When Will mHealth Become Standard Practice in Medicine?

How about when an iPhone replaces a stethoscope?

Long the symbol of the medical professional, this is exactly what's starting to happen with an iPhone app designed by a researcher at University College in London.  More than 3 million users have downloaded this app that turns an iPhone into a stethoscope.  Need more evidence?  Google "mHealth conferences" and see how many results are returned.  Search "#mHealth" on Twitter and admire the minefield of tweets.  Even consider the fact that physicians have adopted smartphones at a greater rate than consumers.

Now that device quality (e.g., form factor) and connectivity have essentially been removed as barriers, what are some of the key factors that will continue to accelerate or potentially slow this fast-paced train? I'll throw out a few of them.

Accelerating Factors:

• Physicians.  As mentioned previously and in many articles of late, physicians love mobile health.  This should not be surprising if only because medical professionals are inherently mobile. Whether rounding in the hospital or shuttling between offices or simply taking a call from a colleague, physicians are always on the go.  If they can access important clinical information upon which to base their decisions all the better.  Despite popular (though fading) opinion, physicians are also technology enthusiasts.
• Consumers.  For better or worse, the largest portion of apps in the "Medical" category on iTunes are really more health and wellness the medical apps.  To the extent these and other apps begin to connect with or take on some of the functionality of a mobile Personal Health Record (mPHR), consumers will be a major driver in the mHealth movement.  Hospitals, practices and vendors will ignore connectivity with consumers apps at their peril (not to mention this kind of functionality will increasingly become required as part of the Meaningful Use requirements).
• Vendors and App Developers.  To date, the most popular apps used by physicians have been drug reference and medical calculators/resources like Epocrates and Medscape.  These will no doubt continue to be popular, but for deep and sustained penetration, physicians will (and have already begun to) demand access to clinical information on their patients - direct access to EHRs and any other system that contains information on their patients.  EHR and mobile devices vendors have been more than happy to oblige and will likely continue to dip their entire leg into the mHealth pool.

Potential Retarding Factors:

• FDA.  The FDA has already begun to drop not so subtle hints that they are at the very least exploring what their role could and should be with respect to regulating mobile health devices.  The degree to which this crosses over into smartphones running "medical" apps or stays primarily focused on devices used to remotely monitor patients remains unclear and developing. Suffice it to say, this bears watching and could help continue the growth of mHealth to the extent it gives hospitals, providers and patients comfort that someone is looking out for their interests. There will of course need to be a balance struck between regulation and innovation.
• Privacy and Security.  Are mobility, privacy, and security mutually exclusive?  They shouldn't be, yet there are still many people who feel they are.  Still others remind us that our mobile devices may already be transmitting information about us that is equal to or perhaps beyond the scope of some PHI.

What factors do you think will influence mHealth positively or negatively?