Open mHealth – powerful tools to accelerate mobile health innovation

As a founding editor of iMedicalApps, I have witnessed first hand the transformation of mobile health from inspiring curiosity to potentialy provoking significant changes in the culture and practice of medicine.
The combination of rapid smartphone adoption and health IT spending spurred by the HITECH Act have in fact combined to launch a mini-gold rush in mobile health.
Yet, even though numerous digital health startups are hurriedly forming to tackle problems for patients and clinicians, there is no agreed upon high level description for storing and analyzing the moible health data they are collecting .
Enter Open mHealth, which was formed in 2011 to accelerate the process of building powerful and integrated mobile health software.
It took as an analogy the early days of the internet and how a few, carefully defined building blocks for computer to computer communication, promoted the incredible flowering that we now know as the world wide web. The hope of Open mHealth is that by nurturing an analogous open development and open governance process, we can promote faster mobile health software development and leave behind fewer isolated data silos.
I recently spoke with Ida Sim, co-founder, and David Haddad, program manager, of Open mHealth. From these conversations, I learned a lot about the platform, the products that have been built so far and where they want to go in the future.
These conversations have left me even more optimistic about the future of mHealth, as a transformative moment in physician and patient empowerment and also a pivot point toward a new era of health information technologies.

Brief history

Open mHealth grew out of a paper co-authored by Ida Sim and Deborah Estrin in 2010 titled “Open mHealth Architecture: An Engine for Health Care Innovation.”  It was published in the prestigious Science Magazine. A year later, Deborah and Ida convened a group of experts from the software and health worlds to strategize about how to create such an architecture in April 2011. From this was launched Open mHealth and the important open governance structure to guide its development. They state their mission as thus:

“Open mHealth aims to bridge the divide between health and technology to enable meaningful collaboration. Our unique role is to work collaboratively with all actors in the mHealth ecosystem to grow shared software and techniques. Open mHealth is part of the solution – whether you’re proprietary or open source, public or private, we can be complementary to, and integrative of, your work.””

Before proceeding too much further, we should recognize that Ida Sim and Deborah Estrin are both from the rarefied upper echelons of medicine and technology.
Ida Sim is a practicing primary care clinician and Professor of Medicine at the University of California, San Francisco. She went to medical school at Stanford where she also obtained a PhD in Medical Informatics. In addition to winning various awards and serving on journal editorial boards, she led the World Health Organization effort in establishing a global system for clinical trial registration. She is also an elected member of the American College of Medical Informatics and the American Society for Clinical Investigation.
Deborah Estrin holds a chaired Professorship in Computer Networks in the Computer Science Department at UCLA and is a Founding Director of the NSF-funded Center for Embedded Networked Sensing (CENS). She received her Ph.D. in Computer Science from M.I.T. In addition to winning numerous awards, she is unique in being a member of both the American Academy of Arts and Sciences and the National Academy of Engineering.
Of note, both Ida and I are members of the organizing committee of the NIH Public Private Partnership on mHealth. As such, we are helping guide a larger, multi-disciplinary group to take on the challenge of making sure the mHealth revolution arrives as healthy and effective as possible.

Open mHealth Goals

Ida Sim believes the philosophy underpinning Open mHealth comes down to this question–

“open innovation and open sharing has gotten us better, faster toward solutions in other industries – so why not mHealth?”

Ida gives examples of large, complex software endeavors such as Eclipse & Apache, where the use of open source has shortened development of timelines. Although there are fewer examples in health, she believes that building out modules and APIs for data and for services, such as cloud hosting for clinical effectiveness evaluation, will also allow for faster solutions in health IT.
For those who wonder whether open source software has a role in healthcare, take a look at this recent Economist article where the argument is made that the complexity of the software that runs medical device may in fact derive important safety benefits from being open sourced, rather than the closed, proprietary model that prevails now.
Ida comments that “mobile health is good at collecting lots of data but not so good at processing that data into more useful guides for improving our own health”.
Much of this information is and will be coming from mobile sensors but much of it is still patient reported. The main thrust of the Open mHealth project is to provide robust tools for analysis and interpretation of this data.
It is important to note that the data in question is primarily patient reported and patient sense data. – i.e. health support data, ecological momentary assessments, data from sensors, e.g. fitbit, blood pressure, glucometers. It is not clinician generated data, whether from the office or the hospital. The clinician data will provide context for patient generated data, but is not the main focus for Open mHealth.
As Ida puts it:

“the fundamental opportunity in mobile health is in patient self care”

This is important because the implication is that these sophisticated building blocks for health data analysis will not revolve around the clinician but rather around the patient, to make it easier for patients to visualize and act upon their own data. She adds “we are looking less at things the clinician might think useful but at things patients wil find useful and interesting.”

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