Alan Portela has more than 25 years of experience in mHealth. With AirStrip, he was a senior advisor and member of the Board of Directors before his appointment as CEO in 2011. Prior to joining AirStrip, he was CEO and principal of Hybrid Clinical Transformation, where he developed successful EHR adoption strategies for the U.S. Military Health System and much of the Veterans Health Administration. He also served as president and chief strategist at CliniComp and in senior executive roles in several innovative healthcare technology and service organizations.
Q. What’s the one promise of mHealth that will drive the most adoption over the coming year?
A. Clinical transformation via clinical decision support is number one. Mobility adoption will be the fastest growing technology trend in healthcare, functioning primarily as a delivery mechanism for clinical decision support for healthcare providers. After all, physicians are clearly mobile professionals, and clinically relevant data needs to be provided to them wherever they are in order to improve the quality of care.
However, clinical decision support delivered via mobile devices will rely on a number of underlying technologies that will be essential for clinical transformation. They include big data analytics; real-time processing engines; tools focused on interoperability, care coordination and patient engagement; cloud computing; disease-specific body sensors and clinical data warehouses – not to mention telemedicine platforms and clinical protocols and algorithms.
Q. What technology will become ubiquitous in the next 5 years? Why?
A. We are experiencing the biggest transformation in healthcare ever. Technology plays a significant role as an enabler of that transformation but will not drive it alone. Caregivers and patients must be engaged and processes need to be established – and user experience is crucial for encouraging adoption.
When predicting the future of mHealth, one must look at the challenges around the increasing patient population due to the Affordable Care Act (ACA) and the shortage of caregivers. It is obvious that as more patients in need of care move into the system, the amount of data needed by healthcare professionals to improve care will increase by an order of magnitude. The impact of adding more data to a limited number of caregivers means that the top technologies to enable clinical transformation and become omnipresent will be data aggregation, big data analytics tools and mobile technology. The ability to collect and analyze clinically relevant data on a near-real-time basis will be the biggest driver of mobile technology adoption. These combined technologies will become strong workforce multipliers capable of improving caregiver workflow and, as a result, improve the quality of care.
Q. What is the most cutting edge application you are seeing now? What other innovations might we see in the near future?
A. For starters, I must say I am very impressed with what the EMR vendors are planning in future releases for population management tools.
So what is next? Ever since AirStrip formed its dedicated business unit – the Translational and Clinical (TRAC) group – this year, I have been exposed to some incredible technology coming from the research community that will revolutionize the way we monitor patients and manage diseases beyond the four walls of the hospital. This includes disease-specific (diabetes, CHF, arterial pressure, etc.) body sensors such as epidermal sensors (patches) and implantable devices. Technology is out there to collect and transmit a wide variety of clinically relevant data – including fetal monitoring, glucose monitoring, ECGs and EEGs – on a near-real-time basis to the caregivers.
We intend to partner with those groups and help with their go-to-market strategy. By leveraging our large customer base, incredible momentum in the industry, as well as our patent-protected IP, we will be able to aggregate and mobilize the data collected from those body sensors around specific clinical conditions, including high-risk pregnancies and congestive heart failure.
By combining the data collected from those disease specific body sensors with big data analytics tools and care coordination tools, we are now looking at real clinical transformation enabled via mobile technology.
Q. What mHealth tool or trend will likely die out or fail?
A. Healthcare organizations exist to keep patients alive. That mission seems to propagate to the technology they use. This industry keeps systems alive even if they bring limited benefit to the user and/or fail to be adopted by caregivers. This could be a topic on its own.
My prediction is that mobile applications that are not interoperable and are designed only to mobilize a single vendor’s own system will fail, since they bring very limited value to healthcare providers. While healthcare will manage to keep them alive anyway, ultimately, innovation around mobility will not come from legacy vendors.
Q. What mHealth tool or trend has surprise you the most, either with its success or its failure?
A. The impact of the ACA is forcing healthcare organizations to consolidate by acquisitions, forming accountable care organizations (ACOs) and clinical integrated networks (CINs). The consolidation is exposing the biggest problem in healthcare: a lack of interoperability.
What surprises me the most is when I see large healthcare organizations that end up with a mess of multiple EMR/EHR vendors, medical devices, imaging systems, etc. Rather than looking at innovative mobile approaches for front-end integration and a better user experience, they look at their legacy systems for mobility. All they end up doing is mobilizing their ‘mHealth mess’ and increasing physician dissatisfaction.
Mobile applications must be leveraged as tools (that are) agnostic to the source systems, capable of supporting all form factors and the bring-your-own-device movement coupled with a seamless user experience. This, in turn, will lead to physician adoption and ultimately improved clinical outcomes.
Q. What is your biggest fear about mHealth? Why?
A. Many healthcare organizations are creating steering committees to accelerate innovation, with mobility at the center of their agenda. My fear is that we are at a very mission-critical inflection point, where steering committees will only create confusion and slow down innovation.
Successful health networks such as HCA, Dignity Health, Texas Health Resources, Ardent Healthcare and St. Joseph’s Healthcare (Calif.) started by looking at their top strategic initiatives, identifying key stakeholders for each initiative, establishing the necessary processes and then evaluating which technologies could enable – not drive – the transformation process. Their model should be followed by other healthcare organizations today. We always need to remind the industry that technology does not take care of patients – doctors, nurses and other healthcare professionals do.
Q. Who is going to push mHealth “to the next level” – Consumers, Providers or some other party?
A. Whether we are caregivers, payers or vendors, we are also consumers of mHealth. Therefore, we share the responsibility to transform healthcare. The first step toward that goal is to unlock clinical data from legacy systems. Without interoperability, there is very little chance for success. This seems to be a hot topic in the industry. Many are talking about it, but unfortunately very few legacy vendors are actually advancing the cause of interoperability.
In my view, 2015 will be the year where providers will have the opportunity and power to lead the industry and force legacy vendors to open up and truly collaborate, instead of just talking about it.
Provider consolidation and collaboration is creating much larger healthcare organizations with a strong need to integrate in order to better manage population health by both clinical condition and market. This trend is further exposing the lack of interoperability, but at the same time is creating an ecosystem of providers that is gaining a degree of power never experienced before. These providers have the power to drive healthcare costs down, improve the quality of care, guide the federal government on introducing and enforcing standards, force vendors to comply with those standards and, eventually, transform healthcare.
That shift of power that we are seeing today will shift yet again if providers do not take advantage of their ability to drive transformation. As data consumers, the patients could take control by refusing to engage with those healthcare organizations that fail to bring transparency to their data. The ultimate goal for healthcare providers is to maximize patient population, and only those providers that drive and innovate will achieve that goal.
Q. What are you working on now?
A. AirStrip has successfully created and deployed an agnostic mobile platform capable of aggregating multiple structured and unstructured data types supporting multiple care settings, delivering the data to the care coordination team via a single seamless mobile application. We call it AirStrip ONE because it is truly one single mobile platform and application.
AirStrip provides an essential tool for healthcare providers. At the same time, we realize that there is a shortage of physicians. We need to improve their workflow by making them proactive via clinical decision support – rather than reactive – as we start monitoring patients outside of the hospital. To support this, we are now leveraging the data collected via the platform to provide real-time streaming into industry analytics engines. This outbound stream of data is organized by clinical condition/protocol and mapped to clinical nomenclature industry standards. It is then ready to be consumed by real-time analytics processing engines and then mobilized to the caregivers via the AirStrip ONE mobile application.
We want to contribute our mobile integration platform and applications to the healthcare community and further collaborate and integrate with third-party systems such as EMRs, medical devices, clinical body sensors, big data analytics and real-time processing engines. AirStrip can then provide mobile caregivers the necessary level of clinical decision support around specific conditions, starting with congestive heart failure, diabetes, COPD and high-risk pregnancies.
Our vertical strength commitment is designed to provide turnkey solutions for each clinical condition across the continuum of care. This year, AirStrip has already demonstrated this commitment in the area of high-risk pregnancies with our acquisition of Sense4Baby (non-invasive ambulatory fetal monitoring) from West Health, and the partnership with PeriGen for their early detection of fetal heart rate distress algorithms.
You will see a number of other partnership announcements from AirStrip coming in the near future.
Have a suggestion for a future profile? Contact mHealth News Editor Eric Wicklund at eric.wicklund@HIMSSMedia.com.
