Introduction to Focused Issue on mHealth Infrastructure: issues and solutions that challenge optimal deployment of mHealth products and services

Abstract

In 2013, when we began researching mHealth as a disruptive innovation in healthcare (1), we traced the origin of the term back more than two decades to a data communications professor, Dr. Robert Istepanian, now a visiting professor at the Imperial College, London, Institute of Global Health Innovation. Our conclusion at that time, and which currently holds, is that mHealth has yet to achieve industry-wide deployment of functional, sustainable products and services that consistently meet financial, quality, and patient satisfaction benchmarks. Although some impressive clinical and financial outcomes have been achieved, and many individuals have benefitted from access to healthcare made possible by mHealth applications, the scope of deployment across the industry and globally has not reached a 'tipping point' where mHealth is a ubiquitous component of the overall healthcare delivery system. We recognize that many factors contribute to this current state of unrealized potential, and many highly intelligent and skilled researchers, clinicians, innovators, and other professional groups continue their work to advance mHealth adoption. The purpose of this focused issue is to draw attention to a specific inhibiting factor, infrastructure, a conundrum from any perspective considered-technology, regulation, business models, skills development. We do so by providing articles that address these topics head on. In A Model for mHealth Skills Training for Clinicians: Meeting the Future Now-Donna J. Slovensky and colleagues assess the current state of mHealth skills acquisition, education, and training available to clinical professionals in educational programs and address an extant curricula gap; specifically, skills training to implement telemedicine services. The authors offer a model to guide the development of future training programs that incorporate effective training strategies across five domains: (I) digital communication skills; (II) technology literacy and usage skills; (III) deploying telehealth products and services; (VI) regulatory and compliance issues; and (V) telehealth business case. These domains are discussed within the context of interprofessional teams and broader organizational factors. Varadraj Gurupur and Thomas T. H. Wan further contribute to the mHealth discussion with their article, Challenges in Implementing mHealth Interventions: A Technical Perspective. Because mHealth is an emerging area of healthcare applications that offers the potential to improve access to health services, the authors consider the many challenges involved in implementing mHealth and identify some of the key challenges and feasible solutions. Five major areas of technical challenges in implementing mHealth include: (I) usability; (II) system integration; (III) data security and privacy; (IV) network access; and (V) reliability. The Wingo et al. original article, Monitoring Intervention Fidelity of a Lifestyle Behavioral Intervention Delivered through Telehealth, focuses on technology-based lifestyle behavioral interventions (i.e., telehealth, mHealth, eHealth, and/or digital health). These types of interventions are becoming an alternative standard of care and possess several advantages over traditional clinical settings such as convenience, cost, and the ability to tailor plans and feedback to a participant's Editorial