Mobile health

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  • 1. Healthcare in Pocket 12HM12 Devesh Thapliyal
  • 2. About the paper  Journal of Biomedical Informatics – Predrag Klasanja and Wanda Pratt  Research from Health Sciences and Computers.  Features of mobile phone for intervention.  Five basic intervention Strategies.
  • 3.  Text messaging interventions – 1) Facilitate smoking cessation 2) To provide diabetes education 3) To encourage attendance of primary care appointments  Physicians to monitor patients : - chronic heart failure - To detect early signs of arrhythmia or ischemia  Patients use phone applications and sensing and measurement devices to keep track of their physical activities and to monitor physiological markers relevant to their health status.
  • 4. Why MOBILE???? (1) The widespread adoption of phones with increasingly powerful technical capabilities. (2) People’s tendency to carry their phones with them everywhere. (3) People’s attachment to their phones. Unlike desktop computers or even laptops, mobile phones are nearly always with the person.
  • 5.  Personal nature of mobile phones reducing barriers.  Technical capabilities : - GPS location tracking, accelerometer-based exercise detection. - Calendar, contacts and other personal information tells what they are doing.  Assistance before engaging in unhealthy behaviours, as well as to provide feedback.
  • 6. Technology behind M-health intervention  Voice, text, third party applications, sensing, Internet access, and wireless connectivity with other devices. 1) Text messaging - penetration has reached 68% . - Easy to process both on Computer and Phone. - Reminders tips and educational content. - Smoking cessation intervention for young adults uses precisely this kind of SMS information loop.
  • 7. 2) Cameras – Health interventions have used cameras in these ways: - As an alternative way to journal health-related behaviors, such as food consumption. - As a way to provide healthcare providers with additional information about a condition. 3) Native Applications – API, Open Source – developing specific apps.
  • 8. Several different types of health applications: -applications that enable users to log and chart data about their diet, exercise, blood glucose levels, and other health-related behaviors and measures - patient terminals for tele monitoring of conditions such as hypertension and chronic heart failure. - applications that receive data from pedometers, blood pressure monitors and other devices. - games that teach health-related skills.
  • 9. 4) Automated sensing – last 2 years, an increasing number of mobile phones have begun to ship with sensors such as accelerometers and GPS built in - connect to digital scales, blood pressure monitors, glucose meters, portable electrocardiograms (ECG), pedometers, and gym equipment, among other sensors. Mobile phones : receivers, transmitter and data stores for the collection of a variety of health-intervention data. e.g. - iPhone application RunKeeper uses built-in GPS.
  • 10. 5) Internet access : - Always-on connectivity means that users’ data, such as blood glucose levels or peak flow readings, can be uploaded as soon as they are captured, thus enabling early detection of critical events. - The data can also be uploaded to websites where users can easily view, chart, and edit their information. - Real time notification.
  • 11. Design space of mobile-phone health interventions  Identify Intervention Strategies :  Five key intervention strategies: (1) Tracking health information, (2) Involving the healthcare team, (3) Leveraging social influence, (4) Increasing the accessibility of health information, and (5) Utilizing entertainment.
  • 12. Tracking health information  Native applications: - UbiFit :Tracking of cardiovascular exercise, strength training, different types of stretching. Daily, Weekly reports on website. - Wellness diary( Nokia): Food intake, weight, mood, blood pressure, stress, and amount of sleep. Charting can be done for trend analysis. - Diab-Memory & Sweet talk – Monitor Glucose level.
  • 13.  Tracking through text messaging – Reminder, intervention at peak times.  Automated sensing for tracking – Self monitoring. e.g. Ubifit, MSP( worn on wrist)
  • 14. Involving the healthcare team  Keeping healthcare team aware of the patient’s symptoms, activities, and physiological parameters. - remote monitoring - remote coaching - automated feedback
  • 15. Leveraging social influence  Importance of Social environment.  Three different ways: (1) by facilitating social support or competition among individuals who share the same health goal (i.e., peer-to-peer influence), (2) by facilitating social support from family and friends, and (3) by leveraging peer who have succeeding in accomplishing similar health goals i.e., peer modeling).
  • 16. Increasing the accessibility of health information  Information at right time. - Informational messages - Reminders - Glanceable displays
  • 17. Utilizing entertainment  Fun applications  Eatwell for customizing food choices.  E.g – jokes, games, quizes
  • 18. Limitations   Covers Individuals who are working on their own health goals not others. Recent upgradation are not taken into account.