Governance tips for mHealth success

BOSTON—Mobile health shouldn’t be used just as a “cool tool” but to transform care, said William Morris, MD, vice chairman of clinical informatics at Cleveland Clinic, speaking during a session at the mHealth + Telehealth World Congress 2013.

“We can have great data and great tools but if they’re not intimately integrated, we’re not going to have that stickiness.”

In this age of consumerization of healthcare, people are expecting healthcare to be mobile, he said. Governance, specifically strategy and priority, is essential. Several years ago, Morris said Cleveland Clinic had several different apps, each with a different look which was confusing for consumers. “We need to make sure we have constant curation and management of both clinical content and the tools.”

The organization had to decide whether their strategy would be build or buy. “We don’t want to build one-off apps, we want an infrastructure that you can repurpose. The overall theme is a technical strategy and a governance process.”

Part of that technical strategy was working with security people to open up access to clinical data. Brent Hicks, director of technology and innovation, said they found that their Wi-Fi hotspots weren’t very good. “We had to work with different groups within the organization to figure it all out because it hadn’t been done before.”

Beth Meese, manager of Cleveland Clinic’s clinical solutions center, said the role of governance is to plan, advise and vet which solutions make sense to all clinicians as an enterprise solution. She advised a well-formed governance group because most organizations have a lot of little pockets of expertise. Because the organization’s existing apps all looked different, “we took a pause and formed an enterprise mobile development center that brought the right people together from IT and clinical. We wanted to make sure apps were not developed in silos and dangerously spread.”

Meese recommended that an organization’s enterprise governance group “fits in with the rest of its technical solutions.” Cleveland Clinic’s clinical solutions center is an offshoot of its clinical systems office which is supported by the overall leadership and governance.

Providers and patients want integration, Morris said. “Involve clinicians early and regularly. Rather than inviting one subject matter expert to a random meeting, bring them into the entire process and make them part of the technical team. Take the time to understand their workflow.” Cleveland Clinic’s director of technology and innovation makes rounds with physicians to understand how mobile solutions will support them. “That’s been an important aspect to the success of the apps we’ve built.”

Morris also said they “keep development where the work is done. We’ve taken solutions to the floors, nurses and physicians to find out if they work. We’re continuously updating to come up with a solution people are using because they built it themselves.” Technology is more likely to be successful, he said, when “we’re not shoving it on them.”

The value proposition comes in the efficiencies and cost savings scalability brings, said Morris. The internal group also allows for reliability, a consistent build team and a relationship with preferred vendors and brand control.