Toolkits

mHealth - Deployment and Support

Mobile health products provide an interesting challenge to organizations looking to provide a controlled, organized deployment to their staff and patients.  Due to the ubiquity of cell phones and tablet devices, it is quite likely that an organization will have to determine how to best integrate existing, personal devices with newly purchased, program-specific equipment.  While there are many different ways to approach the deployment and support of these devices, there are several key considerations for an organization in the process of planning.

Planning

Setting aside time to properly plan the deployment and support of an mHealth program can help prevent problems, and can help you determine how to best approach developing an mHealth solution.

Who is Receiving Equipment?

When first announcing intentions to deploy mobile platforms in an organization, many individuals and departments are likely to express an interest in being included in the rollout.  While there may be a reason to allow many departments to utilize these products, it is critical to think about who truly needs to receive them.

We recommend selecting one department to be the first to utilize mobile products, allowing the Information Technology staff to work out any problems with the system before putting the products into hospital-wide distribution.  Some organizations may have enough comfort and familiarity with mobile platform support to have a larger initial deployment.  Regardless of the approach, being clear up front as to who is going to receive the equipment and who will not is critical to future planning efforts.  

There are four primary usage scenarios for mobile products.  The first is for administrative purposes, where staff may want to utilize mobile devices for tracking meetings, checking email, and communicating about business topics. These personnel may not need to access clinical applications or send clinical data, which makes them an appropriate recipient of mobile technology. Problems in the technology rollout won't directly impact patient care.

The second set of users to consider are those who will use the system for managing patient care, either through inputting patient data or accessing electronic health records and decision support systems through a mobile platform.  These users will likely have a strong use case for implementing mobile systems, but may not have the tolerance for technology failures that could potentially impact patient care.  An organization may choose to support a single department or program with mobile technology, then roll it out to the rest of the clinical staff as any problems with access or workflow are resolved.

A third scenario is to utilize mobile platforms for direct delivery of patient care, either through videoconferencing applications, remote patient monitoring, or patient data review.  In these situations, proper connectivity and support must be in place or else patient care will be adversely impacted.

The fourth usage scenario is to deliver or support patient access to systems, either in the form of patient monitoring devices, videoconferencing, or health and wellness applications. These users may have the lowest initial cost for your organization, as the equipment costs might be carried by the patient.  However, be wary of costs related to equipment failure and patient training and support. Patients may expect assistance if there is a problem with a mobile platform endorsed by your organization.

Within these four groups, it is critical to determine who needs to receive devices from the organization, who may need to provide their own devices, and how these rollouts will be supported.

Existing Devices vs. New Purchases

One of the large questions that organizations must tackle is whether or not it they will purchase new devices for their employees or if they will support personal devices already in use by employees.  There are difficulties in selecting either option, and each must be weighed appropriately.

Existing devices owned by employees have a couple of benefits, namely that the organization does not need to purchase new equipment, and employees will already be familiar with the product.  However, complexities can arise.  

First and foremost are concerns about securing the device and ensuring that data is not improperly sent or accessed by the user.  Clear usage and security policies need to be set up for personal devices.  Additionally, there are concerns in some organizations that personal-use devices will be used for personal business during work hours, as phone calls, entertainment applications, and non-work software may be available to employees.  Once again, clear policies should help mitigate some of these problems.  

One of the more challenging problems to address is how the users will be reimbursed for the use of their personal device in a work setting.  Options range from providing financial vouchers or stipends to their normal salaries, to paying for individual plans directly. Check with individuals and service providers to determine if it is feasible to manage phone accounts as an organization, or if its more prudent to provide reimbursement to individuals.

If an organization chooses to provide mobile devices to their employees, there are several benefits and issues that also must be addressed.  One of the top concerns is whether or not users will be expected to carry their mobile devices home. If so, will they be considered on call while off site? Will they be allowed to use the device for personal use? Many individuals would rather not carry two devices, and may balk when asked to carry a personal phone for personal use and a company phone for work purposes.

Benefits of providing mobile devices to employees include being able to manage phone numbers and accounts.  The organization can ensure that access is blocked to ex-employees, and that important customer information is not retained on personal devices.  Additionally, it's possible to use the bargaining power of a large number of accounts to get reduced rates for data and voice plans, and to establish business partnerships with local service providers.

Setting Minimum Requirements

Once an organization understands who is receiving equipment, it is necessary to determine what equipment will best meet those various individuals' needs.  While it may be possible to set minimum requirements before users are selected, there should be a final round of requirements analysis to ensure that relevant issues and needs are being addressed in the selection of a product.

Examples of minimum requirements may include the number of processors and processor speeds for various mobile computing devices, screen resolution, video camera capabilities, operating systems, and the ability to support and integrate with existing systems and infrastructure.

Configuring Equipment

Establish the required device configuration options early in the planning process. An organization may wish to force encryption of transmissions and files saved to disk, and should consider how new software updates will be managed on the individual devices.  Key software should be verified to will work with the planned devices.  Additionally, consider if there will be a small number of supported devices, or if any device can be supported if capable of conforming with certain configuration requirements.  These lists of configuration requirements can be modified as devices are brought in for testing and deployment.  Once a standard configuration is established, a document should be generated that explains how to configure the relevant devices to meet the requirements.

For the Home User

If your organization will allow access to secure, internal data from an outside network, additional precautions are in order to ensure that you aren't increasing risks by doing so. Consider implementing strict network security policies, requiring encrypted hard disk storage on all devices used remotely, or consider provisioning remote wipe capability in the event that a device is lost, stolen, or not returned.

Purchasing

The act of buying equipment includes more than just finding a vendor.  There are several key issues to consider to support future deployments and to ensure that a service provider can meet organizational needs.

Product Versions and Future Plans

As the mobile device market is largely a consumer-oriented one, there is a very high rate of change within product lines of individual manufacturers.  Each year sees a release of countless new mobile products, with existing models being phased out fairly rapidly.  If an organization is purchasing phones for its employees, it is necessary to have a plan for selecting and deploying new devices.  As new devices come out, ensure that they will work on existing infrastructure and will support all required applications.  Additionally, attempt to work with vendors and service providers to establish pricing discounts if buying products and services in bulk.

Service Providers

There are several different options for working with service providers.  Aside from considering issues raised above, determine if users will each be on their own corporate phone plan, or if they will operate from a shared, managed pool of available data transfer and voice calls.  Figure out who offers which services, and if there is a way to get corporate pricing plans.  Always ensure that the service provider does not block or restrict the use of any relevant applications.  There have been cases where video data or other high-intensity applications are blocked by cellular providers, making it impossible to perform videoconferencing on their networks.  Testing products on a service provider's network prior to performing a larger rollout is a critical step in deploying mobile devices.

Reimbursement Plans

Organizations must decide how to pay people back for corporate utilization of personal phones and data packages. Additionally, consider patients who are using mHealth products on their own.  Is there a reimbursement option for them?  Can they be covered for mobile monitoring devices?

Deployment

Once equipment is purchased and received, it is important to determine how to proceed with deployment. Provide an area to stage and train configured devices.  This will help ensure that support issues are initially addressed by getting users familiar with each phone or tablet before they are released.  

If phones are provided to new employees, it may be necessary to determine if phones will be pulled from an existing stock or if new phones will be purchased and configured on an as-needed basis.  Similarly, considerations must be made for any patient equipment that may be stored, with a process in place for performing final configurations for patients and connecting them to required organizational systems.

The National Institute of Standards and Technology discusses many issues and questions related to the deployment and support of mobile solutions in the workplace. You may find this document in our resources section of this toolkit.

Support

After verifying that devices work with your organization's network and software systems, ensure that there are instructions available to those attempting to utilize the devices.  A basic level of setup and troubleshooting documentation will result in reduced service calls, and this documentation can serve as a guide should issues arise.  

If problems do occur during use, determine who is responsible for providing support. Will service providers, manufacturers, or the organization be responsible for training and supporting users?  Clarifying these issues up front will streamline the support process.