Abstract
Advances in mobile phone technologies coupled with the availability of modern wireless networks are beginning to have a marked impact on digital health through the growing array of apps and connected devices. That said, limited deployment outside of developed nations will require additional approaches to collectively reach the 8 billion people on earth. Another consideration for development of digital health centered around mobile devices lies in the need for pairing steps, firmware updates, and a variety of user inputs, which can increase friction for the patient. An alternate, so-called Beyond the Mobile approach where medicaments, devices, and health services communicate directly to the cloud offers an attractive means to expand and fully realize our connected health utopia. In addition to offering highly personalized experiences, such approaches could address cost, security, and convenience concerns associated with smartphone-based systems, translating to improved engagement and adherence rates among patients. Furthermore, connecting these Internet of Medical Things instruments through next-generation networks offers the potential to reach patients with acute needs in nonurban regions of developing nations. Herein, we outline how deployment of Beyond the Mobile technologies through low-power wide-area networks could offer a scalable means to democratize digital health and contribute to improved patient outcomes globally.
Highlights
The 1962 song entitled Return to Sender by Elvis Presley harkens back to an age when people communicated through letter writing, and the postal service was the principal artery of our data distribution network [1]
A sensor on a wireless device communicates directly to the cloud through a low-power wide area network (LPWAN) or through a satellite uplink without the need for the smartphone-based intermediate step (Figure 2)
Near-term expected developments that will impact global health are on the horizon
Summary
The 1962 song entitled Return to Sender by Elvis Presley harkens back to an age when people communicated through letter writing, and the postal service was the principal artery of our data distribution network [1]. Though the growth and use of health-related apps on smartphones seems likely to continue unabated, there are merits to using alternate and transparent approaches to connect devices, which has led to the emergence of Beyond the Mobile (BTM) as a viable proposition [11] In this scenario, a sensor on a wireless device communicates directly to the cloud through a low-power wide area network (LPWAN) or through a satellite uplink without the need for the smartphone-based intermediate step (Figure 2). There even exists the option to record a simple return message onto such a device, which would be transmitted to a base station (eg, via a LoRa network in small data packets) Such “return to sender” capabilities in essence close the loop between the patient and health care provider, confirming the participatory component of P4 medicine (predictive, preventive, personalized, and participatory) [29]. Though a current limiting factor is the 100-day service life of the balloons, they have already been deployed to assist populations in Peru impacted by floods and over Puerto Rico following Hurricane Maria, and have recently been deployed in parts of Africa [41]
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