Thoughts on Politico’s ‘Health Care of the Future’

At a recent event sponsored by Politico and Microsoft, an interesting mix of innovators and policymakers gathered to discuss how modern health technologies, such as mobile apps and clinical support tools, are changing the future of health care as well as the role that policy plays – or should play –  in the advancement of such technologies.

The impressive list of participants in this informative discussion included Dr. Farzad Mostashari, National Coordinator for Health IT for the Department of Health and Human Services (HHS), Christy Foreman, Director of the Food and Drug Administration’s (FDA) Office of Device Evaluation, Dr. Joe Smith, FACC, Chief Medical and Science Officer of West Health, Dr. Jordan Shlain, Founder of HealthLoop, among others.

As an attendee of the event, I came away with the following key themes and issues:

–          There is a gap between health policy and health care technology innovation.

Although the FDA has developed rigorous testing to determine the safety and efficacy of medical devices and drugs, they have yet to establish standards for recent health care innovations such as mobile health apps. This poses a problem as there are thousands of apps used for health care purposes every day. According to Joel White, executive director of the Health IT Now Coalition, “technology is changing in such a rapid innovative pace, and the current [regulatory] structure doesn’t work.”  There seemed to be a consensus among the non-policymaking participants of the panel on White’s statement. Dr. Joe Smith stated that “the government is struggling at the moment, we’ve witnessed a technological impact in every other aspect of our lives, and healthcare has escaped from it.”

 In the defense of policymakers, Farzad Mostashari states that regulations are much more enablers of innovation than health care technology developers think, the issue is that “[developers] don’t understand the regulations and rules.”

Although steps have been taken by the government to develop standards on mobile health technology, such as draft guidance on mobile medical applications that FDA released in 2011, clear standards need to be defined in order for health care innovation to reach its full potential. One thing we can certainly look forward to is FDA’s final mobile medical app guidelines, which Christy Foreman said will be available by October of this year.

–          With the quantity of data and health care technology out there – developers must not lose focus on quality.  

According to Audie Atienza Ph.D., senior program director of the Science of Research and Technology Branch of the National Cancer Institute, there are currently between 20,000 to 40,000 apps that are used for health, wellness or fitness purposes. With this number of apps, how are they being tested for effectiveness and reliability? The simple answer is that they’re not. While the FDA has developed draft mobile medical guidelines, it has become the health technology developer’s prerogative to ensure that they’re not innovating for innovation’s sake – technology must be meaningful and centered on the patient to make a lasting difference.

Atienza provided one example of how using technology in the right way can lead to desired results – when the National Institute of Health (NIH) sought to reduce teenage smoking, they launched a campaign centered on text messaging called SmokefreeTXT. NIH found that a sizeable percentage of teens using the service were quitting smoking after using their text-messaging service over a length of time. Health technology developers should take a page from NIH’s book – the key to successful innovation is to make it meaningful to its users.

–          There needs to be a shift from the current reactive nature of our health care system to a proactive one.

Dr. Jordan Shlain used a great term to describe our current health care system, calling it a “reactive health care system”. I couldn’t agree more; our health care system focuses on treating patients’ illnesses, rather than providing patients with tools that help them to avoid illness in the first place. Although the health care reform law attempts to address this issue by punishing hospitals that have excessive hospital readmissions, Atienza took it one step further and says that we need to prevent admissions, not just readmissions.

What’s Dr. Shlain’s solution to making our health care system a more proactive one? Email.   He states that personal medical records (PMRs)/electronic medical records (EMRs)/electronic health records (EHRs) capture a fraction of a patient’s health history, but “we live 99 percent outside of the EHR.”  He believes that creating a system that allows doctors to regularly engage with patients by email will keep patients out of the hospital.  Although there are many obstacles to making email a widely adopted practice by doctors, such as fear of malpractice and privacy concerns, I believe that more people need to be thinking like Dr. Shlain. In order for the health care system to be proactive, its players – doctors and patients – need to be proactive.

We’re in an era in which innovations in health care are growing at an ever-increasing rate, but this seemingly boundless potential of health care technology brings its own set of problems. The key is to find the balance between advancement and the quality of the technology. The leaders that participated in this panel brought these issues to table, but there needs to be a systemic discussion among all leaders in the industry in order for health care technology to reach its full potential. This event may be one baby step, but as health care communicators we are uniquely situated to encourage our clients and colleagues to promote and advance key health care issues of our day – one thing I hope you take away from this is to encourage your clients to promote meaningful health care innovation.