Friday, May 6, 2011

How I Stopped Worrying and Love [the name] mHealth

Matthew Holt is very outspoken about his dislike of the name "mHealth" or "Mobile Health".

Although we've traveled in the same circles, both professionally and geographically, for many years (and share a love of EPL, no less), I've never met Matthew.  I have only been able to consume his displeasure in Twitter comments, such as these:

This always left me wondering, do Matthew and I share the same concerns, or is this something else?  Over the last few weeks I've tapped into my network to try to understand the comments, as everyone from my former VCs, employees and friends seem to have a connection to Matthew.  Thankfully, this week, Matthew answered it himself in a recent post to the Healthcare 2.0 blog. This won't surprise you if you know me, but I've got an opinion on his post.

Matthew's key point is that the terms mHealth and Mobile Health limits us to a specific device, such as a mobile phone:

"Calling something mHealth traps it to a device, in particular a cell phone, and ignores the rest of the ecosystem of the technology and culture that the cell phone is but one part of"

I personally don't share that point of view. Some of you may even go further and say  "ah, but at the Mobile Health conference this week, fitbit, dailyfeats, and zamzee all presented, and they do not use a mobile phone!" The reality is, the conference was dominated by SMS and mobile-phone solutions. This is not at all a bad thing, as we saw some wonderfully innovative work. But if you were to oversimplify Matthew's comment to "phone or not phone", you would miss the bigger point, which is the ecosystem and platforms. Specifically, he called it “unplatforms.” 

This is where Matthew and I violently agree.

I'm a platform guy. I believe in systems-thinking. Haley Joel Osment sees dead people, I see platforms and ecosystems. It's what I love, and that was my last role at Bosch, spearheading a new Telehealth Platform.

To that end, I believe one thing that was missing from the Mobile Health conference was the impact on mobile to the caregiver, a key part of the ecosystem. This is something I personally really missed the boat on at Health Hero. Tying a caregiver to a computer screen is a rather ridiculous idea, given this is the industry that made the pager market. That said, when I tweeted that idea of the role of the professional in mHealth, I got a lot of backlash, a lot of "mHealth is about patient empowerment, nothing more". I hope that's not true, or we're missing a good part of how we can improve the health industry with mobile technology.

Naming and terminology, especially in Healthcare, can be analyzed and debated to endlessly - I sometimes think debating mission statements is less painful, if you can believe that. These activities usually resulting in terminology that is either very narrow and specific, or so vague that it has no meaning. As an industry, we have not done a good job of creating a nomenclature that is inclusive of the ecosystem.

For example, I am personally fascinated by the use of Television for providing healthcare and worked on many prototypes in my spare time. Despite the struggles of Motiva, I am sure there is opportunity here. But what to call it? Telehealth? Taken, but who knows what it really means. Telecare? Taken, and differently on different continents! tHealth? Dear lord. I'm already exhausted. (Speaking of which, if I step out of my "Patient Centered Medical Home", is it my "Patient Centered Medical Yard?") Someone will come up with a clever name, and we'll follow along. This only highlights the point that the Television-based solution is but a part of an overall ecosystem, and the clever naming of the solution is far less important than it's systematized impact.

Now, do no misinterpret my point - naming does matter, especially as we, as an industry, achieve scale and impact. Naming is particularly important when it removes our attention from the integrated delivery of care across the ecosystem.

For twelve years at Health Hero, I called our solution everything from "Telehealth" to "Remote Patient Monitoring" and everything in-between. If you want to see someone make a face that looks like they just stepped in something nasty, tell a German during the due-diligence process that you provide "Remote Patient Monitoring" - the idea that patients want to be monitored may seem creepy to someone in the United States, but is down-right blasphemous in more privacy-sensitive cultures like the EU.

I have a somewhat "lighter" story that illustrates the same point. I spent a lot of time in Germany at Bosch Headquarters and UK launching NHS after the Bosch acquisition. I spent so much time, that I came back to to States and once asked someone at Starbucks to "please give me my handy". My advice to you: Don't do that in San Francisco.

As we increase the role of the consumer in their care, these names and terms really do matter. They need to be culturally and globally sensitive, provide a brand and market concept with an aspirational vision, and most importantly, provide simplicity. If I cannot explain to you, the patient, what we do in thirty seconds, why would you even try it?

At the same time, as a group of people trying to effect how care is delivered, let's not lose site of the fact that whatever we call it today will, over time, be adapted and change, and it's far more important that we don't forget the importance of the system of care and the role of our processes, technologies, and people in the healthcare ecosystem.

Update #1: Fixed a few wording and typos based on feedback, mutual friend told me Matthew prefers Matthew to Matt, so fixed all the "Matt" references