Electronic Health Reporter

Alex Bratton, CEO of Lextech, discusses his company, its vision, why it’s important to healthcare and how the changing landscape of health app is affecting health outcomes and the industry as a whole.

What is Lextech and why does it matter to healthcare?

Lextech is a mobile app development company that evaluates business workflows to identify and build apps that improve processes and make the complex simple. Mobile apps will become increasingly important to the healthcare industry for two reasons: they are instrumental in helping caregivers and insurance companies build direct relationships with patients, and they can help drive healthcare costs down. With the massive changes taking place in healthcare, and the uncertainty that goes with change, it’s crucial for healthcare service providers to create a strong bond with patients by giving them tools and information that make their lives easier.

What do your clients say works wonderfully? What doesn’t work so well? Why?

Lextech is known for its Billion Dollar App (BDA) process, which focuses organizations on developing the right app for the right reason, and to use that app to improve processes. This approach often results in significant cost savings and efficiencies. The opposite of this, which doesn’t work well, is what we call the “obvious app.” An example of an obvious app in healthcare is to squish a desktop-oriented EHR system onto an iPad. This is inadequate because it doesn’t streamline a process and it certainly doesn’t simplify users’ access to information. The better approach is focusing on a portion of the healthcare workflow and driving small portions of the EHR data and functionality through a brand new window–an intuitive app. Important questions need to be asked before developing an app, including: what are we trying to accomplish with this app, how will people use this app, why will they use the app, and what problem does it fix?

How are you changing the landscape, and how do you know you are doing so?

The ability of consumers and healthcare providers to access information and streamline processes using mobile devices is having a profound impact on healthcare.

With the consumerization of healthcare, healthcare providers have a vested interest in delivering an experience that builds patient loyalty. At the same time, new healthcare laws are forcing patients to be more responsible for their own care. Healthcare providers who give patients the tools they need to make informed choices will build stronger and longer relationships with patients. Mobile apps will be the heart of these tools. Examples of apps that we’ve created to meet these needs include an app for an insurance provider that helps patients easily locate a doctor or specialist based on a specific need and an iPad app that allows medical professionals to touch, analyze and share X-Ray images with other physicians and patients.

Mobile apps are also used to help streamline processes and reduce costs. One group we worked with needed a solution to allow remote experts to consult during specialized surgeries. Previously the expert had to travel to the surgery location but we developed an app that enables the remote expert to attend surgeries virtually, tapping into an operating room camera and medical equipment screens. This opens up the operating room to remote advisors who can deliver assistance for less cost.

Tell me about mobile apps in healthcare and your wildest projection for what apps will do for it?

In the area of consumer-driven healthcare, the sky’s the limit for apps. We already are seeing apps that help patients live healthier lives. It’s only a matter of time before we see apps that provide information to patients about how effective a doctor is. Right now, patients see doctors based on referrals. Soon they will be able to see their outcomes, as well.

We also will see mobile apps change the relationship between doctor and patient by allowing patients to subscribe to a service and use their device’s camera for a remote diagnosis. While this may disrupt some patient-doctor relationships, it will create new business models for innovators.

In the healthcare setting, mobile apps initially will be focused on streamlining specific processes in specific areas of a hospital or clinic, such as admissions. Soon, mobile apps will be used by doctors to better explain procedures to patients, will allow specialists to participate in procedures remotely, and will give patients unfettered access to their medical health records.

What areas within healthcare can benefit the most from implementing mobile apps?

Doctor practices and hospital systems are ripe with opportunity to use mobile apps to streamline processes and deliver better care. Some of the most obvious areas that can benefit from mobile apps include:

• Better access to patient records and billing. The future points to mobile apps that interface with multiple electronic health record (EHR) systems at the same time and allow doctors to use one app to quickly retrieve and update information regardless of which EHR system is used. The same is true for interfacing with billing systems.

• Ability to provide more timely care. By facilitating communication and the flow of information, mobile apps can notify doctors when test results are in and provide a workflow of next steps. Eventually, doctors will use apps to interface directly with patients using remote video sharing, allowing for a remote diagnosis or quick check-in without a physical office visit.

• A streamlined and improved patient experience. Mobile apps provide the opportunity to streamline office and ER visits, allowing patients to check in using a tablet that accesses patient information and allows fast triage of patients in ERs. Patient-focused apps also can allow patients to set appointments, request prescription refills and set preferences for appointment reminders or receive notifications that the doctor is running late.

• Patient access to meaningful health records. Many doctors hesitate to give patients access to medical records because they are concerned they will not understand the information. Raw medical records are overly complicated and include medical codes that are indecipherable to most patients. Mobile apps can help by simplifying medical information and presenting it to patients in an understandable format.

• Proactive patient care. Patients will be able to use apps to better manage their health and lower their healthcare costs. Apps can remind patients to take medications and can educate patients by providing tutorials on topics like administering shots and taking blood pressure readings. Apps also can provide financial transparency into medical billing, encouraging patients to make financially sound decisions.

Why is adoption of mobile not happening more quickly in healthcare?

Sadly, healthcare IT is held back by massive legacy systems and a fear of change. The industry is dominated by a few large IT systems and it’s hard to break in. Mobile apps will need to work within this established system. Even more troubling is the fear of change among chief medical information officers (CMIOs). I had the opportunity to meet with a group of CMIOs to discuss mobile apps and found that the group was evenly divided between those who want to be change agents and lead what the mobile health enterprise will look like, and those who want to lock the network and fight the push by doctors and patients to incorporate mobile into the enterprise.

What’s the biggest challenge healthcare faces when adopting mobile apps?

The biggest challenge is the complexity of our healthcare system. It is a highly regulated system with massive amounts of data held in legacy systems. For mobile apps to be successful, they have to work within this environment and deliver value to the user, usually by simplifying a process. Although the backend is very complicated, the apps must be elegant and easy to use.

Who are the healthcare leaders in mobile app adoption?

Some companies will claim they are leaders because they have a lot of mobile users. For example, a hospital chain that rolls out an iPad adoption with its legacy EHR system. But, the real innovators are those using mobile to disrupt the industry. These disrupters are  taking healthcare out of hospitals and doctor’s offices, and putting more power in the hands of consumers. They are applying mobile technology to change the way healthcare is delivered.

When faced with building a mobile website or a mobile app, which makes more sense for health care?

There’s been a lot of buzz around HTML5, the technology used to create websites, as a panacea for this issue. Analysts and IT directors both are eyeing HTML5 as the future of mobile app development. In fact, industry analyst group Gartner recently predicted that half of all mobile apps will be HTML5 native app hybrids within three years and recommended organizations begin preparing for the arrival of HTML5. We are not convinced.

Whether apps should be native (built specifically for iOS or Android based smartphones) or HTML5 is the wrong question. Executives really should be asking: What is the app expected to do? For organizations that are developing workflow apps to help streamline processes, we don’t believe that HTML5 is ready yet. However, if the app’s main function is to look up information, such as a marketing website, a mobile website may suffice.

Like every industry, BYOD is an issue for healthcare. What is the best practice in this area?

Bring your own device, or BYOD, is an important issue for healthcare providers. To illustrate, the day after the iPad was introduced, they began showing up on hospital networks. There are a lot of issues with security and HIPAA protections that are unique to healthcare and present special challenges.

Devices to be used on the healthcare network need to be at least partially managed by the organization using mobile device management. In this way security policies can be managed centrally and appropriate apps pushed to users who need them.

That said, it’s not necessary to support every device (either from a management perspective or providing apps). That would be a daunting task. Instead, pick the standards and platforms you wish to support and communicate that to users. It’ll still require more than one platform but can be greatly simplified.