Building the mHealth Evidence Base

Posted by RWJF Blog Team on May 13, 2011
at Pioneering Ideas:

By Brian Quinn, Pioneer team director

Last week at Stanford, innovation guru B.J. Fogg hosted a conference called Mobile Health 2011: What Really Works. As a new member of the Pioneer team, the conference was a great opportunity to learn more about mHealth and meet some of the key players in the field. As the title suggests, this year’s conference focused on what we know about how mHealth is changing behavior and improving health outcomes. Here are three reflections on the conversations that took place during the conference:

1. There is widespread recognition that mHealth has the potential to change behavior and improve health. The good news is that we’re starting to develop some evidence that backs up this belief. But as Eric Hekler said during his presentation, we need to know more. We can’t rest on the basic understanding that if we throw the mHealth kitchen sink at a problem, it can work. We need to learn more about the subtleties of when and where and why and how mHealth works. We also need more research on the long-term effects and sustainability of mHealth technologies on health outcomes. These aren’t trivial issues; they get to the heart of the difference that mHealth can make.

2. Many speakers at the conference expressed frustration with the medical research community and its focus on the randomized controlled trial (RCT) as the gold standard of research. These criticisms are not new, nor are ones that point out the extremely slow nature of the research process, which can deter learning and innovation. Yet what a lot of mHealth’s RCT critics perhaps don’t realize is that for the last several decades, the health services research community has developed a wide range of observational, quasi-experimental and qualitative research techniques. These rigorous analytical approaches offer a credible alternative to RCTs and are best used in the messy real world situations where mobile technologies live. Just as Fred Muench pointed out that the mHealth field would be well served to build off the literature on public health messaging, it may also benefit from use of some public health research methods.

3. Finally, members of the aforementioned health services research community need to pay more attention to mHealth and get involved in research on the topic. I suspect many health services researchers are unaware of all the activity taking place around mHealth. The truth is that mHealth research should be front and center on their list of research priorities. mHealth offers ample supply of the thing that researchers crave most: data. And because that data is rich and produced in real time, mHealth offers a tremendous opportunity for researchers to explore new issues and analytic methods.

“What really works” is the key question that should be driving all of our work right now, whether you’re a patient or a provider, a funder or a developer. If we really believe that mHealth can transform our ability to lead healthy lives, we need to develop a solid evidence base that helps us advance the field. RWJF’s Pioneer team is doing more work in this area, sponsoring an mHealth Evidence meeting Aug. 16, along with the National Institutes of Health, the McKesson Foundation, the U.S. Department of Health and Human Services and the National Science Foundation. If you’d like to contribute to developing this critical evidence base, we encourage you to share your knowledge by contributing a whitepaper on the subject and submitting it by May 27. Authors of accepted papers will be invited to attend the mHealth Evidence meeting and will have their travel expenses paid for.