Oluseyi Ojeifo, M.D., M.P.H. is currently a cardiology fellow at Johns Hopkins Hospital. She completed her internal medicine residency at Massachusetts General Hospital in Boston. Her areas of interest include reducing disparities in cardiovascular care and innovative approaches to improving health care delivery including mobile health. Her dedication to vulnerable populations is evidenced by her work as an Albert Schweitzer Fellow in an underserved neighborhood in Pittsburgh, Pennsylvania and as a volunteer on the cardiology ward at Groote Schuur Hospital in Cape Town, South Africa. Dr. Ojeifo received her medical degree from the University of Pittsburgh School of Medicine in 2009.
Oluseyi Ojeifo, MD, MPH
Oluseyi Ojeifo, MD, MPH
Cardiology Fellow, The Johns Hopkins Hospital, Baltimore, MD
Mobile Health: Getting Ready for the Future…and Beyond
Community health centers (CHCs) are non-profit health care providers that serve the nation’s most vulnerable populations. With one of the goals of the Affordable Care Act being the reinvention of the health care delivery system to make it more accessible, patient-centered, and comprehensive, CHCs are well positioned to help accomplish this goal. One of the ways The Affordable Care Act hopes to change the delivery of care is via health information technology (HIT). The NACHC has also acknowledged that “Electronic Health Records (EHRs) and "going paperless" strengthen the ability of health centers to increase capacity and improve performance consistent with the Institute of Medicine's (IOM) quality standards of timeliness, efficiency, equality, safety, effectiveness and patient-centeredness.” However, HIT has not been successful in engaging patients or achieving patient-centeredness thus far. mHealth, the practice of medicine and public health, supported by mobile devices, has been considered a way to engage more patients as well as support greater connectedness, continuity and team-based models of care.
The Public Health Institute in California is doing a project to engage early adopter community health centers on a national level in planning, implementing and evaluating mHealth interventions to improve patient engagement and clinical outcomes. As part of the larger initiative, a smaller assessment was done in Massachusetts to determine whether mHealth is a worthy investment for Massachusetts Community Health Centers looking to engage patients more. The goal was to provide recommendations regarding adoption and strategies for successful implementation. It is the ultimate hope of the Public Health Institute to provide the first national-level assessment of the current landscape of mobile health within the safety net, provide evidence as to which interventions have been most effective in improving access and delivery of care for vulnerable populations, and identify examples of mHealth interventions that illustrate successful strategies for implementation.
The first step in this process required an in-depth analysis of already existing mHealth interventions or interventions in the planning or near implementation stage. Data was collected through a literature review and key informant interviews in Massachusetts. The second part of the project involved working with Wellframe, a start-up company based in Massachusetts whose product is a mHealth app. The goal was to see the process of how to develop one, how to ensure it fits into the needs of the patients and providers, and how to best integrate it into various hospital systems. The findings were that Massachusetts Community Health Centers were primarily in a very early adoption stage of mHealth. Most projects were in the planning and early implementation stage, but there were many barriers and challenges to getting mHealth interventions funded and running. Furthermore, there was an abundance of interest in utilizing mHealth, but very few ideas of how to get started. The conclusion is that mobile technology does represent an opportunity to improve the capacity of community health centers in better reaching and engaging vulnerable populations. Recommendations for first steps include surveys asking patients about their use of mobile devices and types of mHealth interventions that would be useful to them as well as surveys to providers to determine their thoughts on mobile technology in medicine. Attention should be given to the possibility of in-house mHealth app developers and outside funding for pilot projects.
Andrew Broderick, Public Health Institute
Joanna Kreil, Massachusetts League of Community Health Centers
Trishan Panch, Wellframe