Mobile Health: Exploring Attitudes Among Physical Medicine and Rehabilitation Physicians Toward this Emerging Element of Health Delivery

Health care reform, coupled with recent technologic advances, is driving the rapid adoption of medical technology. Individual medical practitioners and integrated health care delivery systems have been forced to alter their approach to technology and to understand the potential applications within their practice. Among these technologic innovations is mobile health (mHealth), which is the practice of medical or public health supported by mobile electronic devices. mHealth enables the monitoring and delivery of health care and healthrelated information to a broad community in a real-time fashion. The power of mHealth stems from the ability to provide information, education, and resources to both health care providers and patients where and when they need it, thus extending traditional modes of information sharing and dissemination across the spectrum of health delivery. The dynamic nature of the devices and the accompanying software applications (apps) allows users to interact with each other and to access data in an unprecedented manner. For physicians and other members of a multidisciplinary care team, the result could be improved communication and alignment of services, clinical monitoring, multidisciplinary coordination of care, patient education, access to health records, and continuing medical education; for patients, mHealth could provide an additional point of contact with their providers that is interactive and that accompanies them throughout their day in their individual psychosocial milieu, allowing them to access information and become empowered at the point of need. Currently, our physical medicine and rehabilitation (PM&R) department is conducting a prospective study evaluating the impact of tablet computers, specifically the iPad (Apple Inc. Cupertino, CA), on patient care and resident education within a rehabilitation setting. Here we discuss attitudes among PM&R resident and attending physicians toward mHealth to better understand the current use and potential benefits within our field. The rapid movement of technology that is emerging outside of the traditional realm of hospital-driven information technology was initially dominated by personal digital assistant devices and by phones with advanced computer-like capabilities (smartphones) and has recently expanded to encompass tablet computers, including the iPad. There are currently more than 15,000 health-related apps available on iTunes, and at least 3 medical schools have already integrated iPads into the first-year curriculum [1,2]. Recent surveys suggest that 22% of physicians will own an iPad by the end of 2010 and more than 50% will have one by the end of 2011 [3,4]. The rapid adoption of mobile technology by health care practitioners has been matched by the use of mobile devices by patients. In fact, more than 80% of Medicaid patients text regularly, and groups who would otherwise have limited access to Internet services (eg, ethnic minorities) are leading adopters of Smartphones and tablets [5]. Not only can mHealth reach individuals whenever and wherever they carry their mobile device, it has the potential to accompany individuals over long periods of time and to involve underserved communities. Physicians indicate a willingness to have patients monitor their health remotely, with more than 85% of physicians stating they would prefer to have patients take more control of their own care in this way [5]. It is estimated that more than 14% of adult Americans are already using mobile devices to monitor their health [6], with some positive preliminary results reported [5-9].