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Looking more broadly, I think we're very excited about the potential for mobile health tools.

When I think of mhealth [mobile health], as opposed to ehealth or telehealth, I personally am talking about what we call asynchronous communication, a fancy term that usually means that both people kind of aren’t on the line at the same time. So that might be a text message to a patient, it might be an automated call with feedback to the provider or other community health worker or other people in the health care team. It can be an app.

In our own work, we try to go to the lowest common denominator, and that's typically text messages or automated calls that could be used regardless of whether someone can afford or has access to a special device.

In general, the larger message about adherence is that people that need the most support and that find the most value from that support are the most likely to use it. Often what I've seen is that health professionals assume that everyone is like us, but we really know that they're not. I think that's really the role, though, of us in the scientific world to really step back from our own preconceptions about what's going to work and actually test it out. And often, we've been pleasantly surprised about how much people are excited about taking advantage of the increased communication and education they can have with mobile health.

The first generation of mobile health systems that would give feedback to clinical teams had some successes, but limited success, because clinical teams are often overwhelmed by information. And they're overwhelmed by the patients that are out there in the waiting room, let alone be able to respond to the needs of a patient that has a question about their medication, but is out in the community. So through the CarePartner Program, we've tried to engage in a more productive way – family caregivers, like adult children, living outside the home of someone with diabetes – and give them support. One of the original concerns with CarePartners was that we’d stress these adult children out. They have their lives, they have their kids and jobs. To give them more information about their mother or their father who might be ill might make them feel worse. What we found, happily, is this actually makes them less stressed.

I guess the two things that I would say if health professionals are thinking of adopting mobile health tools. First, suspend disbelief. Don't assume. Not all the patients are like us. Just because it might not be something that would work for you or something that you would like to have. In our experience, diverse populations, especially some of the most needy ones, really appreciate the frequent reminders, support, and attention that providers wish they could give, but don't have the time and resources. But now we can get from mobile health.

Try to be a little more open-minded. These mobile health tools are a diverse lot of different services that might be useful for some of your patients, so try them out. Ask your patients what they like, and I bet you’re going to find some things that will actually make your patient's experience of their self-care support better.