Doctor Dictum: Beauty of mHealth is in Behavior Change

Doctor Dictum Beauty of mHealth is in Behavior ChangeDr. Samir Damani, a cardiologist at Scripps Health and a physician-entrepreneur, believes there is much value in the proliferation of digital and mobile health apps and technologies.

Do the apps make people healthier?

Not when it comes to diagnostics, Damani says. The true value, he believes, rests mainly in patient engagement with their own health behaviors.

The story appeared at the MDDI (Medical Device and Diagnostic Industry) online site.

“In an era where cost reduction and better outcomes is key, I’m looking at technology that drives better health outcomes, not technology that simply adds another flavor of the month,” Damani contends.

“As an example of what is cool but really doesn’t move the needle on costs and outcomes, Damani pointed to two devices – the AliveCor smartphone ECG and the Zio XT wearable patch to monitor and diagnose cardiac arrhythmias,” reports the story.

Damani is not sure of how this device addresses costs related to the overall care of cardiovascular disease.

“To be honest with you the transformative ability of mobile health technology doesn’t lie in the diagnostic realm,” he said. “AliveCor is a cool technology but I don’t think it’s proven to save costs. I’m a little bit jaded with people talking about how cool devices are when it doesn’t make a damn bit of difference in costs.”

Damani also cited the Zio XT patch from iRhythm Technologies, often prescribed by doctors to patients who might be suffering from abnormal cardiac rhythm or atrial fibrillation. The device is an alternative to cumbersome holter monitors.

“I use it but it’s not really transformative. It’s only transformative as a patch as opposed to wired holter,” Damani notes. “It doesn’t have wires – that’s the only reason why I use it to be quite honest with you. It’s not that revolutionary.”

Since Damani has founded a digital and mobile health startup – MDRevolution – it should follow that he spies some value in the digital health space.

“On the behavior change side, I think that’s where the real opportunity lies,” he says, noting that changing patient behavior in chronic diseases like diabetes, heart failure, and others can actually bend the cost curve.

At the heart of it, says the good doc, is changing people’s behaviors, lifestyles, and patterns.

“The best applications and best devices for doctors are the ones that his physician extenders can use – nurses, medical assistants, registered dietitians – because you got to realize the point that ACA is going toward value-based medicine,” Damani explains.”It’s a lifestyle issue. So when you look at apps, you look at how can the app enable self monitoring on behalf of the patient and how can it enable accountability so that the patient can say, ‘Oh wait my blood pressure is going up. This is not good. I need to get in touch with my doctor.” or it could be that the nurse sees it in the clinic and alerts the doctor,” he says.

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