From The Editor | June 23, 2011

4G mHealth: Possibilities & Pipe Dreams


By Ken Congdon, editor in chief, Health IT Outcomes

In the world of mobile technology, 4G (fourth generation) cellular is the latest and greatest thing. It seems like every other television commercial boasts the multimedia and data rich transmission capabilities that 4G bandwidth can provide consumers. The healthcare industry has also been peppered with messaging touting the transformative power 4G technologies can have on the delivery of medicine. The possibilities of 4G in the healthcare industry, particularly in the area of mHealth, are inspiring. I recently wrote about the potential of 4G in a recent white paper titled Mobilizing Healthcare In The ARRA Age. Here are a few excerpts:

"4G broadband capabilities are dovetailing nicely with the growing trend of telehealth/telemedicine in the United States, a growing alternative to office or hospital visits for the treatment of the chronically ill or elderly."

"Two-way wireless videoconferencing devices can be placed at the patient bedside for regular physician/patient interaction, complete with high-definition video transfer for accurate visual diagnosis. Wireless patient blood pressure, glucose level, weight, and/or bone density monitors may also be integrated into the solution. These devices provide treating physicians with regular insight into the patient's condition by regularly relaying this data wirelessly to the doctor's computer or mobile device."

"4G telehealth solutions also help remove location barriers from the healthcare equation. With videoconferencing, a patient in a rural area with 4G coverage can receive a consultation from a world-renowned specialist without ever leaving their neighborhood or home."

In addition to the above listed mHealth possibilities, leveraging 4G in the creation of Mobile Body Area Network (MBAN) systems have also been proposed. These systems could be created by attaching multiple miniature wireless sensors on a patient's body. These sensors would take measure a variety of vital patient information such as body temperature, pulse, glucose level, blood pressure, respiratory function, and a variety of other physiological metrics. This data would be wirelessly transmitted to a hub device where it would be regularly monitored by healthcare staff.

Obstacles To A 4G mHealth Utopia

Like I said, the potential of 4G technologies in healthcare are inspiring … and absolutely, 100%, technologically possible. But, are they probable? Will these technologies be regularly adopted by healthcare providers in the U.S. within the next few years, or even the next decade? The jury's still out on that one. There are several factors, some of which have nothing to do with the technology itself, that can potentially stand in the way of making these types of 4G mHealth solutions commonplace in the practice of medicine.

  1. 4G Coverage & Connectivity — In order for the healthcare industry to fully realize the wireless mHealth potential of 4G, 4G cellular coverage must be made available in rural areas. This is still a work in progress. In fact, several rural areas still have limited 3G coverage. Furthermore, many rural areas will be last on the list to receive 4G, after key urban areas and suburbs. Intermittent wireless network connectivity may also have a negative impact on the reliability of these solutions. That being said, I feel the coverage issue will quickly resolve itself – as carriers like Sprint, Verizon, and T-Mobile jockey to offer the most expansive and reliable 4G network.
  2. Standards — This doesn't directly affect 4G networks, but the medical devices and sensors used in mHealth solutions. The medical device community lacks a common platform or set of standards for their technology offerings. This can make compatibility and integration of mHealth solutions problematic.
  3. Reimbursement — As I've mentioned in previous columns, the reimbursement policies for telehealth solutions by the payer community are weak; unclear; and, in some cases, nonexistent. If the provider community isn't confident they will be adequately reimbursed for their technology investment, they may opposed to adopting 4G mHealth technologies, regardless of the potential they have to transform patient care.
  4. Change Management — Both physicians and patients may be accustomed to face-to-face visitations and examinations and oppose the idea of being treated remotely or virtually. Furthermore, many patients may object outright to the idea of having a series of sensors attached to their bodies to measure key physiological metrics.

The possibilities of 4G mHealth are truly exciting, but it's clear that some fairly imposing obstacles may impede the pace at which these solutions become part of mainstream medicine. However, once again, I'll state that I feel this has little to do with the technology itself and more to do with the legislation and circumstances surrounding the technology. In fact, several compelling 4G technologies are already starting to emerge that can improve physician productivity and patient care including 4G mobile hotspots, wireless medical/monitoring devices, tablet computers, and smartphones. Many of these technologies are highlighted in the 4G product showcase listed at the bottom of this week's email newsletter. I encourage you to review these products. While not necessarily tied to mHealth, I feel these products are core tools in the types of 4G solutions I feel will have a more immediate impact on the healthcare industry — those deployed inside the four walls of a hospital or IDN (integrated delivery network). These 4G solutions can be used to provide physicians with mobile access to key patient data (including EHR information and medical images) at the patient bedside, on the road, or at home. All of this increases the speed and accuracy of treatment and increases physician productivity.

Have a comment or feedback for Ken on this article? He can be reached directly at