mHealth and Child Abuse
by David Lee Scher, MD (11/9/2011)
There has not been a more horrific scandal in the world of sports that I can remember than the child abuse scandal (the mainstream media calls it a sex abuse scandal) surrounding The Pennsylvania State University. Let it be said that I am very impressed with the reaction of much of the student body which is one of shock and disdain for the administration charged with covering up alleged abuses of children by a former assistant football coach. According to the grand jury’s report, the school demonstrated willful blindness to the allegations brought to it, none going to state officials. Some of the fans at Saturday’s PSU-Nebraska football game are organizing a blue shirt campaign to show solidarity for the victims (blue ribbon being a symbol of child abuse).
As this blogger is an evangelist for wireless technologies and the noble things it will deliver (efficient, dignified, cost-effective and better continuous healthcare), I think it fitting to discuss how mHealth technologies may, in the future, be useful tools for subjects of child abuse and their loved ones. The mental health ramifications and scars are forever in these people. They require acute and chronic attention and interventions. Once per week hourly sessions with a mental health professional are not the best we can offer. This is analogous to a visiting nurse checking vital signs twice or three times per week of a patient with chronic congestive heart failure. These snapshot moments poorly represent the continuum of pathology.
What if there was an app that a subject of child abuse, in an acute episode of anxiety or depression, can facilitate contact with a network of professionals that would have instant access to a patient health record identified with that account. There would be less anxiety in dealing with it alone, or with someone unfamiliar with the case. The professional would need to ask minimal background questions which provoke anxiety in the subject in recounting perhaps years of history. The subject’s medication history would be immediately known. Contact information of a caregiver or loved one as well as the primary care physician or usual mental healthcare provider would be at hand. One may envision a video teleconference over the smartphone or a computer screen. The app may have customized coaching tips (entered by the subject’s mental healthcare professional after a successful session or intervention) for victims as well. It may contain a ready-set list of local resources, either live or online. It can have the subject’s medications with side effects as well as dosing reminders.
Telehealth is being utilized more for mental health consultations now. Mobile health technologies are being used more in 911 types of emergencies. Crises related to child abuse in the chronic setting deserve the same technological considerations.
Lyndon Johnson’s gallbladder operation, Ronald Reagan’s colon cancer, and Magic Johnson’s revelation of his diagnosis of HIV were watershed moments in publicity for those diseases. I hope that this Penn State scandal, regardless of the outcomes of the criminal proceedings, will raise awareness of the horrors of child abuse and become the impetus for action to limit future victims or to help those who have already been such victims. Let mHealth become a part of the solution or healing process.
About David Lee Scher, MD
Dr. Scher is a medical pioneer (earliest adopter of remote patient monitoring and interoperability with EHR), a lifecycle contributor to development of new technology and regulatory approval as a clinical investigator, and a Medicare Carrier Advisory Committee member. He writes a blog on mHealth and can be reached by email or through Linkedin.
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