Justin Kahn is the founder and CEO of TruClinic, a Salt Lake City-based telehealth provider that emerged onto the scene in 2011 with a platform initially targeting college students and Native American populations. The company has broadened its reach since then, and is working with payer organizations, providers and other groups to connect people in need with healthcare resources.
Q. What's the one promise of mHealth that will drive the most adoption over the coming year?
A. I wish it were the promise of better care, better health and reduced per capita costs as well as the promise of accessibility for millions of people - but that won’t happen until the platforms are easier to use for the providers as well as the consumers and widespread reimbursement becomes a reality. I believe that consumers are ready to adopt mHealth, but the technology is only as good as the people who use it, and providers won’t actively adopt it until they get paid to do so.
We are all watching as reimbursement plays out between Congress, the mHealth trade organizations and state medical boards. When the promise of reimbursement happens, that’s when the healthcare system as we know it will change and adopt it – and the winner will be the platform that is easily adopted, particularly for those providers who are clinically experienced but perhaps not technologically savvy.
With universal payments becoming the new normal, the ACOs are in the best position to drive mHealth adoption and use over the next year because they have more control over how their resources are allocated. It has been proven that certain types of mHealth technologies and services can reduce costs, increase revenues and increase patient satisfaction, but they also have to be proven across a wide spectrum of providers and easy to use. ACOs are consolidating hospitals and practices to create a network in which they can manage their patient populations more effectively and efficiently. As they choose to pilot and move forward with different mHealth solutions, the case is being made stronger with each new adopter.
More and more providers and services are entering into the mHealth arena to offer their services - to cash-paying patients; directly to the consumers and employers; as locum-tenens practitioners (temporarily staffing) for hospitals and clinics; as specialty services (the proven model of teleneuroradiology); for genetic counseling. You name it, mHealth is viable.
The one thing that’s clear is that quality care can be provided via mHealth. I don’t think that topic is really up for debate any longer. Once reimbursement is established, it will be the simplicity and ease of use that will drive adoption.
Q. What mHealth technology will become ubiquitous in the next 5 years? Why?
A. Wow – where do we start? How about electronic medical records systems as we think about them today. There has been a lot of press lately about the post-meaningful use EMR, and I think this is just the tip of the iceberg. We are in the midst of a healthcare data revolution. I believe that the shift is going to be away from closed EMRs that are centered around the hospital/clinical system and morph into systems that are centered around the patient. Blue Button is a great example of what’s coming.
I think the post-meaningful use EMR is going to look like a centralized patient hub or “bank,” where providers will input data from any EMR and patients will be able to access and share their data with any providers, regardless of what hospital or network they are with or what EMR the providers are using. The health information exchanges have been a great jumping-off point, but this is just the tip of the iceberg. As consumers become more educated and engaged they will demand their data, and that data liquidity will drive the new “killer” apps that will turn this industry on its head. We will see an evolution of who will fund these EMRs and future apps. I think payers will be the driving force of this change as they see value in the clinical data.
Q. What's the most cutting-edge application you're seeing now? What other innovations might we see in the near future?
A. One of the coolest applications I have seen is a low-tech disposable timer used to provide patient-centered information in critical events like stroke and cardiac care (docktechnolgies.com). I am also really excited to see how Google, Apple, Samsung, Qualcomm and companies that are participating in the Tricorder XPRIZE approach remote patient monitoring. I think our whole concept of RPM is going to change as more and more real time monitoring and reporting systems come into the marketplace.
Q. What mHealth tool or trend will likely die out or fail?
A. I think the “medical rounds” robots trend will die out. I think it's cool that this type of technology exists, but I have seen it time and time again when I go into a large hospital and I see a robot that has never been used. Already I have heard administrators and nurses call them the “do-nothing” bots.
Q. What mHealth tool or trend has surprised you the most, either with its success or its failure?
A. The biggest surprise to me has been the rise of the direct-to-consumer model of mHealth. It seems every week that I am reading about a new company that is offering services directly to the consumer or employer. Now that Google is going to combine its search algorithm into the ability to meet with a “Doctor on Demand” (which happens to be the company Google Ventures backed in the direct to consumer model), I think that whole segment of the market is going to be scrambling on how they can stay competitive. We all know that the “doc-in-a-box” model has been widely successful, with a few companies dominating the landscape, but with more and more companies entering into the fray, I question how much longer we are going to see that model grow exponentially.
Q. What's your biggest fear about mHealth? Why?
A. What keeps me up at night is managing privacy, security and control of the flow of data, coupled with ensuring the ease of use for patients and providers. There are not enough standards for transfer of this data, and not enough regulations around defined security protocols - being HIPAA-compliant doesn’t mean safe and secure. The user interface and usability has to be on par with making sure that PHI is uber secure. Security breaches, whether intentional or not, are becoming more prevalent, and the fines are staggering, to say the least.
Q. Who's going to push mHealth "to the next level" – consumers, providers or some other party?
A. From where I am sitting, I think consumers will drive the evolution in this space, payers will fund it and providers will be dragged along kicking and screaming.
Q. What are you working on now?
A. We have a lot of exciting new features coming out with our v2 release. We learned from our customers that there was a strong need for a workflow management system that does not get in the way of existing clinical systems. So we have added features like a virtual switchboard and group video calling. In addition, we have built new modules for note-taking and records management that make the sharing of data that much easier for both the patients and providers.
Our next big project is centered around interoperability with other systems. We treat our customers as partners and learn from them as they grow and scale use of TruClinic inside their organization. Having this type of relationship makes it possible for us to add in new features that are at the cutting edge of what is possible with mHealth. It’s a great place to be.