Keywords: Health 2.0, mobile health, conference, e-patients.
Citation: Albin A. Mobile Health 2011: What Really Works: a patient POV. J Participat Med. 2011 Jul 21; 3:e33.
Published: July 21, 2011.
Competing Interests: The author has declared that no competing interests exist.

In May, I had the opportunity to go to Mobile Health 2011: What Really Works, an annual two-day conference at Stanford University, put on by B.J. Fogg, director of Stanford’s Persuasive Technology Lab.

This was an incredibly well-run (down to the chime), well-managed (including healthy food), interactive, innovative, and entertaining conference that explored the changing frontier of how we think about and manage health, especially in the emerging mobile market. It was a big conference in the sense of ideas (and just not people). There were 60 speakers, including researchers, business representatives, entrepreneurs, and public health workers, all of whom had something to say about the fascinating merge and tension between psychology, medicine, technology, and policy. However, as an end user, a patient, a consumer, I left unsure of how this extremely exciting promise and innovation was directly making an impact for the benefit of us patients. That said, and as an observer: Bravo!

Fogg is one of the most amazing conference hosts I have ever seen in action, and he was literally constantly in action. He consistently provided a great venue for students, researchers, and entrepreneurs to bounce off each other like agitated electrons, to create new relationships and partnerships out of their experience. He kept an entire group of extraordinarily bright, busy people making “sticky” connections at a blistering speed, and helped make dense, rapid-fire material presented over the two days fun and engaging. This was often achieved by distracting routines, including a two-minute classical conditioning workshop to train us conference participants that when we hear three chimes in a row to come in from a break. (Did you hear it?)

Even after adding several additional speakers, Fogg managed to end the conference 90 seconds early. That is wow. And the material was wow too. You can find all the slides here. Others, including Andrew P. Wilson, Kevin Clauson, and Text in the City, did a great job of sending out tweets covering the broad range of topics, technologies, and specifics from the conference.

Susannah Fox gave the keynote address, which focused on connecting the data dots to create a composite whole. This was followed by fantastic presentations involving a breadth of tools and business models, from the very simple to the very powerful, such as:

  • Text4baby – SMS to help support pregnant women.
  • Smart Pills by Proteus (incredibly exciting and scary at the same time).
  • Biosensors from Green Goose that monitor and chart a variety of activities
    Glucose meters for your iPhone from Agamatrix.
  • Offerings of secondary healthy rewards programs from straight dollars to the metaphoric digital flower growing– FitBit.

Multiple business models were discussed in the face of the challenges of HIPAA, the FDA, and the length of time it takes to get from research to market. And, of course, there was the big question, especially for people like me, at least: Who is going to pay for these products?

I enjoyed the irony of the last session with Brian Dolan wearing a gold lamé jacket festooned with dollar signs, talking about business models. Also, there was a great moment of contrast on the panel, “What Really Works in Mobile Health Partnerships” between John Maschenic of Verizon (which I now consider the “Sopranos” of Mobile Health), and the Goodwill Ambassador, Josh Nesbitt (whose bottom line is “your partnerships.”)

Some very big and complex ideas came out of the “Hack for Health” session, which was my favorite (although I think it should have been earlier in the day, when our brains were fresher). Aza Raskin’s (Massive Health) “big idea” presentation about solving the wrong problem, failing faster, and the critical importance of tight feedback loops, was quite compelling.

There were plenty of opportunities to connect socially and emotionally with people “In Real Life” (IRL) that you have never really met other than virtually, like Krash 63, the maven of social gaming and advocate for more progressive mHealth; Erica Holt, who posed the insightful question, “Are we talking about ‘check-ins’ to health and mental states … as in, ‘I just checked in to anxiety’?” And finally, there was the great group hug with Susannah Fox and Jen S. McCabe.

One of my personal “aha” moments, aka “wins,” came out of a quick chat with Margarita Quihuis about the importance of simplicity: If you cannot explain an idea to someone quickly and simply, then you don’t really understand it — a lesson she attributed to Fogg (and also to Einstein). This is a concept reinforced daily as we use Twitter to share ideas (which forces us to use a limited number of characters to express our ideas or convey the message.)

Other thought bubbles concerned: The hazards of trying to solve the big idea problem rather than one manageable piece of the problem, an all too common human trait; the tension that comes from the desire to get something done and out to market vs making it right; the overhead contributed by research efficacy and regulations; and — as always — the problematic definition of ROI (when what people really want is American Idol.) And connected to the last point was the really neat and very scary presentation by Eric Leven of Rip Road about tapping into the subtleties of behavior manipulation.

The conference was great and provocative, but from the strict patient “POV” there was little tangible voice. Steph Habif, a health coach who was a walk-on presenter, shared a telling text exchange between her and a client. My nametag said “e-Patients.net,” and when many people innocently asked, “what’s that?” I smiled…shame. By and large, the patient was present in the third person; a data point for the researchers that represented dollars for the entrepreneurs. I marveled at the idea that the diabetes medication adherence business (adherence meaning “taking the drugs”) was a $100 billion market (tell me I am wrong).

The point is that we patients represent a lot of dollars or data that leads to big dollars in the medical industry. There was a fair amount of discussion of patients, but still, it was mostly researchers, employees, and business folks talking about us: The patients, the sick, the consumers, the end users.

While I understand that this conference was given at Stanford — a prestigious nexus of research and innovation — and much of it was connecting people and fostering innovative business relationships, I still felt that we, the patients, were not represented “In Real Life.” The Persuasion Technology Lab team did an amazing job of running a synergistic conference about the direction of an increasingly important and evolving piece of the health care market, with the hope of making healthcare more cost-effective, available, and cutting-edge. Yet I left with the opinion that if we are engaging in any kind of discussion of what works in healthcare, especially in the context of behavior modification, the end user/patient/consumer must be presented. We need the human component. Wouldn’t it be great to hear from a woman who used Text4Baby, or someone who used the Healthy Rewards system? I think so. I would even like to hear from the doctors who use these tools. There is my food for thought and my recommendation for the future. Still, I was so glad to be there. My body paid for it later, but hey, sometimes you’ve just got to go for it. And that is what we e-patients do.

Recommended Reading

@kevinclauson: http://kevinclauson.wordpress.com/2011/05/05/mobile-health-2011-a-look-back-at-what-really-worked/
@TextInTheCityNY: http://textinthecity.posterous.com/lessons-home-runs-and-more-from-mobile-health
@AndrewPWilson: http://andrewpwilson.posterous.com/mobile-health-2011-mapping-the-uncharted
@pioneerrwjf: http://rwjfblogs.typepad.com/pioneer/2011/05/time-to-.html?cid=xtm_pioneer
@chiefmaven: http://socialmarketing.blogs.com/r_craiig_lefebvres_social/2011/05/what-really-works-in-mobile-health-a-summary-of-the-2011-conference.html
@geoffclapp: http://geoffclapp.blogspot.com/2011/05/thoughts-on-stanford-mobile-health.html

Copyright: © 2011 Alexandra Albin. Published here under license by The Journal of Participatory Medicine. Copyright for this article is retained by the author, with first publication rights granted to the Journal of Participatory Medicine. All journal content, except where otherwise noted, is licensed under a Creative Commons Attribution 3.0 License. By virtue of their appearance in this open-access journal, articles are free to use, with proper attribution, in educational and other non-commercial settings.