By Edgar Wilson
When looking at the map of high-speed internet access in the U.S., it has become all too easy to forget that “access” is not the same as “high-speed access.”
After all, with internet media companies like Netflix and YouTube transforming how entertainment is packaged, produced, and even conceived, getting the full web experience requires a lot of data, very quickly.
Mobile networks have similarly placed a premium on high-speed coverage, and the phones and mobile devices most in-demand reflect the entertainment and consumption-focused products consumers seem to want most.
At the same time, designers have quietly programmed increasing sophistication into the concept of ‘mobile-friendly’ in order to reduce the data demands of their content—from websites, to images, even to simple multi-media content.
Mobile connectivity—even with all the new, multi-media capabilities being added to it—is still basically about simple, direct communication. Healthcare in the U.S. is marrying technology, professional philosophy, and government programs to reach the same basic goal of improved communication. Because of this, healthcare infrastructure need not rely exclusively on the spread on high-speed access to ensure quality care access.
The convergence of healthcare IT systems, philosophy, and modern medical technology has ballooned the field of Healthcare Informatics. This multi-dimensional branch of medicine is all about making human and virtual systems work better by working together, relying enormously on communication. This last feature is what frees modern (and future) healthcare, at least in part, from reliance on high-speed internet access.
The federal government’s Meaningful Use (MU) program was developed to move American healthcare online with the universal adoption of Electronic Medical Record (EMR) platforms. This was achieved first by providing incentives for early adopters of EMRs, then penalties for latecomers. As of 2015, MU has entered its latter stages, where the majority of providers are expected to have adopted an integrated EMR platform, and actually started using it as a standard practice (hence, meaningful use).
This is just one—though perhaps the most critical—element of how the government is driving medicine to go mobile on a national scale. Internally, the professional outlook has been undergoing a related revolution.
Historically, best practices in medicine often relied on a treatment or drug that, while more effective than any alternative, still only worked in a limited percentage of patients—often less than half. Patient-centered care puts the emphasis in treatment on the individual (rather than the disease or condition), and looks for long-term management and treatment goals, rather than emergency or short-term care. In this way, the right care can be delivered without undue reliance on aggregate data from a diverse population.
Of course, the shift to digital records is significantly aiding the transition.
Medication Therapy Management (MTM) is one example of how these changes intersect. Centered on the notion that pharmacists should play a larger role in the ongoing care and monitoring of patients with chronic conditions and multiple medications, MTM is all about improving health outcomes by improving communication. As such, it has an obvious need for fast, efficient communication between pharmacist and patient, so EMRs are a major part of broadening how and where this process can be used.
Since 2003, MTM has also been built into Medicare, with the goal of making it a standard element of care. Adoption has been predictably uneven, but the advance of EMRs (driven in part by the government’s MU program), along with the surge in MTM-qualified patients as Baby Boomers continue to live longer and require greater long-term care, ensures it is here to stay.
So what do decidedly domestic policies and developments have to do with making healthcare a globally-accessible product?
Telemedicine, the old idea that medical expertise (and therefore access) can travel without the need for doctors and nurses to travel themselves, is set to be fully realized in coming years. While the internet and all its aggregations of data and interactivity is central to telemedicine’s modern applications, it will be aided more by mobile networks than high-speed lines.
Internationally, mobile internet is the first and often only form of connectivity many have. Because of U.S. initiatives in medicine, for the first time, the expansion of this mobile infrastructure coincides with the transition of medicine onto digital and mobile platforms. In essence, quality health information can be universally accessible. Geography will not be the most significant barrier to receiving proper care.
Unlike many other infrastructure projects whose benefits are spatially limited (that is, you have to live near the highway to take advantage of it; you have to be in the path of the fiber optics to get access; you have to live in the city use the sewer, etc.), mobile infrastructure expansion is projected far behind the physical presence of the access point itself.
Recognition of this fact is part of the drive behind Facebook’s participation (along with many others) in a project to make mobile access truly global. Basic internet access would include social media platforms, along with simple text and data sites like Wikipedia. But by providing even the most basic connectivity, the project’s satellites, drones, and even towers bring valuable information and focused interaction to places cut off from other forms of critical infrastructure.
What the advance of healthcare informatics has done is unify the need for human infrastructure (that is, programmers, developers, and general IT gurus) with the need for physical infrastructure (the broadband and mobile connectivity that puts the technology to work and allows the information to flow between points of contact). Mobile connections realize the mission of telemedicine by expanding its reach to everyone with a mobile device.
The challenge amid all this expansion of access becomes one of controlling access—that is, data security. This is more of a problem in the US, where HIPAA laws and regulations create strong disincentives to mobile sharing for fear of breaching patient privacy. This does not impede the expansion of connectivity or proliferation of mobile devices—it is a significant but user-centric caveat.
Ever since tech-developers started prefixing their newest toys with ‘smart-‘ we have seen the mobile device market expand, driving, in turn, demand for more information, tools, and processes to also become more mobile-friendly. Now developers are looking for new ways to integrate everything from blood pressure-monitors to private vehicles into the ‘Internet of Things.’
By bringing health data—and communications, bio-data, and virtual-consultation capacity along with it—to the mobile world, health care has arrived on global stage in an unprecedented way. To realize its potential, mobile connectivity will be even more critical than high-speed internet access through broadband or fiber-optic lines.
What this mobile medicine shift does not provide is the physical infrastructure of healthcare—supplies, hygiene, and practitioners like surgeons. On its own, information is obviously no replacement for practiced expertise, but it is a huge step forward.
Part of the appeal of telemedicine is its ability to manage care and take a preventive approach to disease and complications. In this respect, telemedicine may be the future of all non-emergency services. For developing nations, as well as isolated communities in wealthier countries, today’s telemedicine should make mobile coverage a top priority.
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Edgar Wilson is an Oregon native with a passion for cooking, trivia, and politics. He studied conflict resolution and international relations at Amherst College, and has split his time between New England and the Pacific Northwest ever since. He has worked in industries ranging from international marketing to broadcast journalism, currently serving as a marketing consultant and blogger.
Tags: Edgar Wilson, Electronic Medical Records, EMR, Healthcare, Meaningful Use
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Excellent article, Edgar.
I think that the relationship between broadband and mobile is complimentary rather than adversarial (not that I think you are establishing an adversarial relationship). The Healthy Infrastructure article I wrote (and linked to under the Related Posts section) covered the one, and now you have covered the other nicely.
I see the relationship like this. Mobile provides the access to information people needs. It functions extremely well for asynchronous needs and as a means for convenient connection with healthcare expertise. It also creates excellent tracking and predictive modeling for both populations and individuals, as you’ve pointed out. (Remind me to write about GIS infrastructure and medical mapping some time.)
However, some of the things you spoke of as not being provided for by mobile are possible through broadband. While many materials will still need to be shipped, a surprising amount can be dealt with via broadband. A doctor in New York can perform surgery on a patient in Ghana. A custom fit artificial knee joint can be designed by a specialist in Los Angeles, then printed out on a medical grade 3D printer in Viet Nam for installation. These are things where the greater reliability of broadband can fill in some of mobile’s gaps.
Great article. Keep ’em coming.
Complimentary rather than adversarial–YES!
I’m glad you saw my intent there. However, to your point in your original article that “if 2015 is the year that Telemedicine really lands, it won’t be landing in the U.S.”–this is where I feel mobile can open doors that broadband currently doesn’t, and may not for some time.
Since mobile-based telehealth in less-developed regions may establish a primary healthcare infrastructure (as opposed to supplementing or replacing existing health systems, as in the U.S.), it is the key to immediate improvement. Of course, if and when broadband systems become feasible, they will represent a significant upgrade to the existing mobile-based delivery systems.
In this sense, they are definitely complimentary, but I think the relationship in the shorter term in less-developed regions differs somewhat compared to areas with significant healthcare and internet connectivity infrastructure.
Oh–regarding the ‘predictive modeling’ potential: I would love to see this. I almost included it in this article, because it provides something of a bridge between the developing and developed world in its relevance and impact (i.e., sending targeted aid and supplies to high-risk areas to counter the spread of an outbreak). Mobile connectivity opens up incredible possibilities for setting up this kind of ad hoc infrastructure globally–without the same need for investment and construction as broadband.
Cheers!
You have an excellent point about the relatively quick pace that mobile can boast in terms of infrastructural reach. I may have to do a little poking around to find out what the comparative prices and installation speeds have.
I’ll have to poke around at writing that predictive modeling article in the near future, and the role improved infrastructure would play in that.