Girish Navani is the co-founder and CEO of eClinicalWorks, a developer of ambulatory healthcare IT solutions. He was awarded the Ernst & Young Entrepreneur Of The Year 2009 Award in the Healthcare Technology category in New England. Prior to co-founding eClinicalWorks, he led successful IT and business initiatives at Fidelity Investments, Teradyne and Aspen Technology. He holds a Master’s of Science in Engineering from Boston University.
Q. What's the one promise of mHealth that will drive the most adoption over the coming year?
A. Most of us agree that informed patients are more likely to be engaged and follow through on physician instructions. Monitoring daily habits inevitably leads to healthier choices, specifically for patients living with chronic diseases such as diabetes or asthma. Having a medical provider linked to these results takes it one critical step further. Not only does the patient have access to their daily readings, doctors can set the tool up to flag upticks that could be dangerous.
Technologies have come to market to aid this and more are on the horizon - especially ones that connect patients with their doctors. In the upcoming year, patient access to health information and healthcare providers will drive mHealth adoption. Having one of these without the other will not work. The market is recognizing that and is responding with more tools enabling this relationship.
Q. What mHealth technology will become ubiquitous in the next 5 years? Why?
A. Telehealth will see a rapid rise now that policy is catching up with technology. When patients can access their doctors via their mobile phones, it enables them to immediately address medical concerns at their convenience. This is particularly important in rural areas, where access to healthcare may be limited. To date, many providers have been resistant because payment for this model is ambiguous or, in many cases, non-existent. With CMS recently announcing that it is expanding reimbursements for telehealth visits through Medicare, we expect other payers to follow suit. This will greatly impact the prevalence of telehealth visits and will allow this medium to move forward.
We will also see more patient-driven health information exchanges. Patients will use their smartphones to exchange records without having to rely on large HIEs. Upon arrival for an appointment with a doctor, they will check in on a kiosk where they scan a QR code, which then asks if they want to share their records with this doctor. The technology is here now. We will see more real-world examples soon.
Q. What's the most cutting-edge application you're seeing now? What other innovations might we see in the near future?
A. Telehealth in itself is a new concept that has positive implications for healthcare - integration of this with wearables, which is then integrated with a doctor’s EHR, takes it to whole new level. For example, if you have a FitBit, data from your wearable will automatically be uploaded to your personal health record (PHR) and shared with your doctor, if you allow it permission. Giving your physician a better informed idea of your activities throughout the year can dramatically improve recommendations and outcomes.
Another example: Let’s say you are taking heart medications and using a tool like Wingscale - an actual scale that monitors patients’ weight and alerts doctors via Bluetooth to any rapid gain or loss - integrated with your PHR. The physician you are working with can know in real-time if you are gaining or losing weight, as this can be a sign that your medication is not working properly. Doctors set parameters to flag any abnormal activity so they can prevent a health emergency before it happens. Enabling doctors to track, consult and diagnose suspicious patient vitals without having them actually in the office is just the beginning of the improvements we are starting to see.
We will also see greater integration of these technologies with public health.
Q. What mHealth tool or trend will likely die out or fail?
A. Healthcare mobile apps that are not tied to a medical provider will likely evolve into something else or fold altogether. People trust their doctor, so a medical provider needs to be tied in. Doctors are the quarterbacks of healthcare; without them, it is difficult to make it to the end zone. Stand-alone PHRs that do not integrate with medical providers will not allow information to be actionable.
Q. What mHealth tool or trend has surprised you the most, either with its success or its failure?
A. Many people were surprised that ventures by large companies failed. Large companies invested millions of dollars in developing PHRs; however, they were missing one critical component - the doctor. Without that, patients will move on to the next thing.
Q. What's your biggest fear about mHealth? Why?
A. I am concerned that the FDA will try to regulate this space. The market should dictate how the industry should move forward, and imposing regulation would inhibit innovation.
Q. Who's going to push mHealth "to the next level" – consumers, providers or some other party?
A. Many parties are interested in moving mHealth forward. In addition to consumers, providers and entrepreneurs, one group that will propel the industry forward is employers. Many companies are offering wellness programs and dealing with increasing costs of health plans. These will benefit from mHealth innovations, including having wearables linked to an online portal that offers incentives to employees or fosters an atmosphere of competition for reaching certain goals.
Q. What are you working on now?
A. We have invested $75 million to create and expand patient engagement tools under our healow health and online wellness unit. In contrast to most mobile health applications available today, healow directly connects patients to their own and family EHRs, allowing immediate access to personal medical records and facilitating two-way communications between providers and patients. These solutions are available via browser and by smartphone. We expect 2015 to be a busy year.
