mHealth Failed? Really! Are you surprised?

Health is part of our every day. It’s how we live.

Complete health is achieved across seven dimensions:

Emotional, Social, Spiritual, Financial, Physical, Intellectual, and Environmental.

How well people sleep, the food choices they make, how they handle money, cope with situations, move about their day, foster relationships, engage with their surroundings, and the many other ways that you participate in life as well as the ways you take care of your mind and body can have a tremendous impact on your personal health.

Health interventions must look at the whole person. Everyday health behaviors are formed by our thoughts and beliefs that influence our actions and habits. Ignoring that and only focusing on medical events and ‘patient’ encounters misses the full picture.

Not Surprised by the Results of the Scripps mHealth Study

I feel that there were three critical flaws associated with the Scripps mHealth Study, and strongly agree with the interpretation presented an associated Chilmark Research article titled, Real-World Reasons the Scripps Study Failed. To fully understand this perspective, there are two terms that need to be clarified: patients and innovation.

Patients are people, however some people only assume the role of a patient when, and only when, they are sick or have some other in a clinical encounter. Addressing an individual as a patient puts them in a ‘system’ frame of reference — not in their own environment. It simply does not address them on their own terms.

Innovation is not the same as applied research. Innovation has distinct purposes and outcomes that result. Research builds on already-existing knowledge, whereas innovation is focused on bringing something new to the market to make an impact or, in many cases, just to make money.3

While both research and innovation are critical across all industries, and especially important to further medical discoveries, innovation plays a key role in the way we live our lives by propelling forward new possibilities. Innovation is responsive and immediate, not studied under a microscope for years then results analyzed, written up, and reviewed and published in a peer reviewed journal. Innovation is the art of designing fast, sometimes failing fast, and adjusting fast to accommodate and fine tune based on early feedback to strengthen impact.

The Scripps mHealth Study began in 2012 and concluded in December 2014. The findings were released in January 2016.

Ideally, intermittent releases of findings during the study period would be available as they provide value to help optimize this specific intervention and many, many others in process. Study findings based on a technology that is currently no longer available, would normally have been released much sooner. In that one year time lag between the conclusion of the study and the release of findings, more than 141 million people began using mobile phones, more than 460,000 apps and over 160,000 games were submitted to iTunes. A multitude of innovative products, like the Hoverboard, Nike One Handed Shoes, and the Tesla, became available to the general public.

We need to make sure that the balance of innovation and research doesn’t “handicap scientific innovation, encouraging incremental research to the detriment of bolder discoveries.

There are three critical elements from the Scripps mHealth study that we must address:

  1. “Stitching mobile devices seamlessly into the fabric of a patient’s [person’s] everyday lives”.
  2. Meet people where they are. Don’t just push mediocre education content or provide an unstructured library of resources. Align with users words and purposefully integrate relevant content.
  3. Data, Oh Big Data….For data to be meaningful, it first has to be understandable. Then it has to be meaningful to the person trying to interpret it. Each person needs to know what to do with it the data they are receiving. Knowledge alone, DOES NOT CHANGE BEHAVIOR.

For mobile health interventions to work, they must become a part of a person’s everyday life and teach them how to make positive changes while supporting the diverse needs of each individual, and it must align with each person’s life in a meaningful way. It must show up in different ways and let the individual control their actions based on their personal goals for their life journey. That way each person can strive to reach their ‘why’ not, and not merely the goal of a particular study or their healthcare system’s requirements.

Lastly, I’d like to comment on the article’s description of the study as groundbreaking. It seems fairly obvious that if you endeavor to make a person do something that is really hard to do, like changing health-related behaviors, through a rigid, unrealistic structure, using strict methods that aren’t typically part of that person’s everyday life — you’re likely to have low impact. In other words, by not weaving the study’s methods into the participant’s day-to-day lives, it was bound to fail.

To bring the point home… If you don’t regularly workout at a fitness center, would you suddenly start going to the gym as part of your everyday life just because some company provided you with a gym membership, new sneakers and directed that you go every Tuesday and Thursday? To what extent do these “things” impact your intentions? The bottom line is eloquently stated in the article: “What works for clinical whitecoats and industry whitepapers won’t always work amidst the vivid colors of the real world.”

I remain hopeful that person-centered, research-driven innovation will begin to blend into our cultural norm, and begin to make an even greater impact on the intentions of most people’s day-to-day lives as they discover and work toward their life goals.

Originally published on February 10, 2016 By Connie Mester, MPH, Founder and Visionary of Thrive 4–7

Call to action:

Consider using an evidence based mHealth evaluation scorecard during your app development or purchasing. Check out this article: Engagement and Mobile Health. Are Solutions Measuring Up?

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