner to better guide and focus people on what they need.” The reasoning is that such coaching will improve clinical outcomes and reduce costs, according to Mobile Health Apps: A Practical Guide for Healthcare Stakeholders, a recent mHIMSS report. (HIMSS is the parent company of Healthcare Finance News and mHIMSS.)

Like Topol, researchers at Accenture, a global management consulting, technology and outsourcing services company, also believe mHealth will have a profound impact on healthcare costs. Their analysis and aggregation of trial data on patient monitoring solutions suggest the U.S. can save “more than $23 billion by targeting patients with chronic diseases.”

Remote patient monitoring seems to offer potential for cost savings, partly because so many patients need the watchful eye of a clinician, a family member, or a mobile app to nudge them into better compliance with their medical regimen. In short, these patients need to be more fully engaged in their own care.

“Patient engagement is the blockbuster drug of the 21th century,” said Omri Shor, CEO of MediSafe, which sells the MediSafe mobile app, is one of many pill monitoring systems that encourage patients to take their medication on time and in the right dose. Since the average person uses a mobile device on average about 150 times a day, the medical community can use that level of engagement to improve medication compliance, which will likely reduce the cost of care, according to Shor.

“If a diabetic patient’s medication adherence is below 60 percent, it costs the healthcare system about $6,500 a year, but if adherence goes up to 80 percent it would cost about $4,500,” said Shor, citing a 2005 Medical Care study.

Of course, mobile health technology also has a price tag and those costs have to be weighed against potential savings. Part of that price tag is having adequate security. An interview with Ciaran Bradley of AdaptiveMobile, a vendor providing mobile network security, suggests that hospitals and medical practices are not going to see ROI on their mobile initiative without investing in adequate security. Depending on the approach you choose to take, that can mean a few dollars per device, or a few million dollars if you choose an enterprise solution.

Jordan Proto-React White/White/White