The “Mobile” in “Mobile Health” Isn’t the Gadget; It’s the Data

Dec 6, 2012, 9:30 AM, Posted by Pioneer Blog Team

Albert Shar / RWJF Al Shar

For the fourth year in a row, the Robert Wood Johnson Foundation (RWJF) is proud to sponsor this week’s mHealth Summit. We see the mHealth Summit—attended by about 4,500 leaders from 50 countries—as an important gathering of thought leaders to source new ideas and learn about innovations in mobile health and the future of wireless medical connectivity. While there is no shortage of private sector investments in these technologies and businesses, we want to help identify investments that ensure that the mHealth space creates the greatest social good. 

In advance of the summit, we caught up with Al Shar, vice president and senior program officer, to talk about his vision for mobile health, as well as the role the Foundation can play moving forward.

Can you define what mHealth means from your perspective?

In general, when people talk about mHealth, they think about the device. But the true definition of mobile health doesn’t focus exclusively on the device, but on the fact that the information and data is mobile. It moves. The information is able to be collected wherever it is needed and transmitted wherever it needs to go. It’s less gadget-oriented, and more commerce-oriented and transaction-oriented, focused on the ability to capture information and transmit it when and where it’s needed.

We’ve witnessed rapid growth in the mHealth arena over the past few years; would you talk about the potential when data becomes more mobile?

Let me start with an example we can all relate to. You go to the doctor and have your blood pressure taken, but it is high because you are anxious about the situation, about being at the doctor. Think about what happens if we can measure and transmit blood pressure when it makes the most sense. Think about what happens if we can transmit information when changes take place—not when there is a specific encounter, such as a doctor’s appointment. Suddenly you not only have the ability to analyze longitudinal data, data over time, but you’re also able to bring on an intervention when that intervention is needed, not just when you’ve scheduled an appointment.

There is a tremendous amount of data created via mobile health. What challenges does this present? 

Two challenges come from the fact that we’re now collecting huge volumes of data, or have the potential to do so. The first is, we don’t have a baseline, and we don’t know what that means. The question becomes: Are we going to take action when action isn’t necessary, just because something has changed? The fact that you can measure patients’ heart rhythms at all times doesn’t mean they’re in some kind of cardiac distress. Not all anomalies are actionable.

The second challenge? Whether we’re dealing with doctors or patients, giving them a huge amount of data without an analysis is of little value. So the date tends to go unused or get discarded. We need to have tools that are valued, validated, have evidence behind them, and allow a person to both interpret and act on the information contained in that data.

Much of the investment in this area has been from the financial sector, which sees incredible financial value. What do you see as the investment role of other groups—such as government and foundations?

At the Foundation, we’ve been involved in the mHealth space and the mHealth Summit for some time. And there has been tremendous growth in that space, with an estimated $1.1 billion total investment in this area from the public and private sectors. It’s reasonable to ask why we need to do anything other than declare victory and move on. But while there are huge investments from private sources, what’s the value we end up adding? Most of the investment I see looks at short-term, individual tools. There are few parties looking at those investments that have a long-term potential to improve health in general and health care specifically. The Foundation is long-term. We’re looking at outcomes that can change the health and health care of all Americans. The second factor is that we care about certain populations that don’t necessarily get the kind of funding in mHealth that is necessary. We’re interested in more vulnerable populations and in public health, where there has been underinvestment. mHealth has the ability to show increased benefits to vulnerable populations and the public health field, if we invest intelligently.

What are some examples of projects RWJF is funding within mHealth and what role do you think they fill?

Our biggest current grant is to Open mHealth. This is one that has a large presence at the summit. It’s looking at how we provide an architecture, a set of standards and protocols, that allow for the efficient development of new applications, and also facilitate the consolidation and collection of those applications that can make a difference in health.

We've also made a series of grants examining value broadly, as well as a more focused and better defined development of new tools to generate evidence. Intuitively, many mHealth interventions make a huge amount of sense, but unless you can demonstrate that they actually can do some good and do it more cost effectively, I don't think that we’re going to have the impact that we need to have. This is an area where we need to work with others. To date, we’ve collaborated with the National Institutes of Health and others in Health and Human Services—and I know that they look to us as a critical partner.

Want to learn more about how better data can lead us to better health? Check out other projects and insight from RWJF.

This commentary originally appeared on the RWJF Pioneering Ideas blog.