AHIP keynoter cites lack of evidence that mHealth works

Not a single study demonstrates the efficacy of mobile healthcare interventions, says Ezekiel Emanuel, MD.

There is a lack of clinical evidence supporting the efficacy of mobile healthcare interventions for improving the health outcomes of patients.

That’s the contention of Ezekiel Emanuel, MD, who holds a joint position in the University of Pennsylvania’s Wharton School of Business and the School of Medicine, where he chairs the Department of Medical Ethics & Health Policy.

“There’s just not a single study that shows that any wearable, connectable smartphone, wireless (technology) has made a difference in terms of outcomes,” Emanuel told Wednesday’s opening session of the 2018 AHIP Institute & Expo in San Diego.

Also See: NIH sets goal of evidence-based mHealth apps by 2020

In his presentation, Emanuel took to task Eric Topol, MD, director of San Diego’s Scripps Translational Science Institute and author of The Patient Will See You Now: The Future of Medicine is in Your Hands, for his contention that smartphones will serve to “democratize healthcare,” giving patients control of their health data, which has historically been the domain of physicians.

Emanuel mocked Topol as the “guru for virtual medicine,” and whose “hidden agenda is to forget the doctor” and embrace smartphone-based medical dashboards that will help consumers track their own vital signs and overall health conditions, using that data for self-management of illness.

He pointed to a 2016 study of remote patient monitoring of heart failure patients and a 2017 study of medication adherence for patients with chronic disease—both published in JAMA Internal Medicine—that call into question the effectiveness of mobile healthcare interventions.

“Lots of studies—over and over—they come to the same conclusion,” added Emanuel. “The wireless this, the pill bottle that—not making a big difference.”

However, Topol says Emanuel’s contentions are patently false and ridiculous.

“I had nothing to do with those studies (that Emanuel mentions), but he is off base to say there has not been an impact on outcomes,” replied Topol in a written statement. “Yes, the results are mixed. But there are multiple studies that have shown improved outcomes for conditions such as managing blood pressure, preventing asthma attacks, diabetics with continuous glucose monitoring, and on and on. He just apparently picked the ones to support his bias and inappropriately quoted me beyond that.”

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