Even more distressing has been the outcry by many American citizens voicing their mistrust of eventual SARS-CoV-2 vaccines that are being rapidly developed and studied as part of Operation Warp-Speed (e.g.- New York Times article– Accessed November 6, 2020).  While anti-vaccination sentiment is not uncommon in our country, and around the world, this most recent episode focused on COVID-19 vaccines is acutely grounded in the perception of political interference with the scientific process, as well as remembered abuses of American citizens of color, particularly African-Americans (More than Tuskegee: Understanding Mistrust about Research Participation – J Health Care Poor Underserved. 2010 Aug; 21(3): 879–897).  Ultimately, this mistrust may prove to be a losing proposition for African-Americans, Hispanic/ Latinos, and Native American Indians since these communities have mortality rates that are 2.2 times (African-Americans) to 1.5  times ( Hispanic/ Latinos, and Native Indians) that of their Caucasian counterparts (See Image 1).  Vaccinations offer an opportunity to defend against the critically deleterious health outcomes that may be associated with natural human infection from SARS-CoV-2.  To refuse the SARS-CoV-2 vaccine certainly increases the chances of succumbing to serious long-term health complications, or even death.

Communication from the African-American Scientific Community  (Enhanced Transparency)

Recognizing the potentially negative impacts of perceived interference in the scientific process to create these vaccines, multiple national organizations have created ad hoc committees to provide oversight into the clinical research and manufacturing practices of the companies and entities developing the vaccines. The American Medical Association directly engaged the US Food and Drug Administration (FDA) by sending a letter encouraging increased transparency and communication into COVID-19 vaccine development.  This engagement seeks to assuage the fears of the public that the SARS-CoV-2 vaccine development is rushed and politicized, which increased the public’s concerns that the vaccines may be unsafe or not effective.

In thorough acknowledgement of the profound historical mistrust from African-American communities with scientific clinical research, the National Medical Association (NMA) formed an interdisciplinary  COVID-19 Task Force to directly engage the FDA, as well as the pharmaceutical companies involved in COVID-19 vaccine research and development. The task force includes NMA physicians who serve on the Centers for Disease Control and Prevention (CDC) Advisory Committee on Immunization Practices (ACIP), Infectious Disease Society of America, Pediatric Infectious Disease Society, and the CDC Health Equity Workgroup. Also included are pharmacists, nurses, and epidemiologists all with the goal of reviewing any SARS-CoV-2 vaccine developed will be safe and effective for all American citizens, and particularly those of color, that choose to receive the vaccine.

The goal of the NMA COVID-19 task force will be to provide timely recommendations to physicians and people in communities about any Emergency Use Authorizations (EUA) and eventual approvals by the FDA for COVID-19 vaccines and therapeutics presently being evaluated in clinical trials.  Next, effective and accurate communication can be provided directly to communities of color about the safety end effectiveness of these vaccines through their trusted health providers.  Hopefully, this will overcome the mistrust that many from the mentioned communities are feeling, and thus give themselves a chance to prevent becoming infected with this terrible virus.

Different Types of Vaccine Mechanisms for Antibody Stimulation

While people in communities may be waiting for “A Vaccine”, actually there are multiple companies developing several types of vaccines with different immunological mechanisms of action.  A small number of companies are in Phase II or III in their clinical research process.  In actuality, there are over 200+ COVID-19 vaccines in development worldwide.  Almost 40 are in some phase of clinical trials. The general perception from the public is that vaccine development just started once the COVID-19 pandemic occurred.  In truth,  serious coronavirus vaccine development began when the original SARS was prevalent in 2002-04 (Tripp RA,  et al.  “Monoclonal antibodies to SARS-associated coronavirus (SARS-CoV): identification of neutralizing and antibodies reactive to S, N, M and E viral proteins” Journal of Virological Methods. 128 (1–2): 21–28 , Sept 2005. doi:10.1016/j.) Once this current COVID-19 pandemic began, world-wide researchers had a 15-year history of studying coronavirus vaccine platforms.

For illustrative purposes, I show only four companies with SARS-CoV-2 vaccine clinical trials in the United States (See Image 2); I have no financial relationships with any of the companies shown.  People receiving COVID-19 vaccines in the near future must be notified, in lay terms, of the type of vaccine being provided, the company, and generally how it will produce immunity.  Two of the vaccines utilize messenger RNA platforms to elicit an antibody-producing immune response in the recipient. This is a new vaccine technology, and can be manufactured relatively quickly when compared to the other vaccines.  It is expected that the two companies that produce this version of the SARS-CoV-2 vaccine, Moderna and BioNTech/Pfizer, will file their Phase III results with the FDA first, and likely seek Emergency Use Authorization approval before the end of 2020.  To date, the messenger RNA vaccines appear to be safe in clinical trials.  The other companies in Image 2 are likely to file for FDA approval in early 2021.  It should be noted that of the companies shown in Image 2, only BioNTech/Pfizer did not receive any public money from the US Government to fund their research.

For many of the companies, mass manufacturing of their vaccines began in summer 2020 in order to get an early boost in producing enough doses for large scale distribution once approved.  All of the research AND manufacturing processes are certain to be scrutinized by the organizations mentioned earlier (NMA and AMA) for overall safety and effectiveness of the vaccines. These companies have taken the financial risk of their vaccines not enduring the rigor of clinical trials, which could in turn lead to their product not being approved by the FDA.

Equitable Distribution of Manufactured Vaccine Product

On the opposite side of the mistrust of COVID-19 vaccines, there are many health-focused and community organizations that will be monitoring and advocating for the equitable distribution of the vaccines once they have been approved by the FDA.  Some lead organizations are the National Academies of Science, Engineering, and Medicine.  They formed a group called the Committee on the Equitable Allocation of Vaccine for the Novel Coronavirus, which issued a guidance document that provided a four-phase allocation plan for COVID-19 vaccines. The goal is to account for the most vulnerable and most impacted individuals and communities affected by the pandemic (See Image 3).  The earliest vaccine allocations will most likely be provided to front-line healthcare workers, and those individuals at highest risk for severe morbidity and mortality (underlying health conditions (chronic included) and older adults living on congregate living conditions).  African-Americans carry a disproportionate share of chronic cardiovascular conditions such as diabetes and hypertension, greatly increasing their mortality potential once infected by SARS-CoV-2.  Subsequent allocations should be provided to a larger majority of Americans in numerous components of society (teachers, essential workers, etc), and those with moderate health conditions.  The next allocations shall go to young adults, lower transmission-risk employees, and finally all persons residing in the United States (National Academies of Sciences, Engineering, and Medicine 2020. Framework for Equitable Allocation of COVID-19 Vaccine. Washington, DC: The National Academies Press).  Again, input and vigilance from organizations such as the National Medical Association and the American Medical Association will be critical to insure that all Americans that choose to be vaccinated will have equitable access.

Taking the Opportunity to Live a Quality Life

In my previous article “Coronavirus Vaccines – ‘Trust, But Definitely Verify!‘”, the attempt was made to convey that COVID-19 vaccination offers the best opportunity to significantly bend the arc of poor health outcomes caused by SARS-CoV-2 in a more positive direction.  The metric of measuring deaths from COVID-19 is not the only concerning statistic, as potentially hundreds of thousands of infected patients may find themselves coping with long-term health challenges well after their infectious state has resolved ( Rubin R. As Their Numbers Grow, COVID-19 “Long Haulers” Stump Experts. JAMA. 2020;324(14):1381–1383). With the known possible negative effects on multiple organ systems in the human body (See Image 4), individuals should make every attempt to protect themselves against this virus through vaccination.  Additional and continual communication with the public will certainly be necessary to achieve this public health outcome.  In order to achieve this level of trust, the FDA must be overly cooperative and transparent with the NMA, the AMA, and the public during the vaccine approval process once they are adequately proved to be safe and effective for the majority of patients that receive them.  Healthcare providers across the country, as they have done and will continue to do throughout the pandemic, stand ready to serve the public health interests to maintain as healthy a society as possible.

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Greater than 198,000 Americans have died as a result of being infected by the novel Coronavirus (SARS-CoV-2) as of late September 2020.  The first confirmed case in the United States occurred on January 20, 2020 ( N Engl J Med 2020; 382:929-936). According to the University of Washington Institute for Health Metrics and Evaluation (IHME), the projected number of Americans that may die from Coronavirus disease (COVID-19) by November 1, 2020 is greater than 229,000 (covid19.healthdata.org Accessed Sep 20, 2020).  Unfortunately, the IHME model has proven to be fairly accurate during the duration of the national pandemic.  As for the racial/ethnic mortality demographics of COVID-19, the largest percentage of the cases have been people of color, and in particular African Americans. (Yancy CW.  JAMA. 2020;323(19):1891–1892; Journal of National Black Nurses Association. 31(1):1-12, 2020 Jul).  From information posted on covidtracker.com (a link connected to CDC.gov), Blacks are 2.4 times more likely to die than Whites; Latinos and Native Indians are dying at 1.5 times the rate (See Image 1).  This disproportionate effect on racial and ethnic American populations further spotlights the stench of health inequities that have befallen our country for decades, if not centuries (Smedley BD, Stith AY, Nelson AR, eds. Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care. : National Academies Press (US); 2003).  In the midst of the current SARS-CoV-2 pandemic, this is a moment that now demands that the entire healthcare system – (patients, healthcare providers and institutions, public officials, and insurers) – all implement actions to drastically slow the death rate and the potentially lasting deleterious health effects of this virus.

During the past several months, a focus on vaccine development to combat the SARS-CoV-2 pandemic has reached a feverish pitch.  The United States’ enhanced SARS-CoV-2 vaccine creation initiative, known as Operation Warp Speed, is focused on public-private partnerships with biotechnology pharmaceutical companies for COVID-19 vaccine development. As the name implies, the goal of this initiative is very rapid vaccine development.  Commonly, new vaccine development can take anywhere from 5 – 10 years; the effort here is to develop a COVID-19 vaccine in approximately 9 months.  While this seems quite expedient, much of this work actually began 15 years earlier during the original SARS-CoV outbreak in 2005. SARS-CoV (2005) was highly lethal, but not nearly as infectious (WHO Consensus document – (SARS) – 2003).  While the SARS-CoV (2005) vaccine development initiatives greatly slowed during the past 15 years, the scientific platforms that were developed helped launch the current world-wide race to create a vaccine.  When we add in predictive analytics, supercomputing, and advanced manufacturing practices, it becomes understandable how this may be achieved.  It also becomes quite apparent why there may be heightened skepticism by the American general public concerning the safety of a vaccine developed this quickly.  This skepticism is also quite elevated in the communities of color.  Many individuals may ask themselves “Do I risk receiving a vaccine, or risk catching the virus?”  With the deadly potential for COVID-19, or even the risk of long-term bodily injury by this novel Coronavirus, I implore everyone to strongly consider receiving an eventually approved vaccine that has undergone the appropriate FDA approval process.  Here are my reasons.

Updates on The Current Coronavirus Research Clinical Trials

There are SARS-CoV-2 vaccine clinical trials emerging across the United States, and the globe.  To date, no deaths directly attributed to the vaccine have been documented in the current clinical trials; there have been mostly mild to modest adverse effects documented for patients during the clinical trials (pain at injection site, elevated temperature, etc).  These conditions were effectively managed with acetaminophen, and the duration of symptoms were short.  More serious adverse effects have been noted in several phases of the trials; the numbers of these more serious effects have been very low when compared to the number of people that have received the test vaccinations worldwide.  Continual reviews of possible adverse effects for all companies administering vaccine in clinical studies are conducted by their respective independent Data and Safety Monitoring Boards (DSMB) to determine if these challenges were due to the vaccine.  DSMBs work independent of the companies to avoid conflicts of interest with pharmaceutical product testing during clinical trials.  With tens of thousands SARS-CoV-2 vaccine doses having been given worldwide thus far in clinical trials, there is growing observational evidence that the vaccines are at least not producing widespread serious adverse effects.  Now, more clinical trial research is needed to confirm the safety profiles of all of the various types of SARS-CoV-2 vaccines being developed, while simultaneously producing evidence that they will protect the user from developing COVID (Coronavirus disease).

Taking a Chance to Live – Time to Engage in the Solutions

Early in the onset of the COVID-19 pandemic, progressive respiratory failure was the most known and recognizable clinical manifestation of COVID-19. Other very noticeable bodily effects began to emerge as the virus continued to spread throughout the globe.  Cardiac disorders (mycarditis- inflammation in the heart; blood clots; heart attacks) have surfaced; neurological disorders (loss of smell and taste; mood disorders; headaches and dizziness); clotting disorders (blood clot development in the lungs and brain; small vessel clots); and gastrointestinal disorders (diarrhea, abdominal pain; nausea/ vomiting) among other disorders. (See Image 2) As the image shows, COVID-19 is far more than “just” a respiratory disease, and can produce very serious illness, bodily damage, and potential death of the infected individual.

Given that the beginning of SARS-CoV-2 has primarily occurred over the past seven months, scientists and clinician researchers have not had enough time to follow patients to see if these medical conditions will completely resolve in all patients.  Persons infected by SARS-CoV-2 that have additional chronic health conditions (high blood pressure, diabetes, obesity, etc.) are at significant risk to experience the most severe health problems.  Because of significant disparities in healthcare, including lack of access to quality healthcare and poorer social determinants of health (factors include: education, food access, neighborhood environment, socioeconomic status, etc.), African-Americans, Latinos, and American Indians (Image 1)  have been most negatively affected (See Coronavirus And Health Equity- Again This (Too) Is Predictable).   The potential for death following SARS-CoV-2 infection is elevated in these racial/ ethnic groups, despite the expanding use of therapeutic treatments (medications).  And with the continued re-opening of the American economy, there is no reason to expect that infection rates will go down in our communities of color.  More must be done to protect the most vulnerable among us.

I am urging individuals from Black/African-American, Hispanic/Latino, Native American, Asian Indian, and any other identified communities of color to participate in the clinical trials for SARS-CoV-2 vaccines.  Before widespread distribution of any vaccine can be achieved, we must first gather credible data and information about the safety and efficacy of these vaccines.  This can only be achieved through clinical research.  While mistrust of clinical research in all of these communities has valid historical reason to exist, we must actively participate in the process to transparently gather and distribute all of the safety and efficacy data that is owed to every individual in all communities that seek to have such information (Scharff DP et al, More than Tuskegee: understanding mistrust about research participation. J Health Care Poor Underserved. 2010;21(3):879-897). Clinical researchers such as myself must be ever-present to watch and protect people from all communities.  We must be available to help the restoration of trust in not only the clinical trial process, but in the healthcare system overall. Trust the Process, But Definitely Verify All Actions with Accountability and Transparency!

We are all faced with a foe in SARS-CoV-2 that has already proven to be deadly, and may leave the afflicted with long-term health ailments.  As I mentioned in a recent community webinar, the most fundamental task we must attempt to accomplish each day is to stay alive.  To live as productive a life as possible.  And to be present for our children and loved ones as they proceed into a world that is changing more rapidly than our ability to keep up with it.  This Coronavirus does not know color or ethnicity; it doesn’t know political affiliation; it doesn’t know rich or poor.  It only knows its eventual victim as being a human being.  We owe it to ourselves to fight back against it.  Please Join Us in the battle against this virus. (See WE-CARE for more information in Florida)

Part II of Coronavirus Vaccines – “Trust, but Definitely Verify!” will follow shortly.  There I will discuss the different types of Coronavirus vaccines presently being developed and studied, along with the necessity to hold all companies and our government accountable for equitable distribution of the vaccine to all communities once they are proven worthy for human application.  Stay Tuned, and Stay Safe!!

Image 1. (Adapted from covidtracking.com/race – Accessed 9/20/2020)

Image 2 (Adapted from the journal Nature Medicine)

As the COVID-19 pandemic continued to evolve, a call-to-action was issued by the US Department of Health and Human Services, Assistant Secretary for Health, Brett P. Giroir, M.D. His office issued an authorization under the Public Readiness and Emergency Preparedness Act (PREP) allowing licensed pharmacists to order and administer COVID-19 tests that the U.S. Food and Drug Administration (FDA) has authorized.  The statement issued by HHS Secretary Alex Azar read: “In an effort to expand testing capabilities, we are authorizing licensed pharmacists to order and administer COVID-19 tests to their patients. The accessibility and distribution of retail and independent community-based pharmacies make pharmacists the first point of contact with a healthcare professional for many Americans. This will further expand testing for Americans, particularly our healthcare workers and first responders who are working around the clock to provide care, compassion and safety to others.”

This PREP Act authorization has been followed by similar state-level executive orders from the governor of Florida, Governor Ron Desantis, and the governor of New York, Governor Andrew Cuomo, among others.   This allows pharmacists, especially at the community level, to provide greater accessibility for people to receive COVID-19 testing. It is universally agreed that significant expansion of testing is necessary to assist the identification of potentially infected individuals.  Contact tracing can then occur more efficiently, and isolation of infected persons can become more targeted and precise.  This also places an additional responsibility upon pharmacists to further engage in the fight against COVID-19 beyond what has already been accomplished.

Expanded COVID-19 testing by pharmacists must also achieve proper reporting mechanisms to regional departments of health, as well as other primary care providers if known.  This moment also offers an opportunity to establish necessary platforms to accomplish interprofessional interoperability between patients, pharmacists, and primary care providers.  Necessary exchanges of pertinent clinical information between health providers is long overdue.  A theoretical model of newly emerging roles for pharmacists is shown below (Figure 1):

Figure 1 – original from Kevin B. Sneed, PharmD, FNAP, FNPHA

In previous posts I have fervently advocated for the expanded utilization of mobile health technologies (mHealth) as a means of implementing a new type of data collection for medication therapies. Pharmacists can play a major role in the measurement and monitoring of medications, leading to more complete optimization of medication therapies.  In a recent conversation with a physician colleague, I stated that just because a medication was prescribed, and the patient took the medication, does not mean it worked, or achieved a metric-driven outcome.   During this COVID-19 pandemic event, numerous reports of patients suffering strokes or myocardial infarctions have been documented. (¹Zhang J, Wang X, Jia X, et al. Clin Microbiol Infect. 2020; ² McMichael TM, Clark S, Pogosjans S, et al.  MMWR Morb Mortal Wkly Rep. 2020;69(12):339-342; ³ Roncon L, Zuin M, et al. J Clin Virol. 2020;127:104354.). The increased internal vascular bio-inflammatory status of patients is likely a strong contributor to these events.  I would suggest that if mHealth technologies were already in widespread use, concomitant with enhanced implementation of telehealth platforms, the incidence of severe morbidity and mortality of patients with chronic diseases requiring multiple medications may have been fewer in number.  Further, facilitated implementation of mHealth and telehealth in underserved/ underrepresented communities may have attenuated the severe negative clinical impact in these populations. (Coronavirus And Health Equity- Again This (Too) Is Predictable – KBSneed)

Expanded COVID-19 testing is necessary to succeed in providing proper public health surveillance of viral spread containment strategies.  Community pharmacies are keenly positioned to contribute meaningfully to these community strategies.  Issues of PPE for pharmacists and staff, as well as costs of the tests remain key items to be figured out. The enhanced engagement of pharmacists during this COVID-19 pandemic will be essential in providing needed support to already strained health systems. There can be little disagreement that pharmacists should, and must, enhance our engagement in healthcare activities beyond purveyors of medicinal product and join the other health care clinicians in the war against COVID-19. The public health, societal, and economic implications are too great for anyone not to engage.

Effective medication therapy is at the core of managing patients with chronic disease states, such as diabetes or hypertension.  Unfortunately, medication therapy in this country has been far less than optimal, and in some cases creates harm (1).  Through multiple studies and reviews, it is well known that 50% of medications prescribed by health providers are not taken as prescribed within six-months, and 25% of prescribed medications are never filled or picked up (2).  Prescribers, most notably physicians, simply do not have the additional time or focus to follow behind patients about these medication challenges.  Pharmacist clinicians offer the best opportunity to not only improve adherence, but to measure and monitor the effectiveness and potential barriers to successful medication optimization (3).   Using mobile health technologies, these monitoring and measurement technologies create improved connectivity with patients in their daily ambulatory lives without requiring additional timely and costly visits to healthcare clinics.

I also foresee the possibility of bringing these technologies into underserved and underrepresented communities, which are often affected the most by lack of healthcare access. Putting these technologies into the hands of community health workers and other “health extenders”, with proper medical provider supports, could become an effective means of improving health disparities in many communities. Decreased emergency room visits and hospital readmission rates can be achieved, while creating an inclusive environment where people from all communities can benefit from emerging health technologies.  Ultimately, poor health in any community is a drag on all communities. The public health impact holds so much promise with the implementation of these technologies.

In my two most recent posts (Time for Pharmacists to Move from Behind the Counter  and Interprofessional Health Initiatives- Health Systems Cannot Succeed Without Them!) I expressed that Interprofessional Clinical Collaborations simply must evolve to achieve optimal health outcomes.   Interoperability of electronic platforms, Collaborative Practice Agreements, and capitated reimbursement models for clinical services will provide pathways for pharmacist clinicians to optimize medication outcomes as members of patient-centered healthcare teams.  Status quo healthcare delivery, siloed health providers, and avoidance of emerging health technologies will certainly stifle opportunities for our national and regional healthcare systems to provide the most outstanding healthcare at lower costs.  Mobile health technologies offer the best opportunity to initiate new communication paradigms between patients and their health provider teams. The Time is Now to embrace mobile health technologies.

1. Watanabe JH, McInnis T, Hirsch JD. Cost of prescription drug-related morbidity and mortality. Ann Pharmacotherapy. 2018;52(9):829-837.
2. Viswanathan M. Golin CE, Jones CD, et al. Intervention to improve adherence to self-administered medications for chronic diseases in the United States: as systematic review. Ann Intern Med. 2012;157(11):785-795
3. https://www.pharmacist.com/article/acos-can-do-more-medication-optimization-study-says (accessed 06/04/2019)

Sewn into the optimistic fabric of mHealth is the belief that patients will accept these technologies, which may lead to a level of patient engagement in each patient’s own health status that has been evasive in this country for several decades.  The goal ultimately is simple: have the patient gain empowerment and control of their health with constant reinforcement of their health status through the use of mHealth. And, overall improved health in our communities means lowering the costs associated with healthcare. The promise of improved community health may literally be in the palms of patients’ hands.

The use of mHealth is not without peril. A recently released report by the IMS Institue for Healthcare Informatics revealed that while there are major opportunities to advance mHealth technologies to augment patient care, the current state of mobile apps does not yet have the evidence or overall utility to provide meaningful health supports. Some of the identified deficits noted in the report include:
• More than 50 percent of all healthcare apps were downloaded fewer than 500 times –
• Current healthcare apps do not fit well with the greatest areas of spending within healthcare – specifically those patients facing multiple chronic diseases and typically over the age of 65.
• Physicians’ concerns included lack of scientific evidence that mobile apps improve overall health outcomes, concerns about security, and the ability to incorporate this information into a health information technology infrastructure.

My personal concern involves the development of informatics systems that can effectively harness all of this patient-generated information, and turn it into usable information for interprofessional health teams.  There are ongoing plans with our USF Health Information Systems team to accomplish this goal.  I am confident we can achieve this outcome.

I also foresee the possibility of bringing these technologies into underserved and underrepresented communities, which are often affected the most by lack of healthcare access. Putting these technologies into the hands of community health workers and other “health extenders”, with proper medical provider supports, could become an effective means of improving health disparities in many communities. Ultimately, poor health in any community is a drag on all communities. The public health impact holds so much promise with the implementation of these technologies.

We all claim to want to achieve true “Patient-Centered” care; our currently existing health systems do not provide an adequate platform to truly achieve this for the entire USA population.  Interprofessional teams, including robust IT supports, will offer the best means of corralling the overwhelming data that mHealth can generate. Physicians, nurses, pharmacists, physician assistants, physicial therapists, and public health officials must all lock arms to create authentic patient-centered teams. There is no turning back these technologies; we must all embrace the future of mHealth…today!

As the country grapples with accepting and implementing the Affordable Care Act, along with looming challenges for patients to gain access to adequate and affordable healthcare, I view mobile health (mHealth) technologies as a means of improving many of the daunting challenges that people in our communities face today. Long waits to be seen by providers, limited time, limited travel resources, limited access to THEIR patient records (and labs), lack of insurance, lack of discretionary finances, and the list can continue. If we as health systems’ providers can find effective means of providing mHealth technologies to patients, we can substantially improve many of these challenges. Through my work with the American Heart Association, we know that an overwhelming number of Americans currently use mobile phones, and many even have smartphones for their daily use. The use of this communication medium will only increase with time, and offers a grand opportunity to engage patients about their health.

The public is ready to accept these technologies; mobile downloads continue to increase annually, and companies expect that by the year 2016 smartphone sales will outnumber mobile phone sales (Canalys.com). The ability for patients to access mHealth apps will continue to expand.  Companies such as Scanadu, Withings, AliveCor, Bosch Healthcare, and many others are providing various mobile health devices for patients to effectively monitor their own health, while also providing the opportunity to provide this information with others of their choice. Hopefully their health providers will be included on their list of recipients. The health system must prepare to provide guidance to patients concerning these technologies, assess the effectiveness of these technologies, and be accepting of the transformative nature of these technologies. What we providers must NOT do is reject the presence of these technologies; they are here to stay. There is a grand opportunity to capitalize on having patients truly Engaged in their own health. Disruptive technologies have affected many other segments of society, and now it is health’s turn. I am prepared to (Em)Brace (for) the Future of Health in our country!

Stay tuned for “Emerging Mobile Health Technologies- Finally an answer to achieving Patient-Centered Care?” Part 2 where I discuss the impact that these disruptive MHealth technologies will have on the health system, and particularly health providers. If not implemented correctly, these technologies can produce unintended consequences, though I feel proper planning and innovative foresight can avert many problems.  See you soon!