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Interoperability Becoming Important To Consumers

Posted on June 26, 2015 I Written By

Anne Zieger is veteran healthcare editor and analyst with 25 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. She can be reached at @ziegerhealth or www.ziegerhealthcare.com.

The other day, I was talking with my mother about her recent primary care visit — and she was pretty po’d. “I can’t understand why my cardiologist didn’t just send the information to my family doctor,” she said. “Can’t they do that online these days? Why isn’t my doctor part of it?”

Now, to understand why this matters you need to know that my mother, who’s extremely bright, is nonetheless such a technophobe that she literally won’t touch my father’s desktop PC. She’s never opened a brower and has sent perhaps two or three e-mails in her life. She doesn’t even know how to use the text function on her basic “dumb” phone.

But she understands what interoperability is — even if the term would be foreign — and has little patience for care providers that don’t have it in place.

If this was just about my 74-year-old mom, who’s never really cared for technology generally, it would just be a blip. But research suggests that she’s far from alone.

In fact, a study recently released by the Society for Participatory Medicine and conducted by ORC International suggests that most U.S. residents are in my mother’s camp. Nearly 75% of Americans surveyed by SPM said that it was very important that critical health information be shared between hospitals, doctors and other providers.

What’s more, respondents expect these transfers to be free. Eighty seven percent were dead-set against any fees being charged to either providers or patients for health data transfers. That flies in the face of current business practices, in which doctors may pay between $5,000 to $50,000 to connect with laboratories, HIEs or government, sometimes also paying fees each time they send or receive data.

There’s many things to think about here, but a couple stand out in my mind.

For one thing, providers should definitely be on notice that consumers have lost patience with cumbersome paper record transfers in the digital era. If my mom is demanding frictionless data sharing, then I can only imagine what Millenials are thinking. Doctors and hospitals may actually gain a marketing advantage by advertising how connected they are!

One other important issue to consider is that interoperability, arguably a fevered dream for many providers today, may eventually become the standard of care. You don’t want to be the hospital that stands out as having set patients adrift without adequate data sharing, and I’d argue that the day is coming sooner rather than later when that will mean electronic data sharing.

Admittedly, some consumers may remain exercised only as long as health data sharing is discussed on Good Morning America. But others have got it in their head that they deserve to have their doctors on the same page, with no hassles, and I can’t say the blame them. As we all know, it’s about time.

Bosch’s Telemedicine Shutdown Suggests New Models Are Needed

Posted on June 25, 2015 I Written By

Anne Zieger is veteran healthcare editor and analyst with 25 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. She can be reached at @ziegerhealth or www.ziegerhealthcare.com.

While many new telehealth plays are rapidly gaining ground, the previous generation may be outliving its usefulness. That may be the message one can take from one giant German conglomerate’s decision to shut down its U.S. telemedicine division.

Robert Bosch GmbH recently announced that it would shut down its U.S. telehealth unit, Robert Bosch Healthcare Systems, which makes business-to-business telemedicine systems. Its offerings include patient interfaces, software and platforms.

You may never have heard of this healthcare company, nor of its massive corporate parent Robert Bosch GmbH, but it’s part of a very large conglomerate with virtually infinite resources.

As it turns out, Bosch is a massive firm which competes with market leaders like GE and Siemens. Robert Bosch GmbH, which has existed since 1886, has more than 350 subsidiaries across about 60 countries and employs about 306,000 people. (I could share more, but I’m sure you get the idea.)

While the failure of one company’s telemedicine strategy doesn’t necessarily mean death for all similar plays, it does suggest that the nimble smaller firms may have more of an advantage than it appears.

Bosch Healthcare was actually way ahead of the market with its offerings, which included remote monitoring tools such as a touch-screen device for home use after hospital discharge and a family of mHealth tools aimed at chronic care management.But they appear to have been held back by proprietary technologies in a market that demands cheap and easy.

Ultimately, the end came when the parent company wasn’t happy with how the telehealth division was performing financially, and decided to cut and run. A statement from the company said that Bosch plans to shift its medical focus to sensor technologies to support improved diagnostics.

It’s hardly surprising that a company Bosch’s size would fail to keep up with the marketplace, given its size. No matter how smart the division’s 125 employees were, they were probably saddled with big company politics which prevented them from making big changes. Not to mention low priced tablets appeared and created a low cost competitor.

The question is, will other large players follow Bosch’s lead? It will be worth noting whether other large companies cede the telehealth market to small and emerging entrants as well. It’s not a no-brainer that this will happen; after all, there’s billions to be made here. But they may actually be wise enough to know when they’re ill-equipped to proceed.

I’ll be particularly interested to see what strategies existing health IT players adopt toward telehealth. It’s unclear how they’ll react to rising consumer and professional interest in telehealth technology, but whatever they do it will probably be worth analyzing.

That being said, with smaller companies out there breaking new ground with next-gen telemedicine apps and tools, they’re probably going to be in the unusual position of playing catch up. And in this case, slow and steady may not win the race.

Lessons To Consider When Weathering M&A Transitions

Posted on June 24, 2015 I Written By

Anne Zieger is veteran healthcare editor and analyst with 25 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. She can be reached at @ziegerhealth or www.ziegerhealthcare.com.

These days, the need for sophisticated IT infrastructure and the shift to risk-bearing insurance contracts are increasingly favoring large, muscular players. Not surprisingly, healthcare industry M&A is reaching a new peak.  Just about any substantial healthcare organization is facing the question of whether to acquire outside players and bulk up, merge with a bigger healthcare player or risk going it alone.

Particularly if you’re doing the acquiring, however, achieving critical mass is just the first in a long, difficult series of steps necessary to success. Health systems, in particular, face difficult management challenges when they try to integrate all of the moving parts necessary to survive as a next-gen organization.

A new study commissioned by West Monroe Partners, however, may shed some light on how to think about M&A integration issues. The study, which focuses on mid-market deals (between $300M and $2B) looks at post-merger integration across several industries, but I’d argue that its lessons still make sense for hospitals. Their tips for managing post-merger transitions include the following:

  • Start planning early:  West Monroe researchers found that companies which considered integration strategies as they began targeting and negotiating with merger partners were more successful in integration. Specifically, these companies were able to integrate more deeply than firms that didn’t began planning till pre-merger preparations were already under way.
  • Pay close attention to cultures: Here’s an eye-opening stat: more than half of companies surveyed by researchers said that merger value was lost due to lack of attention to differences in corporate cultures. Clearly, giving lip service to this issue but failing to address it intelligently can be costly.
  • Poor change management impacts future dealmaking:  In a clear case of “sadder but wiser,” a whopping 94% of survey respondents said that they would place more emphasis on change management next time they managed post-merger integration efforts. The study doesn’t spell out why but it seems likely that their past efforts blew up on them. Given that many health systems won’t stop at one deal in this climate, this is an important point.
  • Communicating change well is essential: About three-quarters of mid-market execs said that communicating change to their staff was one of the hardest parts of integration, and 62% said that communicating to outsiders was a major challenge. Many seem unhappy with the results of the past efforts, as 57% said this was a key area for improvement.

Some of these suggestions may be discouraging for hospital leaders. After all, required and important changes like the ICD-10 transition and ongoing EMR changes may already have staffers near burnout, and they may react badly to coping with added cultural changes.

That being said, the survey results also suggest that many of the integration challenges healthcare organizations face can be headed off somewhat by smart planning.  At least there’s something execs can do to cushion the blow.

Even Without Meaningful Use Dollars, EMRs Still Selling

Posted on June 10, 2015 I Written By

Anne Zieger is veteran healthcare editor and analyst with 25 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. She can be reached at @ziegerhealth or www.ziegerhealthcare.com.

I don’t know about you, readers, but I found the following data to be rather surprising. According to a couple of new market research reports summarized by Healthcare IT News, U.S. providers continue to be eager EMR buyers, despite the decreasing flow of Meaningful Use incentive dollars.

On the surface, it looks like the U.S. EMR market is pretty saturated. In fact, a recent CMS survey found that more than 80% of U.S. doctors have used EMRs, spurred almost entirely by the carrot of incentive payments and coming penalties. CMS had made $30 billion in MU incentive payments as of March 2015. (Whether they truly got what they paid for is another story.)

But according to Kalorama Information, there’s still enough business to support more than 400 vendors. Though the research house expects to see vendor M&A shrink the list, analysts contend that there’s still room for new entrants in the EMR space. (Though they rightfully note that smaller vendors may not have the capital to clear the hurdles to certification, which could be a growth-killer.)

Kalorama found that EMR sales grew 10% between 2012 and 2014, driven by medical groups doing system upgrades and hospitals and physician groups buying new systems, and predicts that the U.S. EMR market will climb to $35.2 billion by 2019. Hospital EMR upgrades should move more quickly than physician practice EMR upgrades, Kalorama suggests.

Another research report suggests that the reason providers are still buying EMRs may be a preference for a different technical model. Eighty-three percent of 5,700 small and solo-practitioner medical practices reported that they are fond of cloud-based EMRs, according to Black Book Rankings.

In fact, practices seem to have fallen in love with Web-based EMRs, with 81% of practices telling Black Book that they were happy with implementation, updates, usability and ability to customize their system, according to the Q2 2015 survey. Only 13% of doctor felt their EMRs met or exceeded expectations in 2012, when cloud-based EMRs were less common.

Now, neither research firm seems to have spelled out how practices and hospitals are going to pay for all of this next-generation EMR hotness, so we might look back at the current wave of investment as the time providers got in over their head again. Even a well-capitalized, profitable health system can be brought to its knees by the cost of a major EMR upgrade, after all.

But particularly if you’re a hospital EMR vendor, it looks like news from the demand front is better than you might have expected.

Behold The Arrival of The Chief Mobile Healthcare Officer

Posted on June 9, 2015 I Written By

Anne Zieger is veteran healthcare editor and analyst with 25 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. She can be reached at @ziegerhealth or www.ziegerhealthcare.com.

Managing fleets of mobile devices is an increasingly important part of a healthcare IT executive’s job. Not only must IT execs figure out how to provide basic OS and application support – and whether to permit staffers and clinicians to do the job with their own devices – they need to decide when and if they’re ready to begin integrating these devices into their overall lines of service. And to date, there’s still no standard model using mobile devices to further hospital or medical practice goals, so a lot of creativity and guesswork is involved.

But over time, it seems likely that health systems and medical practices will go from tacking mobile services onto their infrastructure to leading their infrastructure with mobile services. Mobile devices won’t just be a bonus – an extra way for clinicians to access EMR data or consumers to check lab results on a portal – but the true edge of the network. Mobile applications will be as much a front door to key applications as laptop and desktop computers are today.

This will require a new breed of healthcare IT executive to emerge: the mobile healthcare IT leader. It’s not that today’s IT leaders aren’t capable of supervising large mobile device deployments and integration projects that will emerge as mHealth matures. But it does seem likely that even the smartest institutional HIT leader won’t be able to keep up with the pace of change underway in the mHealth market today.

After all, new approaches to deploying mHealth are emerging almost daily, from advances in wearables to apps offering increasingly sophisticated ways of tracking patient health to new approaches to care coordination among patients, caregivers and friends. And given how fast the frontier of mHealth is evolving, it’s likely that healthcare organizations will want to develop their own hybrid approaches that suit their unique needs.

This new “chief mobile healthcare officer” position should begin to appear even as you read this article. Just as chief medical information officers began to be appointed as healthcare began to turn on digital information, CMHOs will be put in place to make sense of, and plan a coherent future for, the daily use of mobile technology in delivering care. The CMHO probably won’t be a telephony expert per se  (though health systems may scoop up leaders from the health divisions of say, Qualcomm or Samsung) but they’ll bring a broad understanding of the uses of and potential for mobile healthcare. And the work they do could transform the entire institution they serve.

FDA-Approved Digital Health Should Save $100B+ Over Next Four Years

Posted on June 8, 2015 I Written By

Anne Zieger is veteran healthcare editor and analyst with 25 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. She can be reached at @ziegerhealth or www.ziegerhealthcare.com.

Here’s some research which suggests that a lack of “medical grade” digital health tools is perhaps the final obstacle holding healthcare back adopting them full scale — and reaping the benefits.

Accenture released a study last week concluding that FDA-regulated digital health solutions should save the U.S. healthcare system more than $100 billion between now and the next four years.

The scant number of digital health solutions the FDA has already approved has already had a meaningful impact, generating $6 billion in cost savings last year courtesy of improved med adherence, fewer ED visits and digitally-supported behavior changes, Accenture reports.

But that’s just a drop in the bucket, if Accenture is right. The consulting firm expects our health system to save $10 billion this year thanks to use of such devices. And then, as the FDA approves more digital health technology, the savings figure should make dramatic jumps over the next few years, hitting $18 billion in ’16, $30 billion in ’17 and $50 billion in ’18.

What’s intriguing about these numbers is that they assume each FDA approval will seemingly generate not only more savings, but also a cumulative “whole is greater than the sum of its parts” effect.

After all, in raw numbers, the number of devices Accenture is relying on to achieve this effect is small, from 33 approved last year to 100 by the end of 2018. In other words, 67 devices will help to generate an additional $44 billion in savings.

That being said, what makes Accenture so sure that the ever-so-slow FDA will approve even 70-odd devices over the next few years?

* Provider demand:  At present, about one-quarter of U.S. doctors “routinely” use tele-monitoring devices for chronic disease management, researchers found. As hospitals and medical practices look to integrate such solutions with their core EMR infrastructure, they’ll look to please providers who want digital health tech they can trust.

Reimbursement shifts:  Accenture argues that as value-based reimbursement becomes more the norm, health leaders will increasingly see digital health solutions as a means of meeting their goals. And medical device providers will be only to happy to provide them.

Regulatory conditions: With FDA guidelines in place specifying when wellness tools like heart rate monitors become health devices, it will be easier for the FDA to speed up the process of digital health technologies, Accenture predicts. This should support 30% annual growth of such solutions through 2018, the study found.

Consumer health tracking:  Consumer demand for health tracking devices, especially wearables, should continue its rapid expansion, with the number of consumers owning a wearable fitness device to double from 22% this year to 43% by 2020, according to the consulting firm.

While Accenture doesn’t address the impact of digital health tech that doesn’t get FDA approval, there’s little doubt that it too will have a significant impact on both health outcomes and cost savings. Ultimately, though, it could be that it will take an FDA seal of approval to get widespread adoption of such technologies.

Hospitals Favor IT Investments Over Cash on Hand

Posted on June 5, 2015 I Written By

Anne Zieger is veteran healthcare editor and analyst with 25 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. She can be reached at @ziegerhealth or www.ziegerhealthcare.com.

Today I was reading a piece in Healthcare Finance News concluding that now more than ever, hospitals are being judged by financial analysts by the number of days’ cash they had on hand. At the same time, the story noted that hospitals are facing some of the biggest financial stresses they’ve faced in decades, with high patient deductibles and copays leading to drops in collections, switches to risk-based compensation cutting margins and the ever-present need for EMR and other IT investment looming.

When you boil all of this down to the essentials, you’ve got a pitched battle going between the need for current liquidity and the need for future liquidity. While having cash on hand shored up for a rainy day makes analysts like Moody’s happy, failing to spend on the right IT infrastructure undercuts the chances of making it work a few years in the future.

After all, if you don’t have a current revenue cycle management system in place, payments can slip through your hands that could have been collected.  Without spending the right amount in (on the right product, at least) on tools that help manage risk-based contracts, health systems and ACOs can end up losing big money on these contracts.

And even hospitals that aren’t in robust shape are betting their financial future on big EMR investments because they clearly consider it necessary to do so. For example, as I noted in a post earlier this year, Chattanooga, TN-based Erlanger Health System just committed to a 10-year, $100 million deal to put Epic in place despite its only recently having recovered from serious financial challenges.

So the question becomes whether hospitals can risk being cash-poor for now — at least by one measure — in an effort to keep the IT tools they need at hand. Obviously, there’s no one-size-fits-all answer, but industry strategies seem to offer a hint.

The reality seems to be that many health systems and hospitals feel they need to invest in IT upgrades and new technologies whether the traditional metrics fall into line or not. As scary as the regulatory issues (such as the ICD-10 upgrade) and changes in compensation are, health organizations like Erlanger are making the bet that even if it makes them uncomfortable now, having the right IT in place is a must-do.

While I’m no financial genius, my guess is that this means hospitals are going to voluntarily let key metrics like DCOH slip in favor of building for a solid future. I suppose we’ll know in five years or so whether taking such a risk pushed a bunch of hospitals over the cliff.

Hospitals Test New Early-Warning Systems

Posted on June 3, 2015 I Written By

Anne Zieger is veteran healthcare editor and analyst with 25 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. She can be reached at @ziegerhealth or www.ziegerhealthcare.com.

The following story offers some tidbits on how new technologies, some EMR-based and some offering independent forms of patient monitoring, are popping up in hospitals.  I found the technologies profiled to be quite interesting and I think you will too.

According to a new piece in The Wall Street Journal, U.S. hospitals have begun to test wireless monitoring systems to track the condition of potentially unstable patients, such post-surgical patients or those on narcotic meds that can suppress breathing. The new technology is most popular on med/surg units where patients aren’t generally monitored 24/7 for changes that can prove fatal.

One approach hospitals are adapting is a wireless monitor which is placed under a mattress and tracks patients’ breathing and heart rate. The monitors, which were developed by an Israeli firm called EarlySense, also lets nurses know when patients get out of bed and when to turn them to avoid bed sores. According to the WSJ, EarlySense costs between $80,000 to $200,000 for a 30-bed unit; prices vary depending on how big the hospital is and how many features the product includes.

Academic research is already suggesting that such monitors can make a significant impact on patient care in hospitals. One study appearing in the American Journal of Medicine last year found that use of the wireless monitors was correlated with both shorter stays and a lower rate of code blue events as compared to units that didn’t use the monitors.

Another technology, software known as the Rothman Index, cross-references 26 variables in medical records and uses them to score a patient on a scale from 1 to 100, with lower scores suggesting that the patient needs to be watched more closely or receive immediate help. The software, which costs roughly $150,000 for a 300-bed hospital, places updated scores regularly on a graph. Some 70 hospitals already have the software in use.

The University of Pittsburgh Medical Center children’s hospital will soon join that number, rolling out a pediatric version of the Rothman Index software in June. UPMC, which has always invested heavily and inventively in new HIT approaches, chose to implement the new software after a research study appearing in Pediatric Critical Care Medicine found that it could effectively supplement staffs’ effort to track kids.

Yet another technology, used at Brigham and Women’s Hospital in Boston, rates patients’ risk of developing serious problems in real time, by analyzing patterns found in lab results, vital signs and nurses’ assessments gathered from EMRs.

Regardless of how you slice it, it’s clear that hospitals are poised to make big leaps in how they monitor patients on the verge of destabilization. This looks like a very promising set of approaches.

Partners Goes With $1.2B Epic Installation

Posted on June 2, 2015 I Written By

Anne Zieger is veteran healthcare editor and analyst with 25 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. She can be reached at @ziegerhealth or www.ziegerhealthcare.com.

After living with varied EMRs across its network for some time, Boston-based Partners HealthCare has decided to take the massive Epic plunge, with plans to spend an estimated $1.2 billion on the new platform. That cost estimate is up from the initial quite conservative spending estimate from 3 years ago of $600M, according to the Boston Globe.

As is always the case with an EMR install of this size, Partners has invested heavily in staff to bring the Epic platform online, hiring 600 new employees and hundreds of consultants to collaborate with Epic on building this install. The new hires and consultants are also tasked with training thousands of clinicians to navigate the opaque Epic UI and use it to manage care.

The move comes at the tail end of about a decade of M&A spending by Partners, whose member hospitals now include Brigham & Women’s Hospital, Massachusetts General Hospital, the Dana-Farber Cancer Institute, McLean Hospital, Spaulding Rehabilitation Hospital and the North Shore Hospital.

The idea, of course, is to create a single bullet-proof record for patients that retains information no matter where the patient travels within the sprawling Partners network. Partners can hardly manage the value-based compensation it can expect to work with in the future if it doesn’t have a clear patient-level and population level data on the lives it manages.

Even under ideal circumstances, however, such a large and complex project is likely to create tremendous headaches for both clinical and IT staffers. (One might say that it’s the computing equivalent of Boston’s fabled “Big Dig,” a gigantic 15-year highway project smack in the middle of the city’s commuting corridor which created legendary traffic snarls and cost over $14.6 billion.)

According to a report in Fortune, the Epic integration and rollout project began over the weekend for three of its properties, Brigham & Women’s, Faulkner Hospital and Dana Farber. Partners expects to see more of its hospitals and affiliated physician practices jump on board every few months through 2017 — an extremely rapid pace to keep if other Epic installs are any indication. Ultimately, the Epic install will extend across 10 hospitals and 6,000 doctors, according to the Globe.

Of course, the new efforts aren’t entirely inward-facing. Partners will also leverage Epic to build a new patient portal allowing them to review their own medical information, schedule appointments and more. But with any luck, patients will hear little about the new system going forward, for if they do, it probably means trouble.

Hospitals Should Give Smartphones To Sick Patients

Posted on June 1, 2015 I Written By

Anne Zieger is veteran healthcare editor and analyst with 25 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. She can be reached at @ziegerhealth or www.ziegerhealthcare.com.

As I see it, hospitals have developed a new and rapidly emerging problem when it comes to managing mobile health services. Not only do they face major obstacles in controlling staff use of tablets and smartphones, they’re right in the center of the growing use of these devices for health by consumer. It’s BYOD writ even larger.

Admittedly, most of the consumers who use mobile devices don’t rely that heavily on them to guard and guide their health. The healthiest of consumers may make a lot of use of wearable fitness bands, and a growing subset of consumers may occasionally leverage their phone’s video capabilities to do telemedicine consults, but few consumers base their medical lives around a mobile device.

The chronically-ill patients that do, however, are very important to the future of not only hospitals — which need to keep needless care and readmits to a minimum if they want to meet ACO goals — but also the insurance companies who finance the care.

After all, the more we dig into mHealth, the more it appears that mobile services and software can impact the cost of care for chronic conditions. Even experiments using text messages, the lightest-weight mobile technology available, have been successful at, for example, helping young women lose weight, change their diets, and slash their risk of cardiac problems. Just imagine the impact more-sophisticated technologies offering medication management, care coordination, blood glucose and pulse ox tracking could have on patients needing support.

But there’s a catch here. A long as mHealth services are delivered via the patient’s own device, the odds of successfully rolling out apps or connected health monitoring services are minimal. I’d argue that such mHealth services will only have a major impact on sick patients if the technology and apps are bolted to the hospital or clinic’s IT infrastructure.  And the operating system used by patients, be it Android or iOS, should be the same one the hospital supports among its employees, or maintaining apps, OS upgrades and patches and even firmware upgrades will be a nightmare to maintain.

Given the security and maintenance issues involved in fostering a connection between provider and patient, I’d argue that providers who are serious about advanced mHealth services absolutely must give targeted chronically-ill patients a locked-down, remote controlled smartphone or tablet (probably a smartphone for mobility) and lock out their networks from those trying to use connected apps on a rogue device.

Will this be expensive?  Sure, but it depends on how you look at costs.  For one thing, don’t you think the IT staff costs of managing access by various random devices on your network — or heaven forbid, addressing security holes they may open in your EMR — far exceed even the $700-odd retail price for such devices?

This might be a good time to get ahead of this issue. If you’re forced to play catch up later, it could cost a lot more.