Table 1.

Suggested roles for different stakeholders to improve implementation and integration of physical activity data via mHealth technology to support CDV risk reduction.

Stakeholders	Security/Privacy	Clinical Utility	Integration into Clinical and Community Care Workflow	EMR Integration
Clinicians/Community care team	HIPAA/HITECH compliance	Provide guidance and support to patients to adopt mHealth technology	Utilize data to guide assessment, counseling, interventions and follow-up	Collaborate on developing detailed use-case scenarios for mHealth integration and data use; data access must be approved by patient
Health systems	As above	Establish data analysis processes as required to ensure clinically actionable data	Collaborate on developing detailed use-case scenarios for mHealth integration and data use, plus implement customized approaches for different clinical departments and community care referral networks	Support integration efforts once summary actionable data is proven clinically useful to improve patient care, customized for different clinical departments and community care referral networks
Researchers	As above	Rapid assessment of validity and efficacy of mHealth technologies	Collaborate on developing detailed use-case scenarios for mHealth integration and data use; assess real-life effectiveness of mHealth technologies	Evaluate integration efforts
App/WAM developers	As above, plus FDA evaluation if apps/WAMs are classified as regulated mobile medical devices	mHealth technology must be valid, reliable; include evidence-based behavior change strategies	Include data collection/reporting features consistent with evidence-based PA recommendations	Open API available and constantly updated to enable integration efforts
Digital health ecosystem platforms	As above	Ensure a secure and simple to use platform for data download and standardization	Collaborate with researchers, clinicians and health systems to ensure appropriate analytics and data summarization protocols are in place to make data actionable and feasible for integration	Integration through secure and private network and platform
EMR platforms	As above	N/A	Data analytics and compliant for clinical use	Collaborate with app/WAM developers, digital health ecosystem platforms and health systems to streamline integration efforts of key summary actionable data
Regulators	Surveillance of HIPAA/HITECH compliance	HIPAA compliance certification of apps/WAMs if used in clinical practice	Assure patient privacy and secure use of data within clinical and research content, as approved by patient	HIPAA compliance

Abbreviations: mHealth: mobile health; EMR: electronic medical records; App: software applications; WAM: wearable activity monitors; HIPAA: Health Insurance Portability and Accountability Act; HITECH: Health Information Technology for Economic and Clinical Health Act.