Evidence is lacking to support mHealth's effectiveness

Mobile health technology, or mHealth, has the potential to change healthcare by improving the flow of information and interactions between providers, organizations, and patients. But will this happen? An essay published on 12 February in PLOS Medicine issues a warning.

The current scattershot approach to pilot mHealth projects, in the absence of a programmatic implementation and evaluation strategy, may dampen opportunities to truly capitalize upon the technology, wrote Mark Tomlinson, PhD, a professor of psychology at Stellenbosch University in South Africa, and co-authors. As a result, global financial resources spent without forethought on mHealth could be wasted.

More than 500 healthcare-related pilot studies using mobile technology have been implemented and tracked by the World Bank. How well did the technologies perform? Did the studies achieve their objectives? Evidence is lacking, according to Tomlinson and colleagues.

They recommend that before expanding any mHealth project, research to demonstrate efficacy and effectiveness must be undertaken. They point to two standard models to follow, one from the U.S. Institute of Medicine and the other from the Society for Prevention Research.

"There are currently no mHealth interventions that meet these standards for scale up, despite numerous calls to scale up mHealth projects," they noted.

Furthermore, "no major investments have been made to create a robust platform for mobile phones that could be used by designers of applications and electronic medical records that will allow cross-fertilization or integrated systems to be utilized," the authors wrote. Without this, a patient with two or more health conditions may have to use numerous applications, which could prove too difficult or too much of a nuisance.

Interoperability is critical to promote research initiatives, and interoperability standards are needed, according to Tomlinson and colleagues.

"Not creating robust interoperable platforms will ensure failure for mHealth initiatives to be scaled to improve health outcomes for at least the next decade," they warned.

It will be the responsibility of governments, industry, and financial investors to cooperate to set standards to create a self-governing, commercially viable ecosystem for innovation.

The short, advice-filled essay can be read in its entirety on the PLOS Medicine website.

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