Can Mobile Technology Cut Health Costs?

A new report says there are steps policymakers can take to increase the use of mobile applications in health care — but they aren’t being taken.

A man uses an UP fitness wristband and its smartphone application in Washington on July 16, 2013. Jawbone, the San Francisco-based company behind 'smart' wireless earpieces and Jambox speakers, late last year released redesigned UP wristbands that combine fashion with smartphone lifestyles to help people along paths to improved fitness. UP wristbands are priced at $129 in the United States. UP applications tailored for Apple or Android mobile devices collect data from the bands to let people get pictures of activity, sleep, eating, and even moods on any given day or over time.
National Journal
Clara Ritger
March 12, 2014, 2 p.m.

Mo­bile tech­no­logy could vastly im­prove ac­cess to health care ser­vices and lower costs, but poli­cy­makers aren’t tak­ing the right steps to in­cor­por­ate tech­no­logy in­to care, a new re­port con­cludes.

Re­search­ers at the Brook­ings In­sti­tu­tion stud­ied China and the United States — two coun­tries that face sim­il­ar chal­lenges in re­du­cing health care costs due to aging pop­u­la­tions and are look­ing at mo­bile tech­no­logy as part of the solu­tion, said Dar­rell West, found­ing dir­ect­or of the Cen­ter for Tech­no­logy In­nov­a­tion at Brook­ings.

Among the bar­ri­ers to wide­spread use of mo­bile health tech­no­logy in China and the United States is the fact that phys­i­cians don’t get re­im­bursed for us­ing the tech­no­logy to de­liv­er care. Also, de­velopers are un­clear about the rules and reg­u­la­tions sur­round­ing mo­bile health ap­plic­a­tions, which lim­its in­nov­a­tion.

“There’s a chick­en-and-an-egg prob­lem,” said West, who was also a coau­thor of the re­port. The Cen­ters for Medi­care and Medi­caid Ser­vices “doesn’t want to re­im­burse un­til there are demon­strable be­ne­fits, but it’s hard to demon­strate un­til it’s ad­op­ted,” he said. “And mo­bile health won’t be widely ad­op­ted un­til there’s re­im­burse­ment.”

Mo­bile health has the po­ten­tial to dra­mat­ic­ally im­pact the health care mar­ket in part be­cause the tech­no­logy has be­come widely avail­able world­wide. The num­ber of mo­bile In­ter­net sub­scribers has skyrock­eted from 2.3 bil­lion in 2008 to 3.4 bil­lion in 2013, and it’s ex­pec­ted to sur­pass 3.9 bil­lion by 2017, ac­cord­ing to a GSMA Wire­less In­tel­li­gence re­port.

Among the be­ne­fits of mo­bile health lis­ted in the re­port are that it can provide rur­al pop­u­la­tions with ac­cess to urb­an spe­cial­ists, re­duce in­ef­fi­cien­cies and er­rors in pre­scrip­tions and med­ic­al test­ing, help phys­i­cians re­motely mon­it­or pa­tients with chron­ic ill­nesses, and re­mind pa­tients about ap­point­ments and tak­ing their medi­cine.

Re­search about how mo­bile tech­no­logy im­proves pa­tient out­comes is on­go­ing, West said, but early find­ings look prom­ising.

“What people are find­ing is that pa­tients pay closer at­ten­tion to their health when they’re wear­ing a device know­ing that their vi­tal signs are go­ing dir­ectly to their doc­tor,” West said. “You get a pre­vent­ive health be­ne­fit, and doc­tors get real-time data to make pro­act­ive de­cisions about treat­ment.”

In­creased tech­no­logy use, the re­search­ers say, will also em­power poli­cy­makers to make bet­ter de­cisions about health care — what works and what im­proves costs — by giv­ing them more in­form­a­tion about pop­u­la­tion health.

“We think there are tre­mend­ous op­por­tun­it­ies in mo­bile health in terms of im­prov­ing the pa­tient ex­per­i­ence and con­trolling costs,” West said. “When you get people us­ing mo­bile health, it cre­ates the pos­sib­il­ity of do­ing data ana­lys­is that helps us an­swer ba­sic ques­tions about health care.”

China and the U.S. are two coun­tries where health costs have spiraled out of con­trol, un­der­lin­ing the need for in­nov­a­tion to rein in spend­ing. An­nu­al health spend­ing in China has grown from 4.55 per­cent of the na­tion’s gross do­mest­ic product in 2006 to 5.15 per­cent in 2011, ac­cord­ing to gov­ern­ment fig­ures. Health spend­ing in the United States is pro­jec­ted to rise from 16.2 per­cent of GDP in 2006 to 19.6 per­cent in 2021, ac­cord­ing to the Health and Hu­man Ser­vices De­part­ment.

Aging pop­u­la­tions ac­count for much of the growth. By 2050, 20 per­cent of the U.S. pop­u­la­tion and 33.3 per­cent of China’s pop­u­la­tion will be over 65, re­search­ers an­ti­cip­ate.

The rise in the two na­tions’ eld­erly pop­u­la­tions has been ac­com­pan­ied by a rise in the num­ber of people suf­fer­ing from chron­ic ill­nesses. Some 260 mil­lion people are dia­gnosed with chron­ic ill­nesses in China each year, ac­cord­ing to gov­ern­ment fig­ures, ac­count­ing for 70 per­cent of over­all costs. The U.S. also struggles with the cost of chron­ic care, amount­ing to about 75 per­cent of over­all health care costs, ac­cord­ing to fig­ures from the Cen­ters for Dis­ease Con­trol and Pre­ven­tion.

Both coun­tries also wrestle with dis­par­it­ies in ac­cess to care, es­pe­cially with rur­al and low-in­come pop­u­la­tions. Rur­al areas have few­er med­ic­al per­son­nel per cap­ita, a prob­lem that could eas­ily be solved by al­low­ing rur­al pa­tients ac­cess to urb­an doc­tors through video con­fer­en­cing and oth­er re­mote mon­it­or­ing tech­no­lo­gies, the re­port says.

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