Patient engagement is the blockbuster drug of the 21st century. With recent innovations in technology changing the landscape of patient engagement, this article discusses some emerging use cases that will help organizations make the best use of their new opportunities. 

In America, cell phones are now almost as ubiquitous as televisions. Recent PEW Research survey data shows that 90 percent of Americans own mobile devices as of January 2014, and 64 percent own smart phones as of October 2014. This data is independent of socio-economic status, education, race and gender. In a word, this means mobile is the perfect candidate to change engagement across various populations.

As with any technology, the conversation begins by investigating emerging use cases and seeing how they can be used in your organization. The majority of the use cases we see – and the apps that appear on the market – are health lifestyle use cases. They have social media integration points that are intended to effect behavior change or drive loyalty.

Although these are interesting from a person-to-person perspective, they do not engage the patient with the healthcare system. This means that patient-engaging paradigms need to come from other sources. What follows are six non-lifestyle-use cases in which mobile devices can enhance collaboration to drive healthier outcomes.

Use Case No. 1 – Mobile Integration

Health data collection has become the most well-established use case in mobile. From fitness trackers to smart watches, it is easy for users to track activity, heart rate, oxygen levels and sleep, but it is far harder to use this data for purposes outside of behavior change and loyalty. The missing step is to integrate this data with health systems and allow providers to make better-informed decisions about patient care.

Ignoring the performance and security requirements around integrating data from thousands (or millions) of cell phones and smart apps with electronic health records (EHRs), EHR clearinghouses or personal health records, let’s assume that this can be done. Some of the most interesting scenarios that are enabled by this level of mobile integration involve passively collected mobile data. This can be used to detect changes in patient activity or routine and red flag those changes if they are considered significant.

For example, if an elderly patient suddenly begins walking and sleeping much less than he or she has in the past, this becomes a significant predictor of a health event. That red flag can result in a caseworker, a relative or a caregiver getting a notification, which leads to a phone call, a request for an appointment or other rule-driven outcome. Similar scenarios can be developed for heart rate, blood oxygen and a handful of other passively observable data points. 

Active monitoring scenarios are a different conversation and a different set of integration points. While passive monitoring makes use of data that is collected just by holding a cell phone, installing a monitoring device or wearing a watch, active monitoring only occurs when a user proactively logs information into a device. This information can include caloric intake, pill consumption or other key data points about health-related activities. 

Although this data isn’t as accurate as passively monitored information, it can be incredibly useful if this data is integrated with EHRs and with insurance programs. For example, creative incentive programs that decrease insurance premiums if pills are taken can encourage patients to, at a minimum, log their activities into their mobile phones. Remembering to log an activity correlates with a patients’ likelihood of performing that activity. 

Use Case No. 2 – Mobile Organizers

A good portion of health compliance involves following the physician’s instructions in a timely and consistent manner. Instructions lend themselves to simple organizing techniques, such as schedule reminders. Simple reminders integrated into our daily lives can have a major impact on compliance and can also de-obfuscate tricky instructions.

As patient portals evolve, auto-configured reminder apps will accompany patient procedures to ensure that patients are staying in compliance with their regimes. 

Use Case No. 3 – Mobile Laboratories

As point-of-care becomes less point-specific, we may be entering an age when some conditions can be handled without a brick-and-mortar office visit. This is a step beyond healthcare retail-ization through Minute Clinics and Walmart providers. For many acute conditions like sexually transmitted diseases, survey wizards can guide patients through an easy-to-follow set of questions to determine if a lab test or photograph would be beneficial.

In the case of lab testing, integration with third-party facilities, like LabCorps and Quest, can actually allow patients to get lab results without seeing a physician. If the lab results are negative, the patient is notified through the mobile app and follow-up is not required. With positive results, the app will connect the patient to a hospital system or provider for a follow-up, with the specific details of the lab test provided in the appointment request. 

This also could be beneficial for certain dermatological conditions where digital photographs can be used for triage and diagnostics. Although doctor’s offices will never disappear, we may see a day when they are used only when absolutely necessary.

Use Case No. 4 – Mobile Prescriptions

This isn’t what you think. Instead of prescribing drugs, doctors prescribe mobile applications. Knowledge, as it turns out, is not only power, but it also can be medicine. When integrated into patients’ lives, mobile apps have proven to help manage chronic conditions such as diabetes. Insurance companies also may begin to pay for these applications as clinical trials prove out their effectiveness. This eventuality is being considered by the Food and Drug Administration, and regulatory policies and requirements will be put in place to accommodate the influx of mobile as a medical device. 

Use Case No. 5 – Mobile Diagnostics

This is what you think. Mobile applications already support ultrasounds and microscopes. Not only do these new devices allow patients and untrained personnel to create and send images to teleproviders, they are also evolving as image recognition technologies improve. As a first line of defense, image interpretation can be done directly by the device. This is a major opportunity to bring the office to the patient and change the triage process for hospital systems.

Use Case No. 6 – Reducing Uncompensated Care

Even after the passage of the Affordable Care Act, one of the key problems facing underserved populations is a lack of insurance. Currently, health insurance exchanges and calculators rely on patients to perform their own analyses. Hospital administrators, however, have an opportunity to help their uninsured patients by prescribing a mobile service that allows them to find insurance that works for their situation. This is good news for the patient and the provider. Combining this service with other patient engagement and lifestyle management functions may be the biggest innovation in the next five years for hospital administrators.

Although there is no magic wand, mobile patient engagement strategies can improve outcomes and lower costs significantly, and they have the ability to dramatically improve patient outcomes. Combining technology, creativity and new care models in innovative ways is the next exciting challenge for health organizations. Those who understand this and prioritize mobile will be ahead of the game.

Stephen Goldstein, is the director of life sciences for Sapient Government Services, supporting bioinformatics and health and communications projects across the federal government. With more than 19 years of experience, he brings a fundamental understanding of technology, project management and life sciences to every engagement, with the goal of enabling flexible, scalable approaches to complex scientific and technical challenges. For more information, visit

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