Wes Valdes, DO, is medical director of telehealth and virtual medicine at Intermountain Healthcare in Salt Lake City. He was named in 2011 as the system's first telehealth director and has been instrumental in making Intermountain one of the nation's top telehealth-friendly providers.
Q. What's the one promise of mHealth that will drive the most adoption over the coming year?
A. Access to services like consumers have never had before.
Q. What mHealth technology will become ubiquitous in the next 5 years? Why?
A. I don’t know but I do expect that in five years, growing healthcare systems will have clinical operations officers that have adopted a call center-style clinical workforce as part of their internal operations. Ones who don’t or outsource that type of care service will be losing leverage in the market.
Q. What's the most cutting-edge application you're seeing now? What other innovations might we see in the near future?
A. With all the technical advancements in medicine in the past few years they are incremental at best when compared to the entirety of healthcare delivery. I still see the most transformative pieces coming out of business models that are placing the power of choice in the hands of consumers and forcing the old business model to adapt or become irrelevant.
Q. What mHealth tool or trend will likely die out or fail?
A. Constant remote monitoring with little to no justifiable clinical benefit. There will always be a section of the market that is interested in self-analysis and monitoring, like we’ve seen with the fitness band movement, but the patient space is getting so crowded that it will be difficult for tested and trialed medical devices to explore this space outside of existing companies who have been in the space prior to the consumer devices coming on the market. The current marketing is promoting data gathering for recreational use, which is fine for those purposes, but without a clinical justification it will be hard to rationalize for clinical purposes.
Q. What mHealth tool or trend has surprised you the most, either with its success or its failure?
A. A few things have surprised me. One is the cultural acceptance of solutions looking for problems. Perhaps it is a fad, but I sit in a lot of presentations where someone has found a way to collect some type of information unrelated to any known disease and is convinced that data is important to the healthcare delivery system. Also surprising is the lack of security and compliance regulations around consumer devices that are considered wellness or fitness devices. I suppose it could be “buyer beware,” but when there is an attempt to bring that type of device into a clinical environment for clinical purposes, then I start to see the red herring dance of data begin. A general statement I hear a lot is “It doesn’t need FDA approval because it is a fitness device, but it could really help you treat your patients with ______ chronic disease."
Another surprising thing to me has been the cultural line shift of the for-profit vs. goodwill motives in healthcare. There have always been for-profit companies in healthcare, but there was also a perceivable balance of goodwill and social contract that was particularly evident in the desire to publish new findings in various medical journals rather than to immediately conclude that an idea could be the next billion-dollar idea for healthcare. Maybe it is just because I’m spending more time in a different area of the healthcare delivery ecosystem, but it just seems that line has shifted quite a bit over the past several years.
Q, What's your biggest fear about mHealth? Why?
A. My biggest fear is that bad (or absent) science heralded on the shoulders of great marketing and deep financial investment pressures will override the historic attempts to remove bias from determining if products are useful in patient care in both wellness and clinical disease. A simple look at the fitness band industry and some widely disputed claims of tracking sleep patterns, monitoring glucose or even being accurate at all for what they are designed for will show a concerning trend to many.
On top of that, the new avenue of consumer-funded start-up possibilities like KickStarter has the risk of bad apples making unscientific claims to garner investments. Healbe GoBe’s Indiegogo campaign is a good example, having raised over $1 million from the public on over-the-top marketing claims and significant lack of clinically relevant science or studies. There is little protection for the public from these efforts, and a possible consequence is a shifting of opinion away from the benefits of mHealth concepts due to abuse and greed in the market place.
Q. Who's going to push mHealth "to the next level" – consumers, providers or some other party?
A. Consumers historically are the ones to push economic paradigm shifts to the next level for better or for worse.
Q. What are you working on now?
A. Mostly exploring visualization tools to facilitate overcoming obstacles created by the immense amount of data that mHealth solutions are creating. We are well past spreadsheets being able to adequately present information in an efficient manner. Combining that with efforts to ask the right questions, as opposed to reacting to trends, while keeping the patients' best interests in mind but still providing choice. We are working to stand up an online health news show and create a place for accurate content that would be as free as we can be of bias.
Other episodes in our mHealth master series:
Joe Kvedar's quest to personalize health
American Well's Roy Schoenberg has high hopes for Apple's HealthKit
Harry Greeunspun on the promise of applied analytics
David Lee Scher sees bright future for wearables, just not smartwatches
AirStrip CEO Alan Portela on the biggest transformation ever in healthcare
