Thursday, April 21, 2011

CoHealth Recap - The mHealth Episode

The post below is a recap of the workplace wellness tweetchat (#co_health) that I co-founded with Fran Melmed. For more information, background and history on CoHealth, see the CoHealth page on Fran's blog and our page on the Employee Wellness Network.

Today, Fran and I were honored to have one of the country's leading experts on mobile health as our co-host and content developer. Andre Blackman, whom I've known since my early days in Humana's Innovation Center, has become one of the greatest advocates for mobile health applications - especially as they impact public health and underserved health communities. Andre wears a lot of hats, but you can find him most of the time in one of these roles: the Director of Digital Communications and New Media at the American Heart Association, a member of the advisory board at the Mayo Clinic Center for Social Media, and blogger at Pulse + Signal. Fran and Andre did a terrific job researching and preparing for today's chat ... which wound up being one of our liveliest ever. After our introductions (which included several new and notable participants*), Fran kicked off with question one - a foundation for the rest of the chat:

Q1: What IS mHealth, anyway?
Andre responded: "mHealth is the use of mobile communications/devices for health services and information (apps, mobile sites, etc.)." He also added the first of what would turn out to be a treasure trove of links: This time to one of the most popular mobile health blogs; MobiHealthNews. He also referred us to a compilation video of what others think mHealth really is.

"mHealth is the fastest moving, most exciting segment I've ever worked in"

Q2: What's the value proposition for mobile health?
Andre noted that the great thing about the mobile opportunity is that instead of having people search for information or resources, it can come directly to them. He also pointed out that the number of people using mobile/smartphones has increased dramatically over the past few years, so there is a critical mass of users. For more information and statistics relative to mobile phone usage, Andre referred us to the Pew Internet Project and Susannah Fox's research as a leading example: Fran also noted that mHealth was "squashing the digital divide; [offering] simplified tracking [and] immediate access to information at point of need." When Kathy Mackey questioned whether there was really a digital divide in the workplace (e.g., company use of mHealth technology for wellness), Fran clarified that there are many people without smartphones in the corporate world: retail, manufacturing, etc ... and was backed up by Sarah Monley.

Fran then posed Q2a: "The growth has been tremendous, yet smartphone adoption still lags. Does that make SMS the better solution right now?"
Andre answered in the affirmative - that SMS is still the most available form of mobile communication, whether you have smartphone or not.

"Also key, the personal connection people have w/ their cell phones. As BJ Fogg says, 'we don't adopt mobile devices, we marry them.'"

Q3: How have you seen SMS used to better public health that we in workplace wellness can benefit from knowing?

This prompted a flood of examples of SMS being used to successfully impact health and healthy behaviors. Andre: "a great program likeText4Baby which is aimed at expectant mothers, is a great example of how workplaces can show support; also initiatives like @Medic that focus on empowering community health workers make use of public health and mobile." Fran pointed to as an interesting SMS-based behavior change support which is currently being researched.

Matt Pepe added that SMS has been shown in numerous studies to increase medication adherence, which in turn saves the healthcare system money. There were a couple of cautionary notes raised, though ... first from CTorgan: "Re SMS, etc, must remember issues with health literacy - see recent IOM report" Chia Hwu also noted some of the shortcomings of SMS: "SMS is powerful in a lot of ways but it's hard to track outcomes. Smartphones can push AND pull information." Along those lines, Jane Sarasohn-Kahn and Kathy Mackey pointed to some excellent studies on how smartphones are changing face of health

Dr. John Lapuma posed a question about whether Jamie Oliver uses SMS or #Likes with LA schoolkids, as it seems a perfect noncorporate public health fit. We all agreed, although nobody knew whether SMS was a part of his #foodrevolution program. Fran did note, though, that Jamie Oliver does have a new corporate venture: cooking & company, started with IDEO. We may be featuring some of the folks from that program as future co_health guests.

To close out the SMS question, Sarah Monley asked intelecare matt about what kind of 2-way SMS interactions were happening;perhaps texting with a personal coach? Matt responded affirmatively: "As well as automated systems which record what someone texts in and replies depending on the message." And LukeLibrarian painted a picture of a program in which a patient wears pedometer, and is reminded daily to text in their number of steps walked that day. Those texts then could populate a database, which can be analyzed in the context of monitoring overall health. And while it didn't come up in this week's chat, I wanted to be sure to give a shout out to "friend of the show" Chris Hall, whose SMS-based program, Mood 24/7 has shown real promise in treating and managing depression.

Q4: Let's talk about some examples of mobile-ready sites, another form of #mhealth - and more relevant to many right now.

This one prompted a flood of examples of mobile-enabled sites that our crew felt were innovative and/or particularly useful:

Kathy Mackey: "Humana & Walgreens have excellent benefit related sites & apps; MedPage Today has mobile ready site & popular app"

Andre: Example of a great mobile website is MedlinePlus and companies like Blue Cross of NC and Aetna have great mobile information applications. The HealthNAV app for @BCBSNC and AETNA site for apps. Another great org in the Maryland area that I just found out about, @Nexercise working on mobile for #co_health; SMS Best Practicse - Lessons Learned from a Text Messaging Pilot at CDC (webinar recorded, slides)

Fran Melmed: County Health Rankings has an interesting app: county health calculator:

BlausenGroup: Blausen healthcare apps are in over 12+ languages at 6-7 grade level on web & mobile to help w literacy

CTorgan: Another example, Keen doing a 15 min recess challenge:

Q5: How can companies take advantage of all of these available tools, apps -- even if they're not producing them?

This one brings it all together. Fran noted that Companies can share recommended, vetted sites and tools with their employees. And let employees review their own favorites. Kerry Johnston felt that companies need to aggregate relevant information, provide links from intranet sources; and most of all let employees know it's OK to use them.

PFAnderson couldn't have been more clear about what role the company ought to be playing relative to mHealth: "CURATION! Collaborate with libraries & experts on assessment". Andre pointed to GE's @gehealthy (Healthymagination initiative) as a source of "a fantastic array of smartphone apps that companies should look at." Carol Harnett noted that yesterday's JAMA featured a great article on games in yesterday's JAMA

To that end, I noted that I was really interested in how to build some mHealth games into my company's wellness arsenal - and that I am particularly intrigued by qubop's new iPhone 4 augmented reality game, "TapCloud." I had a whole bunch of folks who were ready and eager to brainstorm some workplace use cases for games like tapcloud; I'll be getting together virtually soon with Kathy Mackey, Jody Schoger, Janet McNichol and Chia Hwu to bang out some ideas. If you're interested, drop me an email at or DM me at @chimoose. Whichever method you choose, be sure to let me know your email address and twitter handle.

Fran capped off the discussion by noting that there is a significant gap between the consumer health market and the company-provided health effort - and that it's time to close the gap! I think that we can all get behind that one.

This chat was chock-full of resources and links ... but there is no better source than all of you who were on the chat. Particularly notable experts are @mindofandre, @healthythinker @mobilehealth and @ctorgan; be sure to connect with them to stay in tune with all the latest.

CoHealth tweetchats occur on the 3rd Wednesday of every month at 12:00 noon EDT, so our next chat will be May 18th. We have a lot of exciting guests coming up in the not-too-distant future, including the Robert Wood Johnson Foundation, MetLife and IDEO. As always, if you have ideas for topics or guests, please contact Fran or I and let us know!

* Jane Sarasohn-Kahn (who I FINALLY met in the flesh last month at SxSW) was in the house; Fran correctly pointed out Jane's web site as a wonderful resource for our group; We were also honored to welcome new (or newish) participants Carol Torgan, P.F. Anderson, Brian Dolan, baciagalupe, Matt Pepe, Luke Rosenberger, and Paul Jacobs.


  1. This is a GREAT recap, Greg! I had such a wonderful time on the chat that hoping I can come back for something else to talk about. I'm so happy that mobile is getting the attention now, especially in the workplace, so that employees can get plugged in and employers can support healthy habits in their workforce.

    I have amassed some additional links in my Delicious account on mobile health - though many are not specifically related to workplace wellness - for those interested.

  2. Thank you Gregg! This was such a fun chat filled with interesting people and ideas. I'm looking forward to more.