A Review of the midyear progress of mHealth

A Review of the midyear progress of mHealth focuses on several mHealth IPOs,  specifically Fitbit and Teladoc.

They serve two separate niches, fitbit in the area of mhealth wearables, and Teladoc as a provider-patient centered application allowing remote video patient encounters with physicians.

Several transformative shifts are occuring between mHealth and EHR integration. In some cases mHealth is driving EHR integration.

Our blog today offers a quick centralized source for progress in mHealth application development.

Will mHealth's rise signal the end of the EMR?

One of the hot trends is the integration of patient-facing data into the electronic medical record. 

EPIC , is developing it's own mhealth application in concert with Apple's Healthkit. Epic has begun to offer details about what the platform will look like when the kinks are finally ironed out. 

From Epic's new app store to Validic's partnerships with Cerner and athenahealth (to name just a few), EMR platforms are evolving to accept health and wellness data from devices to better define a patient's profile outside the medical encounter.  "It's not just physician documentation any more," says Girish Navani of eClinicalWorks. "The patient is part of that equation … but there have to be filters."  Consumers, she says, "are more involved in their healthcare, which puts the onus on (clinicians) to work with them, but we haven't seen much good data come out of the FitBits and other consumer-facing devices" that would make a doctor sit up and take notice.

 EHRs and wearables - their time has come?]

The convergence of two industry titans, Apple and Epic portends another swift sea-change fueled by adequate capitalization of IPOs and equity funding. Does this mean the EMR is becoming obsolete? Or is it evolving into an EHR?

Much of the conversation between a doctor and a patient focuses on what the patient is doing outside of the doctor's office – in other words, the doctor is looking for data that today's health and fitness wearables are collecting. This means that all that information in the margins is now being pulled into the record.

Providers say they don't want all that extra information coming into the medical record, but they can't deny the value of health and wellness data in developing a care management plan for their patients. They're worried about validity – is data entered by the patient reliable enough to be included in clinical decision support?

At this point, the answer is no, and mHealth vendors and EMR providers understand this. As Navani points out, the data has to be curated first – collected, sifted and organized into something that a provider can trust and ultimately use. Some EMR companies tackle this issue by shunting consumer-entered data into a PHR or similar silo; the consumer then grants permission to the provider to parse over that data and determine what can be pulled out and ultimately entered into the medical record.

f that's the case, then this truly is a health record, not a medical record.

The proliferation of consumer-facing apps and devices has also given rise to a dichotomy in how mHealth data is collected. On one side stand platforms like Apple's HealthKit and ResearchKit, which gather consumer data for use by healthcare providers. On the other side are platforms like Qualcomm Life's 2net hub, which takes data from reliable devices – not the consumer – and goes to great lengths to ensure that such data is "medical grade."

Can both data streams share space in the same record? That depends on how EMRs and EHRs are defined.