The Journal of mHealth Vol 1 Issue 1 (Feb 2014) | Page 36

EPHA Briefing on Mobile Health

mHealth faces multiple barriers to full-scale
implementation
Nine key barriers to implementation of mHealth identified by the WHO
Share of countries listing barriers as important
60%
50%
40%
30%
20%
10%
0%

Priorities

Knowledge

Policy

Ecosystems barriers
Regulatory/policy barriers

Cost
Effectiveness

Legal

Operating
Costs

Demand

Technical
Expertise

Infrastructure

Other

Source: WHO, BCG Report 2012

Continued from page 33

health decision-making requires
more than raw data, including information obtained from face-toface contact that can put the data
into context, which is unique for
each individual. [29]
What is more, the evidence base
for mHealth needs to be further
developed. As noted in a study by
the European Connected Health
Alliance (ECH Alliance), more
data is needed to demonstrate that
mHealth scenarios do, in fact, lead
to improved health system performance, improved health status
and health-related quality of life
for older people.’ [30] In this context health technology and impact
assessments will be important to
determine whether investments in
mHealth technologies are worthwhile in the long term.
As any area in healthcare, mHealth
is also open to abuse. For example, under the banner of ‘wellness
apps’ are products promising better health outcomes (e.g. weight
loss, smoking cessation, stress re-

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February 2014

duction), which are not backed up
by evidence.
Implementation Challenges
The World Health Organization
(WHO) has identified nine key
barriers to the implementation of
mHealth. They are divided into
two groups –ecosystem and regulatory/policy barriers. As shown in
the graph below, competing priorities and lack of knowledge are the
top challenges for mHealth diffusion. Due to the lack of a strong
evidence base to back up its impact
on health outcomes, about half
of the responding WHO Member
States reported competing priorities as their main obstacle. mHealth
programmes require evaluation so
that policy-makers, administrators
and other actors can base investment decisions on facts. [31]
Policy Issues
Effective and coherent policymaking will become important as
mHealth matures. As mentioned
before, a key obstacle is lack of
access to fixed and mobile broad-

band coverage for health providers
and individuals, particularly in rural
and peripheral areas.
Reimbursement policies will also
require adjusting given that remote
care and treatment [32] will become
more relevant with the transposition of the Cross-border Patients’
Rights Directive.
Furthermore, technology changes faster than the legal regulatory framework it is situated in.
mHealth is situated in a complex
policy and legal environment; the
boundary between eHealth and
medical devices needs to be clearly
defined given that the latter are
increasingly digital and integrated
into eHealth. One potential way
forward would be to maintain a
clear focus on technical and data
interoperability and to ensure that
the eHealth Task Force recommendations [33] are implemented,
e.g. by developing policies that are
aligned with the technological demands of mHealth. [34]
Data protection and patient safety are particularly important in
healthcare. The security of personal information entered, transferred