Elementary Dear Watson !



No, not THAT Watson, this Watson … the future of medicine as we know it – or least as IBM would like for us to know it.  By the way, for the record, Sherlock Holmes never said ‘Elementary Dear Watson’ – lest I digress.

Watson is a supercomputer that’s being designed with the analytical capacity to diagnose and provide treatment decisions as it relates to common illnesses and various disease states.  Although it may be a novel concept, it’s from it’s infancy, quite the contrary, it’s already being used to ‘treat patients’ on a pilot basis at many major institutions like the Mayo Clinic and elsewhere.  So what’s this got to do with Mobile health – everything of course.


Ever since 2009 when President Obama introduced the HiTECH act as a provision of the ARRA or American Recovery and Reinvestment Act, congress earmarked $831 Billion, yes, that’s Billion with a ‘B’ in appropriations for healthcare expenditures related to the electronic health record and meaningful use or meaningLESS use as we healthcare providers often lovingly refer to it.  It’s a love hate relationship but I digress, yet again.  The result of this stimulus package was an outpouring of healthcare startups and initiatives, some of which were aimed to curb readmission rates for chronic disease in hospitals, amongst others.  Mobile health was born, in large part, as a result of this act.  It seems as though just about everyone has jumped on this bandwagon in one way, shape or form. Wether it’s in an effort to capture some of these government earmarked dollars $$ or in response to drive down costs or all of the above, we see the result everyday.  They may not be all that visible to those of us that are healthy, but I can assure you they exist .  For instance, the other day I went to refill a subscription for a medication that I take rather regularly and was able to do so entirely via text messaging, INCLUDING and arguably most importantly, the rebate card ! You see even big pharma has jumped on the proverbial train.

Mobile technology’s low start-up cost, text messaging capabilities, and flexible payment plans make it extremely attractive for use in supporting of a host of healthcare related initiatives. These can generally be classified into 5 categories that include both individual- and system-level interventions.  They run the gamut from health promotion/disease prevention to chronic disease management and emergency response (Mechael et al. 2010):

  1. Health promotion and disease prevention, such as delivering health information and prevention messaging to promote healthy behaviors or referral to services
  2. Treatment compliance, such as providing patient reminders to take drugs or attend medical appointments to improve management of asthma, diabetes, or HIV/AIDS
  3. Health information systems and point-of-care support, such as offering clinical support for health professionals and community health workers through telemedicine
  4. Data collection and disease surveillance, such as obtaining real-time data from community health workers, patient self-reports, or clinic and hospital records on disease outbreaks
  5. Emergency medical response, such as maintaining alert systems that disseminate information in an emergency or during disaster management and recovery

“The first two types of interventions are aimed at improving the health status of individuals, the latter three at improving health care systems. Most of them, regardless of whether they target the individual or the system level, use cell phone devices and widely adopted applications such as text messaging. Text messages, typically limited to 160 characters, require attention to health literacy and cultural appropriateness for diverse populations” (Tirado 2011).

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Lastly, the Northwest University Center for Public Health Practice published an interesting article listing 6 points as they directly relate to SMS and texting in healthcare.  It can be found here.


3 thoughts on “Elementary Dear Watson !

  1. Mark,
    I liked the link to the site with suggestions about how to conduct an effective text campaign. I was particularly interested in the point about HIPAA. I agree with the suggest to be careful because sending personal health information by text could be a violation. Also, the list of ways that text messaging was very interesting.

  2. I actually have the same question as Julie! If this type of healthcare catches on, then I think a system needs to be put in place to allow people to cancel this service, if their phones are lost or stolen. Pretty much the same way you deal with a lost credit card. It would be a big violation of privacy, if someone else received information about a person’s prescription or medical condition.

  3. Hi Mark,

    Thanks for sharing such an interesting post. I am not really aware of some of the new and innovative ways that mobile technology is being used to not only promote health and wellness but to refill prescriptions and aid in the treatment and management of chronic disease conditions (to name a few). Personally, I would feel a bit nervous knowing that I could refill my prescriptions by text message because what if someone else got a hold of my phone!? I think my concerns are similar to Julie’s and Luda’s based on their posts. And what if a cell phone tower went down and my text message wasn’t received by my healthcare provider? From personal experience, there’s been times when text messages I’ve sent to people have gotten lost in cyberspace. Then again, I guess there would be some kind of quality control protocol in place to ensure that this doesn’t happen or when it does, the sender would be made aware. I’m interested to know more about how this technology can help to make the healthcare system more efficient, especially when such a large amount of public funding is being dedicated to the HiTECH Act.

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