Driving Change with mHealth

Driving Change with mHealth Kevin A. Clauson, PharmD

This slide deck is comprised of lectures delivered at Nova Southeastern University Colleges of Medicine (MI) and Pharmacy (PHA) in the following courses: MI 6410 Consumer Health Informatics and Web 2.0 in Healthcare PHA 5203 Consumer Health Informatics and Web 2.0 in Healthcare

Objectives  Detail the use of mobile phones in various populations  Examine the 12 clusters of mHealth  Discuss how mHealth can be used to enact change and improve health  Delineate hurdles and psychosocial issues associated with mHealth initiatives

mHealth is the use of mobile devices and global networks to deliver health services and information

mHealth Devices Smartphones o iPhone o Blackberry (RIM) o Misc o iPad/TabletPC o PDA o USB

Who uses mobile phones?

According to CTIA Wireless Survey, mobile penetration in the US was 69% in 1995

Today mobile penetration in the US is 91% Source: CTIA 2009

This translates to 82% of American adults owning a cell phone* Owns *Range: 57% (65+) to 90% (18-29) Does not own Pew Cell Phones and American Adults 2010

The United Arab Emirates boasts a 204% mobile penetration rate UAE Telecommunication Regulatory Authority

Wireless-only households in the US went from untracked in 1995…

…to almost a tenth of households by 2005…

…and grew to a quarter of all households by 2009

Pew Internet Mobile Access 2010 87% of blacks and Hispanics own a cell phone* *Compared to 80% of whites

Pew Internet Mobile Access 2010 Hispanics use their phone to go online and to text more frequently than any other group* *English-speaking Hispanics

Pew Internet Teens and Mobile Phones 2010 Texting has eclipsed all other forms of communication for teens to connect with friends

31% of teens who take phones to school text every day during class Pew Internet Teens and Mobile Phones 2010

Due to connectivity, accessibility, and preferences – teens may be particularly well suited for targeted mHealth interventions

Antisocial Phone Tricks http://www.ted.com/talks/renny_gleeson_on_antisocial_phone_tricks.html

The 12 Clusters of mHealth mHealth Initiative – Peter Waegemann http://www.mobih.org/observatory/

1) Patient Communications

2) Access to web-based resources How SmartPhones Are Changing Healthcare for Consumers and Providers 2010

JACC Cardiovasc Imaging 2010;3(5):482-90.

3) Point of Care The 12 Clusters of m-health • 3) Point of Care

“That it will ever come into general use…is extremely doubtful” - London Times in 1834 appraising value of stethoscope J Healthc Inf Manag 2010;24(3):9-10.

4) Disease Management HIV medication and visit adherence Trials 2009;10:87.

Walgreens sees hockey-stick growth for text alert program Mickey Alam Khan By August 13, 2010 BALTIMORE – SMS text alerts are a big hit for Walgreens Co., a $63 billion drugstore chain which puts its 7,500 stores nationwide at the center of all marketing and commerce. Walgreens has seen tremendous growth in registrations for its prescription SMS alerts in the eight months since the Chicago company began the program. In fact, SMS sign-up is outpacing email, according to a senior executive. “Both are growing, but text alerts are hockey-sticking – we weren’t expecting that,” said Abhi Dhar, chief technology officer for ecommerce at Walgreens.

Cough into your cell phone • Diagnostic extender; help with triage/ decision making • $100,000 grant by Bill & Melinda Gates Foundation

5) Point of Care Education

Video telephony-enhanced teaching of needle thoracocentesis Emerg Med J 2009;26:177-179.

6) Professional Communication

7) Administrative Applications J Biomed Inform 2010;43(1):75-80.

8) Financial Apps

9) Ambulance/EMS

10) Public Health

How did purposefully limiting access to this creation cost millions of lives? SuperFreakonomics: Global Cooling, Patriotic Prostitutes, and Why Suicide Bombers Should Buy Life Insurance, 2009.

http:// www.vimeo.com/10354420

Frontline SMS:Medic • Add poptech vid about frontline SMS viemo from mindof blog http://vimeo.com/7392090

How do we balance needs with available resources?

Text BABY to 511411 Envia BEBE al 511411 para Español www.text4baby.org

Mobile Giving

11) Research Data/image collection by first responders Data collection in 11 languages in Africa Self-administered sensitive data collection in Peru

Mobile Mediated Research • Fewer inconsistencies and missing values with the PDA-based system vs. paper-based system BMC Med Inform Decis Mak 2008;8:11. • PDA-based systems less likely to suffer from transcription errors and data more easily analyzable Eval Rev 2003;27(2):165-78. • Review of PDA-based collection vs. paper J Clin Epidemiol 2007;60(1):8-17.

12) Body Area Network Applications EDA Tech Forum 2008

Wearable Cardiac Monitoring System Bluetooth heart monitor records ECG and transmits information via patient's phone Analyzer circuit checks the ECG signal for signs of cardiac failure Cell phone automatically alerts the patient and nearest medical center via SMS International Journal of Electronic Healthcare 2007;3(3):303-16..

What would it be worth to keep you or a family member living independently? JAMA 2002;287(8):1022-8.

Wireless Assisted Living One way to help manage the approaching storm of an increasingly aging population…

„Nana technology‟ vs Nanotechnology J Gerontol A Biol Sci Med Sci 2008;63(3):298-307.

mHealth Security Measures

How young is too young?

The changing nature of mobile mediated social interactions

JAMA 2009;302(11):1159-60. Honk if you love Jesus Text to meet Him! if you’re ready

JAMA 2009;302(11):1159-60. Texting increases crash risk by 23.2 times!

Policymakers Interoperability Scalability Change management Culture

“Let‟s make technologies that make people more human, and not less” - Renny Gleeson

Summary mHealth offers opportunities to improve individual and population based health as well as address health disparities Strategy is to find the tech that serves as a solution, not the reverse Barriers exist for mHealth initiatives as with all aspects of healthcare

Images • http://www.mhealthalliance.org/ • http://weblogs.baltimoresun.com/business/consuminginterests/blog/apple-iphone.jpg • http://www.letsgomobile.org/images/news/blackberry/blackberry-bold.jpg • http://regmedia.co.uk/2005/05/11/htc_mda.jpg • http://www.ixbt.com/editorial/images/itogi/itogi2k2-may/TabletPC2_H.jpg • http://www.ted.com/talks/renny_gleeson_on_antisocial_phone_tricks.html • http://www.doh.state.fl.us/family/mch/text4baby/text4baby.html

Images • http://pillbox.nlm.nih.gov/ • http:// www.handylife.com/ • http://www.mobilemarketer.com/cms/news/commerce/7071.html • http://dianhasan.wordpress.com/2010/03/29/mobile-phone-innovation-cough-into-your-phone-and-get- diagnostics-theres-an-app-for-that-too/ • http://www.airstriptech.com/ http://jeffreyleow.wordpress.com/2008/06/10/iphone-in-medical-education/ • http://emj.bmj.com/content/26/3/177.long

Images • http://www.mobiletor.com/img/motorola-droid-phone.jpg • http://theandroidsite.com/wp-content/uploads/2010/08/twitter30.png • http://www.ushahidi.com/platform • http://www1.sciencemuseum.org.uk/hommedia.ashx?id=8903&size=Small • http://www.mirlabs.org/jias/800px-Open_Access_PLoS.png • http://www.vimeo.com/10354420 • http://www.mhealthsummit.org/conference/speakers-moderators • http://vimeo.com/7392090

Images • http://www.mgive.com/ • http://s3.edatechforum.com/legacy_images/june2008/images/eda0806_tou1.jpg • http://www.excointouch.com/ • http://www.fitbit.com/ • http://www.jasonhill.com/wp-content/2009/06/zeo.png Unreferenced pictures are licensed images

Recommended Poolside Reading Waegemann CP. mHealth: the next generation of telemedicine? Telemed J E Health 2010;16(1):23-5. Vital Wave Consulting. mHealth for Development: The Opportunity of Mobile Technology for Healthcare in the Developing World, 2009. Smith A. Mobile Access 2010. Pew Internet & American Life Project, July 2010. Lenhart A, Ling R, Campbell S, Purcell K. Teens and Mobile Phones. Pew Internet & American Life Project, April 2010. Lenhart A. Cell phones and American adults. Pew Internet & American Life Project, September 2010.

www.unhub.com/kevinclauson

Thank You!