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Can mHealth Make a Difference in Population Health?

Dr. Garth Graham, a former HHS official now presiding over the Aetna Foundation, explains why the payer is launching two new mHealth fellowships.

By Eric Wicklund

- Payers are starting to take a serious look at mHealth platforms for population health.

The latest to take on the challenge is Aetna, whose charitable arm recently launched two programs to fuel mHealth innovation in underserved markets. The Aetna Foundation Health Equity Innovation Program at Yale University supports student-developed technology solutions to address health challenges that affect low-income communities, while the Aetna Foundation Fellowship in Healthcare Innovation at Massachusetts General Hospital supports hands-on experiences that encourage students to use digital solutions for more sustainable healthcare improvements. 

Leading this initiative is Aetna Foundation President Garth Graham, MD, MPH, a cardiologist and former deputy assistant secretary for the Department of Health and Human Services, where he led the Office of Minority Health. recently spoke to Dr. Graham about the promise – and challenges – of mHealth.

Q. The Aetna Foundation grant to InnovateHealthYale and the Fellowship in Healthcare Innovation at The Massachusetts General Hospital (MGH) Healthcare Transformation Lab seek out “innovative ways to tackle public health issues.” What types of innovation are you looking for? Why did you select these two institutions?

Dr. Graham: From an innovation perspective, the Aetna Foundation has always been focused on the people who can be potentially impacted by the technology rather than just the technology. We are less focused on just the tools, but more interested in how the vision to use the tools can have a positive impact on people’s lives. Technology is just one tool, but ultimately we want to transforms lives when it comes to health and healthcare.

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Yale has a strong track record in technological advancements and innovations for underserved communities internationally. We see an opportunity to leverage that expertise and make an impact in local communities.

Massachusetts General Hospital is a renowned institution with proven success and results in building strong educational programs – specifically medical education. These programs have had impacts that extend beyond the healthcare field, and into the lives of local communities.

Q. What role does mHealth (digital health, telehealth, connected health …)  play in these innovations?

Dr. Graham: We want to use mHealth as a powerful equalizer to spark change. Digital health, telehealth and connected health all have a tremendous amount of potential to reach people where they spend their daily lives, using technology already at their fingertips. We already know that members of underserved communities, who are more likely to face chronic diseases, are strong adopters of mobile technology.

Q. What are the challenges that mHealth can overcome in reaching underserved populations?

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Dr. Graham: Mobile health has the potential to reach people as a part of their daily lives. There’s an opportunity for greater penetration because individuals in underserved communities use mobile technologies to function in many aspects of their daily lives. From communicating with friends to searching the web, mHealth serves as a gateway to information.

From our perspective and knowing this, we can develop preventative health tools for mobile technology and try to incorporate them into people’s day-to-day activities. If we can educate communities in a culturally and linguistically appropriate way, individuals will be able to conveniently make important health decisions right from their mobile devices.

Q. What are the challenges that mHealth can overcome in taking on chronic diseases?

Dr. Graham: The most effective method to tackle chronic disease is prevention. We can use mobile health to influence healthier daily habits, like selecting better food options or participating in more physical activities. We can also empower preventative behaviors and provide better education in the earlier stages of a chronic disease process. Mobile health has the best potential if we can enhance preventative healthcare choices. 

Q. Healthcare has been slow to adopt mHealth tools and services because doctors generally don’t trust the data coming from consumer-facing mobile devices. Can programs like this change that perception?

Dr. Graham: There are many challenges that physicians face, and primarily it seems to be (a lack of) comfort in evidence-based mobile health being incorporated into the clinical setting. The best way to overcome the challenge of negative mobile health perceptions is to use programs like those at Yale and Massachusetts General Hospital to improve integration and confidence. We can also have success by empowering physicians to incorporate mobile health in their patient care experiences and workflows through treatment, care management, information gathering, diagnosis and prevention plans.

Q. What role do payers like Aetna play in mHealth adoption in healthcare?

Dr. Graham: At the Aetna Foundation, we see ourselves playing two roles. The first is to support projects that are developed, tested and optimized in real settings – both clinical and non-clinical – to determine the best use. Second, we can help in the dissemination of research to help individuals have more awareness of the tools and information available.

Q. What more can be done to convince healthcare providers to adopt mHealth?

Dr. Graham: We should continuously work to help providers feel comfortable with mHealth and the ease-of-use benefits. Typically, most providers rarely change practices – rather, they stick with what they learn during their residency or fellowship. By targeting them earlier in their careers through programs and training, we can influence adoption of these tools in the future.

Q. Is there a particular innovation – a device, app or platform – that you’d like to see in the near future? Something that would be a “game-changer”?

Dr. Graham: A mobile health “game-changer” would be a device, application or digital platform that can seamlessly integrate social determinants of health with non-clinical community health information in real time. The kind of information and data that can provide more insight into daily challenges that may impact overall health. This can include information about geographical challenges like commuting, or access to education that feeds directly into clinical decisions. 

Dig Deeper:

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