Mobile Health

By September 13, 2019 Commentary

Mobile Health has now been around for a while so the hype volume has lessened somewhat.  It’s basic premise was that if consumers and patients had smartphones, they could use all kinds of apps to improve their health and their use of health care services, resulting in better outcomes and lower costs.  Same old, same old.  A New England Journal of Medicine article discusses where we are with mobile health.   (NEJM Article)   The article focuses on use by consumers, not health professionals.  The author also focuses on the combination of sensors and apps available on smart phones, the diagnostic software which compiles and interprets the data, and how the resulting data might be used in routine clinical care.  He also discusses dangers from relying on mobile phone generated data.  According to the article, 81% of US adults have access to a smartphone and 40% have two or more chronic conditions (most likely vision, neck and hand problems caused by too much smartphone use).  Therefore it would seem natural that smartphones might be able to aid in the management of these conditions.

Basic smartphone sensor capabilities include three dimensional inertial motion detectors, cameras, microphones and geo-location.  Just using these can turn a smartphone into a fall detector, a spirometer or a heart rate monitor.  The phones can also be connected to various wearables, like smart watches.  These wrist sensors can also detect heart rate and variability and even the motions associated with smoking.  In addition, companies are designing specific sensors to attach to a smartphone, like electrodes.  These sensor capabilities can supplement patient-reported data (and are probably more accurate, since they don’t lie) and can be used to perform some tests remotely, like walking tests or assessing tremors.  The data can be compiled into “digital bio markers” like step counts or sleep time.

Then we move on to digital therapeutics, in which smart phone apps are used to actually help treat conditions and manage care.  A lot of this is monitoring adherence to recommended care and offering encouraging messages or reminders.  One issue is that patients don’t tend to stay engaged in smartphone health use for an extended period of time.  Another is not adding to already over-information-saturated clinicians burden.  The information that is presented to treating physicians needs to be accurate, clinically relevant and useful in modifying treatment plans.  Other obvious issues are the privacy and security of patients’ health data.  There is promise, but progress is very slow in seeing the smartphone actually make those outcome differences that are promoted so heavily.

Kevin Roche

Author Kevin Roche

The Healthy Skeptic is a website about the health care system, and is written by Kevin Roche, who has many years of experience working in the health industry through Roche Consulting, LLC. Mr. Roche is available to assist health care companies through consulting arrangements and may be reached at khroche@healthy-skeptic.com.

More posts by Kevin Roche

Leave a Reply