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Are mHealth Programs Targeting the Right Populations?

An mHealth program in rural Texas targets what one official says is a huge gap in healthcare: Underserved communities who can't get the preventative care they need.

By Eric Wicklund

- A Texas health official says mHealth isn’t working for underserved populations because they can neither afford nor access it. She’s now part of an ambitious program that seeks to provide that access to those who need it the most.

Called Project DOC (Diabetes and Obesity Control), the collaboration includes AT&T, IBM, Walmart, PriceWaterhouseCoopers and the University of Texas School of Public Health, among others. Dr. Lynda Chin, of the University of Texas School of Public Health, says it aims to create a “healthcare highway” that brings these services to the consumer, rather than waiting for the consumer to go to a clinic, doctor’s office or hospital.

“Our healthcare system was never built to deal with chronic diseases,” says Chin. “It’s always been focused on the provider,” with little incentive to keep people healthy. “We’re now starting to turn the system upside-down and bring healthcare to the patient.”

The project is being launched in Cameron County, Texas, the state’s southernmost county and home to more than 400,000 residents. Officials estimate that roughly 60 percent of the resident in Brownsville, the county seat, are diabetic or pre-diabetic, and are part of a state-wide healthcare crisis that consumes roughly $19 billion a year in state healthcare costs.

Cameron County is also very rural and poor, says Chin, with a large influx of Mexican immigrants. They don’t seek out healthcare unless they have to, she says, and they have no time, money or interest in using wearables or mobile devices to check on their health.

Project DOC, Chin says, looks to create a public-private approach that pushes a remote patient monitoring platform to, eventually, hundreds of Brownsville-area residents identified as high-end healthcare users (those with more than one chronic condition). The network also promotes mHealth monitoring for residents through local retail outlets like Walmart, and improves data sharing and analytics (including Watson Health) among the region’s healthcare providers.

Chin says the region’s residents “are very interested in learning more” about mHealth, but not if they’re forced to go out of their way to get it. The local healthcare infrastructure has to bring the message to them that health and wellness are important.

“Preventative health maintenance is the cornerstone to improving chronic disease management,” says Chin.

That won’t be easy. She says today’s healthcare ecosystem, while slowly moving toward value-based care, is still skewed toward those who can afford mHealth services – and those are most often people who are already health-conscious. This “exaggerates the mismatch of coverage without care,” and leads to an unsustainable cost structure.

Project DOC, she says, looks to create a “healthcare ecosystem that addresses engagement and gives people more choices.” It targets underserved populations with chronic conditions, she says, because that’s where healthcare dollars are being spent – and, ultimately, wasted.

“We need to get these patients to a point where they care about their health,” Chin concludes. “Better engagement leads to better health, fewer complications and better clinical outcomes, both short-term and long-term.”

Dig Deeper:

A Global mHealth Project Sets its Sights on America’s Underserved

Can mHealth Make a Difference in Population Health?



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