September 12, 2013

Is it time for a dedicated mHealth manager, and team?


What is mHealth? To date I have struggled to find a standard definition.  According to the World Health Organization (WHO) it is “an area of electronic health (eHealth) and it is the provision of health services and information via mobile technologies such as mobile phones and Personal Digital Assistants (PDAs).”  PDAs…..Really??  The mHealth Alliance defines it as “mHealth stands for mobile-based or mobile-enhanced solutions that deliver health. The ubiquity of mobile devices in the developed or developing world presents the opportunity to improve health outcomes through the delivery of innovative medical and health services with information and communication technologies to the farthest reaches of the globe.”

To me mHealth is simply leveraging mobile technologies to provide, or improve positive clinical outcomes.  That includes using mobile devices in an inpatient/outpatient hospital or clinic setting. It also includes home health, and using mobile technologies to promote and improve wellness.   No matter how we define it, the mHealth market is growing at a fast rate, and is expected to reach $10.2 billion by 2018 up from 1.3 billion in 2013 according to a recent report from Transparency Market Research.

One view point pertaining to mHealth implies that mHealth is essentially how healthcare will be delivered in the future and that the genre does not merit its own name, but should be defined as healthcare. The idea is that having an mHealth silo in an organization would be counterproductive and add unnecessary levels of beaurocracy.  In my opinion, this view is taking for granted the level of expertise required to ensure that seamless mobility functions properly and that appropriate measures are taken to ensure a positive end user QoE (Quality of Experience).  Not to mention concerns about patient data security, and privacy.

I embarked on a journey to co-author a book about Mobility in healthcare about a year and a half ago, and what myself and the other authors quickly found out is that mobility is a vast field of expertise and we had to limit the book to focusing in on Wi F in Healthcare.  The mediums that allow for mobility range from Mbans, cellular networks (DAS), WiMax, Wi-Fi, Zigbee, and the list can go on and on.  In order to truly understand mobility, one has to be well versed in all of these areas.

MHealth has tremendous potential, but it requires talented individuals with a wide skill set to shepherd the technology and use cases in the right direction ensuring that end users have a positive experience along the way.  A typical hospital Wi Fi network today is providing services for employees, guests, medical devices, voice devices, video devices, BYOD, etc.   All of these share a common bandwidth and are at the mercy of half-duplex transmission.  In order for the various types of devices to play nicely together in the sandbox, it’s crucial that a well-designed end to end QoS (Quality of service) strategy is in place, and that some form of role based access control with a backend policy enforcement is implemented.  This protects the devices from each other and ensures that packets from a specific type of device or application are prioritized appropriately.

It is crucial that the administrators of the mHealth infrastructure have a solid foundation in Wi Fi network design, deployment and troubleshooting, but are also involved in various organizations like HIMSS, mHIMSS, the AAMI , the WI FI Alliance, etc. to ensure that they stay up to date with the latest developments  in the field.  A solid understanding of RF spectrum management is a necessary to ensure that the various devices under evaluation do not interfere with each other from an RF perspective.  The AAMI has taken initiative in this space by forming the Wireless Strategy Task Force (WSTF) comprised of manufacturers, regulators, users of technology, and other interested parties and is developing educational resources and tools and sharing best practices to address wireless challenges in healthcare.

Every wireless engineer and clinical engineer working in a hospital, handling mobile medical equipment should read through the documents posted.  HIMSS developed the mHIMSS organization last year to focus on mobility, mHealth, and mHealth applications.  The Wi-Fi Alliance has released a couple of great whitepapers referencing mobility in healthcare.  My favorite is “Wi-Fi® in Healthcare: Improving the user experience for connected hospital applications and devices”.

People often site the Kaiser Permanente hospital system as a leader in the space.  This is no coincidence. This organization uses a mobile first strategy, and has a world class wireless team with a thought leader and visionary at its helm.   It does not take long to run into Shawn Jackman when you start reading about Wi-Fi in Healthcare.

It is my feeling that in order for a system to be leader in the mHealth space, there needs to be dedicated focus on mHealth. That means having an mHealth group comprised of a manager/director with dedicated staff.  Managing mHealth initiatives is different from managing Wi Fi network operations.  It requires a higher level of coordination between clinical engineering, and input form the clinical community.  It also entails understanding and managing mobility use cases within as well as outside the traditional hospital or clinic.  This entails a shift in focus from Wi-Fi infrastructure to cellular, and smartphone applications.  A close alignment with the vision for mobility at an organization is also crucial.  An end user having a smooth experience while using mHealth technology or tools can not be left to chance.  Part of the responsibility of the mHealth group would be to ensure that all regulatory mandates are met, technology best practices are implemented and last but not least that end user expectations are clearly set.

About The Contributor:
Bob ZemkeDirector of Healthcare Solutions

Bob Zemke is the Director of Healthcare Solutions and is responsible for the healthcare market strategy at Extreme Networks. An IT professional with a broad span of experience in healthcare, Bob has over 14 years working both within hospital IT and as a consultant in next generation network design, deployment and management. Bob has been featured in publications such as HealthCare Design Magazine, Mobile Wireless Magazine, and Healthcare Executive Exchange. He is coauthor of a book entitled "WiFi Enabled Healthcare" that is available on Bob frequently participates industry-specific events including HIMSS, Enterprise Connect, Interop and is active in the AAMI, CWNP, IEEE, and HIMSS organizations . Bob holds an BA degree in Telecommunications Management from Western Michigan University and his MS in Telecommunications and Network Management from Syracuse University's iSchool.

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