mHealth: evidence, not anecdotes, needed

Earlier this week, Editor Donna, in reviewing David Shaywitz’ Forbes ‘2013 awards’ article on the top book for 2012, noted that disease management (and telehealth overall) has had difficulty with determining traditional ROI. Our long-time readers might remember this editor’s lamentations on the lack of large N studies done over extended periods–the studies which are hard to finance, justify and conduct objectively, especially by early-stage companies struggling to survive. Mr. Shaywitz has graciously commented on our article here noting the ‘outsized claims’ that many programs make, and the difficulty in actually calculating valid ROI not only for health but also wellness outcomes. A further whacking on the same subject was given at the close of the 2012 mHealth Summit by Francis Collins, MD, PhD, the National Institute of Health’s (NIH) director. NIH has only conducted 20 randomized trials of mHealth, and less than half documented any clear evidence of improvement. Despite his own personal commitment (he was a test subject for AliveCor‘s heart monitor), he correctly chides us that ‘the plural of anecdotes is not data.’ Companies, the scientific/academic and healthcare ‘communities’ need to work faster. Here’s his suggestion: a national research network of millions of people, linked through electronic medical records platforms, which would create a database of real-time data. The EMR linkage is ambitious–and probably not workable due to HIPAA privacy regulations–but Ed. Donna has two additional suggestions: incentivize people to do it through a small stipend, like mystery shopping–or use crowdfunding tools to enlist subjects. NIH’s Collins says mHealth needs evidence, not anecdotes (mHIMSS)