Healthcare IT Solutions

Engaging Patients with “Gamified” Mobile Care

There’s a new buzzword floating about town.  That word is “gamification”.  So, what is it, and why do I think it has everything to do with the fastest moving trend in healthcare technology?

In their great piece on gamification, Mashable defines the term as “the use of gameplay mechanics for non-game applications. The term also suggests the process of using game thinking to solve problems and engage audiences.”

Gamification is seen as the next frontier in mobile, web, and social technology.  Industries far and wide are climbing on board with the trend in hopes of engaging consumers.  In this age where patient engagement is at the fore (read: I sunk a good half hour of my life playing with the symptom checker on the Texas Health homeage) healthcare organizations can certainly profit from this trend more now than ever before.

Using Gamification to Solve Health Problems

The best thing about gamification is that it can be used to solve real-world health problems like diet, fitness, adherence to medication, and managing care protocols.

In a recent article on MobiHealth News entitled, “Should health apps be as fun as Angry Birds?”  Dr. Jessie Gruman is profiled as asking developers to explore what their target audiences have to accomplish in their daily lives to manage their medical issues.  Devices and apps should simplify those tasks for patients.  Even more, Dr. Gruman feels it is important to not just get caught up in the fun and frivolity of gamification.  Rather, these health apps should make the lives of those managing chronic disease easier.

In the Mashable article, Gabe Zichermann, the author of Game-Based Marketing, speaks of balancing the fun and frivolity of gamification with the task of making life easier for cancer patients.  He says, “I don’t presume to think that we can make having cancer into a purely fun experience,” he says. “But, we have data to show that when we give cancer patients gamified experiences to help them manage their drug prescriptions and manage chemotherapy, they improve their emotional state and also their adherence to their protocol.”

The obstacle that gamified health apps enable clinicians to overcome is helping patients manage guilt over failure to comply.  This is the key obstacle patients face when attempting to follow a diet, fitness, or medication regimen.  Games help patients manage that guilt.  The game navigates patients through their story of successes and failures until they ultimately become victorious.

Docs Love Mobile Devices, But Need Smarter Features

Vendors need to provide native applications and more intelligence to get EHRs to “play nicely” with mobile devices.

“Whatever the objections to mobility have been in the past, they are falling away as everything wireless becomes more powerful, more affordable and more user-friendly.”

That’s the conclusion of a new white paper from research firm Frost & Sullivan that summarizes the burgeoning new uses for mobile devices in healthcare.

Kenneth Kleinberg, a consultant with the Advisory Board, agreed with this perspective. “There’s a huge flood of interest in using tablets and smartphones by physicians,” he said. “They’re going to use whatever works to make their jobs easier and faster. They love these devices. They want to use them in the hospital and the provider environment.”

Frost & Sullivan projects smartphone penetration in North America will jump from 24% to 67% by 2015. Physicians are far ahead of the general population in this respect. Sixty-four percent of doctors were using smartphones in March 2010, according to a Manhattan Research study.

Frost & Sullivan noted that smartphone applications for healthcare range from drug and clinical references to diagnostic tools to real-time patient recordkeeping. In addition, its report said, “Electronic health records (EHRs) can be accessed via smartphone, allowing caregivers to diagnose and communicate virtually anywhere, anytime, including at the point of care.” It noted, however, that smartphones have limited displays and processing power, so they may yield incomplete information and require time-consuming paging through multiple screens.

The white paper pointed out that tablet computers have been around since the 1980s–and, noted Kleinberg, have had some impact on healthcare for the past decade. “However,” Frost & Sullivan observed, “a slimmer, less expensive, more feature-packed version is now taking the mobile device industry by storm. These new iterations, launched by a growing list of top-tier vendors, have significant potential in the healthcare sector.”

Among the uses for these tablets–which include iPads and the like–are applications for “diagnostic imaging and video, quick access to educational and reference resources, and on-the-spot access to electronic patient records,” said the report. Native applications being developed for the tablet, it notes, include those for MRI viewers, mobile film readers, and mobile medical calculators.

Kleinberg pointed out that clinicians can’t make good use of EHRs on either tablets or smartphones unless the software vendors have written device-specific native versions of their EHRs. “Depending on how the screen was designed and what the resolution is, the application might not fit well,” he said, if it were accessed through a browser or Citrix. “Also, the handwriting recognition might not be effective.”

So where do the vendors stand on mobile devices? “Almost every major vendor has a ‘skunkworks‘ that is working toward native support of at least a couple of these devices, like an iPad or an Android smartphone,” Kleinberg responded. “Some of them can demonstrate this now; some of them have even released it. But it’s a difficult, time-intensive venture to design these versions.”

The mobile health explosion is coming at a time when other issues–including Meaningful Use and ICD-10–are placing big demands on their resources, Kleinberg noted. The bigger companies are capable of forging ahead on all fronts, but the smaller firms may have to put off designing native mobile applications.

The new generation of devices “is almost there,” he said, for effective use of EHRs. A physician can document a visit on an iPad, for example, by using the touchscreen, typing, digital handwriting, and voice recognition. But the workflow factor has not been sufficiently addressed. To reduce the number of screens a physician has to go through and the amount of data he has to enter, he said, applications must be designed with more intelligent features.

“EHR vendors have not done a very good job of designing knowledge-based algorithms that take the information you’ve provided and attempt to reduce the number of questions you have to answer to get to the solution,” said Kleinberg.

iPads are perfectly capable of handling other tasks, such as viewing digital images or taking photos of a patient to show his condition, Kleinberg said. And doctors can use various mobile devices to place orders in computerized physician order entry systems, as long as they don’t expect much in the way of decision support, he added.

The main advantage of mobile devices, he said, is that they have the potential to increase physician adoption of health IT, because doctors love their smartphones and iPads. “If these mobile devices get physicians to use these systems, the adoption issue–which is crucial for Meaningful Use—will be alleviated.”

Statewide HIE

HIE, or Health Information Exchange, systems are a central component of state and national health reform. The goal of these systems is to make electronic medical records mobile, allowing the effective exchange of data between medical organizations. HIE systems can provide many advantages over traditional medical record management. HIE systems are expected to lower costs for medical providers as well as patients and more thoroughly and effectively communicate important patient information. HIE systems will also dramatically reduce wasteful or redundant tests and consults, and will provide more comprehensive public health data. Furthermore, HIE systems are expected to significantly reduce the medical industry’s carbon footprint.

In 2009, the American Recovery and Reinvestment Act (ARRA) allocated millions of dollars in federal funding for the organization of California’s HIE systems. Earlier this year, the State of California Health and Human Services Agency announced it would begin the process of creating a new governance entity for statewide HIE development and implementation. With the promise of safer, more patient-centered care; lowered medical costs; and more efficient, effective, and environmentally responsible record management; these HIE systems will be integral to the advancement of public health, medical progress, and economic stability in California.

Public-private partnership will form the backbone of successful HIE development. It’s crucial that California’s new HIE governance entity and public health officials make statewide HIE goals, requirements, and necessary protocols salient in an expeditious manner. Timely collaboration between California and its medical technology innovators will ensure that the most robust and effective solutions ultimately make it to market. California’s medical technology industry is poised to develop these solutions that will benefit both medical professionals and patients alike.

CALinnovates will continue to work with statewide HIE and our membership to ensure fluid communication as these policies are developed.

Health Care WiFi Spending Ushers in $1.3B Market

By: Brian T. Horowitz

Mobile devices and emerging technologies are fueling the creation of a $1.3 billion health care WiFi industry within the next five years, according to ABI Research.

The increasing use of mobile devices such as smartphones and tablets, as well as cutting-edge technologies, is pushing the health care industry to invest more in its WiFi infrastructure. In turn, these changes mean that the wireless market within health care is poised to grow to a $1.3 billion industry within the next five years, according to a new report by ABI Research.

Healthcare creating IT jobs faster than other industries

By Ken Terry

Partially due to an infusion of federal funds, the healthcare industry is creating IT jobs faster than other industries, according to a new Bureau of Labor Statistics report. The number of IT positions in healthcare is expected to grow 20 percent annually through 2018, the report says.

Since 2009, the number of health IT jobs has increased 67 percent, according to an article in Computerworld. Online employment agency, lists 7,200 open positions in the field, the article points out.

Most in demand are CIOs and CTOs, but jobs in health IT administration also are growing rapidly,’s database reveals. Since 2009, database administrator positions have grown 94 percent, and other administrative jobs in networking, systems and storage have also seen strong growth. In addition, the healthcare industry needs thousands of software developers and system analysts.

Overall, the BLS report notes, healthcare and social services jobs are expected to grow 24 percent from 2008 through 2018. Healthcare support jobs will increase by 1.1 million during that time period–more than any other service job category. However, healthcare employment took a nose dive in July, according to a report just released by The Conference Board.

In health IT, BLS predicts that a rise in medical testing, treatments and procedures performed, and electronic health record use all will be pivotal in terms of growth. “[M]ore technicians will be needed to complete the new responsibilities associated with electronic data management,” the report notes.

The problem that many hospitals and other providers encounter in filling these jobs is the shortage of qualified, experienced health IT staff. While the federally funded training programs in 82 community colleges may help meet some of the demand, the majority of the available positions are not entry level, say consultants and CIOs.