Topic: What factors aid and what factors inhibit in the adoption of mHealth in the following areas a. b. c. d.

Technology Legal and Governmental Frameworks Clinical Effectiveness Payment System

1. What are the factors that aid the adoption of mHealth a. Broad usage of technology i. 4G MNO 1. Scandinavia Geography is smaller and mobile reach is extensive even to remote areas 2. Parts of the US are still not covered ii. Smartphones Device Makers 1. Apple 2. Android 3. Windows 7 iii. Peripheral Device Makers Sensors 1. Commercial of the shelf 2. FDA approved devices iv. Patients more aware 1. Technology is widely used v. Doctors more adept at using technology 1. Doctors are more comfortable using their smartphones vi. Healthcare organizations are more and more turning to the use of Electronic Health b. Legal and Governmental Frameworks i. HIPAA in the US (patient privacy is more strict in Scandinavia) ii. HITECH ARRA iii. Governmental registries for Disease control c. Clinical Effectiveness i. Cardiac Rhythm Monitoring Aortic valve monitoring is effective ii. Wellness monitoring help in avoiding issues iii. Remote Treatment both doctor/patient and doctor/specialist d. Payment System i. The single payer system of Scandinavia encourages ii. Growing health cost iii. Ageing population 2. What are the factors that inhibit the adoption of mHealth

a. Broad usage of technology i. Difficulty of the elderly in using the technology b. Legal and Governmental Frameworks i. Not specifically targeted to mHealth c. Clinical Effectiveness i. Cardiac Rhythm Monitoring Has not been that effective in forecasting the health of patients ii. Clinical effectiveness has seen mixed results and hence most of the doctors are not a 100% sold d. Payment System i. The multi-payer system i.e. insurance, Medicare, subsidies, etc. do not aid in the usage of health care ii. The elderly are less inclined to use technology

Questions to be asked 1. Are there Cardiac Rhythm monitoring devices for mobile health a. Yes both commercial and clinical devices are available b. Clinical e.g. Merline.Net and USB adapter c. Commercial e.g. Heart Rate Monitors, Blood Glucose Level, Oxygen level monitors 2. What is the role of Cardiac Rhythm Monitoring using mobile a. Basically the role of Cardiac Rhythm monitors focus on the wellness of patients rather than on cure 3. Do the governmental policies and infrastructure encourage the usage of mHealth? a. In the US with the multi-payer system, it does not encourage the usage of mHealth and in fact hampers the usage of mHealth b. In the Scandinavia single payer system, the governments are keener on doing what works for their people. Hence it is more likely to be incentivized in the Nordic countries. 4. How effective is the usage of Cardiac Rhythm Monitoring using Mobile technologies for clinical effectiveness? a. Most of the studies that are done cut both way and there is no clear cut observation that mHealth improves clinical effectiveness b. The only cardiac rhythm monitoring that has proven to be conclusive in forecasting the health of a patient is the aortic valve monitoring 5. What obstacles do you see in the widespread usage of mHealth? a. One of the significant drawback of mHealth is that the elderly are less likely to use SmartPhones and related applications and hence the penetration among the elderly is going to be low b. The multi-payer system is a big drawback c. The incentives are not for preventive care and wellness. Rather it is for disease treatment and in medication