Like many people in the world, I can’t live without mobile technology in my life. Every minute of each day, I am one button away from calling, messaging, emailing, blogging, Facebook-ing and tweeting to a global audience. However with statistics such as 67.6% of adults worldwide have access to a mobile phone, and of the 5 billion wireless subscribers world wide, 70% are from low to middle income countries, mobile health (mHealth) might just be a key element in tackling and managing chronic diseases worldwide.
mHealth is defined by the WHO as the use of medical and public health practices, which are supported by mobile devices, such as mobile phones, patient monitoring devices, personal digital assistants (PDAs) and other wireless devices. Out of the range of electronic devices mentioned, the most utilised and rapidly expanding platform to date, is seen through the use of mobile phones. With wireless signals covering 90% of the world, specialised health applications (apps), which are widely available to download in the App Store, can utilise some of the mobile phones functions to improve management and prevention of chronic diseases.
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| Infographic on the Rise of Digital Health |
As we know management of chronic diseases is a time consuming and expensive element of health care systems globally. Patients with long term conditions in developed and developing countries, are often treated within the community setting and encouraged to self manage their conditions. However it is not that simple. Patients forget to take medication, forget to follow recommended guidelines, and can misjudge the severity of their health status which can have fatal consequences. However mHealth apps can provide a quick, inconvenient and cost effective solution.
For example, mHealth apps can provide patients with a timely daily reminder of when to take medication, snippets of daily health information related to healthy lifestyle practices, or answer questions and provide advice on symptoms and when to seek medical advice. All of this can be achieved through a touch of a button and the opportunities are truly endless.
| mHealth iPhone Application |
One of the areas which is of particular interest to Non Communicable Disease community, is the potential role mHealth has within the management and prevention of type 2 diabetes mellitus (DM). DM mHealth apps have been developed by a variety of private and public organisations, covering a wide variety of interventions spanning diet, physical activity, monitoring blood plasma glucose levels, taking medication, problem solving and highlighting risk factors. These mHealth apps utilise the mobile phone’s utilities such as: voice and short messaging service (SMS); general packet radio service (GPRS); third and fourth generation mobile telecommunications (3G and 4G systems); global position system (GPS) and bluetooth technology. Furthermore mHealth devices can also utilise accelerometers, gyroscopes, goniometers, piezoelectrodes and electromyography, to accurately measure a variety of biochemical and physical data such as blood glucose, blood pressure, heart rate, weight and physical activity.
Subsequently data can then be sent wirelessly to a mobile device, computer, or healthcare information system, where the patient or healthcare professional, can actively monitor the personal data in realtime. There are also DM mHealth apps which include DM diaries, where the user enters anthropometric data, dietary intake, physical activity and blood glucose, thus again allowing the user to actively self monitor their health status. Similar apps also allow the user to look up nutritional information regarding the foods they are going to consume, comparing this to the recommend daily nutritional guidelines.
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| Images of a DM management App (Årsand, et al., 2012). |
As a result, mHealth apps can provide a positive management and preventative tool, which is able to build upon existing technologies which many people globally, have in their pocket every day. These inexpensive, energy efficient, discrete, and portable applications are increasingly being used on a therapeutic and commercial level. Between 2009 and 2011, there has been a 400% increase in the number of DM management apps available on the iTunes store. However as there are number of organisations who are dipping their fingers into the mHealth pie, this makes it difficult to regulate this rapidly expanding sector.
Due to the wide variety of developers within the iTunes store, there is no method for users to browse certified or empirically reviewed apps. This could potentially lead to users being misinformed and result in damages to their health. There are also more general barriers such as illiteracy, lack of technical support, language barriers, and security and privacy issues regarding the collection and storing of patient health information. However with time and development of the mHealth sector, these issues can hopefully be efficiently addressed. The potential benefits of mHealth significantly outweigh the challenges which can be overcome.
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The reality is that mHealth applications design can include the traditional health promotion elements of motivation, information, adaptation and usefulness. As a result mHealth apps could save 6 billion USD each year in global medical costs, thus tackling the crippling healthcare costs of DM and other chronic diseases. However the boat doesn’t just stop with mobile applications and chronic diseases.
As mobile and health technology advances, there are increasingly interesting and even controversial mHealth solutions. Google recently announced their prototype ‘smart contact lens’ , which are able to detect blood glucose levels through a miniaturised sensor and wireless device located on the cornea. What about a pill which you consume, has a camera attached and actively records data within your body ? There are also increasingly ‘wearable tech' devices with watches which monitor real time health data, and Google Glass which is currently in the beta trail period. There are also mHealth applications tackling maternal mortality, the spread of infectious disease and improving healthcare facilities, just to name a few.
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This article really has only touched the tip of the mHealth iceberg which is towering towards the mainstream global community. It also re-enforces the fact that Global Health practitioners and the wider health community have to work alongside other fields of science to tackle the onslaught of chronic health issues. The endless possibilities of mHealth not only makes this a slightly daunting challenge, but also one which is throughly exciting for the next generation of global leaders.
mHealth is here, it’s rapidly expanding, and it’s definitely here to stay.
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