Mobile Health Services Research Articles

The IoT for Healthcare Applications

The Internet of Things (IoT) is a concept of the internet so that all things in our life can connect to the internet or to other to send and receive data to do all functions through the network. IoT is a new concept based on the use of the Internet to facilitate our way of life. The presence of mobile medical applications and mobile health services that have contributed to drawing innovative features of the way to provide health care services. Also, the spread of emerging technologies such as robotics and artificial intelligence, accompanied by the simple exchange and spread of medical information thanks to the internet, and the discovery methods of treatment. This fundamental shift is reflected positively on patient care after it enabled the doctor to give a more good diagnosis and thus get better treatment results. This combination of the features of the IoT in medical devices contributed greatly to improving the quality and effectiveness of medical services. Mobile devices, wireless networks, and other smart services more than 80% of health care institutions which means that more hospitals, institutions, and health centres have activated smart health devices. Today, “IoT” technologies and digital devices connected to the internet are prevalent in hospitals. It has come to the point where it can be said that many doctors and other health care providers have dispensed with paper and have become either totally or largely dependent on devices connected to WiFi networks and tablets. In this study, nine patients have been applying this technique to them, and their results have varied and will be reviewed.

Water ambulances and the challenges of delivering mobile emergency healthcare to riverine and maritime communities.

• Riverine and Maritime areas demand special configurations of mobile emergency health services. • In Brazil, water ambulances must deliver care to very remote and diverse areas, such as indigenous communities. • The design of water ambulances, the environment, as well as the geography of the places covered, hinder the availability of services.

Palyatif bakım hastalarında semptom ve mobil hizmetlerin değerlendirilmesi

Introduction: Palliative Mobile Health Unit started to serve in in February 2019 at University of Health Sciences Samsun Training and Research Hospital. In our study, it is aimed to evaluate the symptoms and ongoing status of the registered patients by mobile health services of palliative care unit.Methods: The population of this descriptive, cross-sectional study consists of individuals who are registered in Samsun Training and Research Hospital's palliative mobile unit and discharged from the palliative service. In our study, all patients enrolled in mobile services were evaluated. The data were obtained from computer records. Pearson chi-square and Mann-Whitney U tests were used to evaluate the data. p <0.05 was considered statistically significant.Results: Since the introduction of palliative mobile services for discharged patients in our hospital, 112 patients have been reached. At the time of this study, 46.42% of these patients are still provided with palliative mobile service. The average age of the participants is 65.60 ± 16.34 years, and 54.35% of the patients are women. 64.20% of the patients are fully bedridden. The patients we see most frequently (64.24%) are patients with a diagnosis of oncology. Foley catheter is the most performed procedure as an invasive procedure.Conclusion: Our patients enrolled in the palliative mobile unit were mostly bedridden and oncology patients. With palliative mobile services, it is aimed to improve the quality of life of patients who encounter problems arising from life-threatening diseases after discharge and to evaluate symptom management. It may be appropriate to disseminate palliative mobile services across the country by evaluating the results.

Mobile health services and the elderly: Assessing the determinants of technology adoption readiness in Pakistan

Technological innovations changed people's daily lives. Wireless technologies, such as mobile phones and other portable gadgets, are becoming an essential part of each generation. With the increasing size of the elderly population around the world, opportunities for the older generation to use wireless technologies, such as gerontechnologies, are increasing. Older adults can use mobile health (mHealth) to receive healthcare at their doorstep. This study uses the UTAUT theoretical framework, extended to perceived ubiquity (PU), perceived trust (PT), and technology anxiety (TA), to investigate the elderly's intention to adopt mobile phone technology for healthcare (i.e., mHealth) in the socioeconomic environment of Pakistan. This study surveys 286 respondents from Islamabad, Pakistan. Structural equation modeling (SPSS version 25 and AMOS version 24) is used to analyze the data. Outcomes show that performance expectancy (PE), effort expectancy, social influence (SI), facilitating conditions, PU, and PT have a positive significant relationship with mHealth adoption intention (AI). However, the results do not indicate the negative relation of TA with mHealth AI. Moreover, gender significantly moderates the relationship between PE and SI and mHealth AI. This study contributes comprehensive knowledge to the existing literature on gerontechnology adoption in the socioeconomic context of a developing economy.

Optotheranostic Nanosystem with Phone Visual Diagnosis and Optogenetic Microbial Therapy for Ulcerative Colitis At-Home Care.

Ulcerative colitis (UC) is a relapsing disorder characterized by chronic inflammation of the intestinal tract. However, the home care of UC based on remote monitoring, due to the operational complexity and time-consuming procedure, restrain its widespread applications. Here we constructed an optotheranostic nanosystem for self-diagnosis and long-acting mitigations of UC at home. The system included two major modules: (i) A disease prescreening module mediated by smartphone optical sensing. (ii) Disease real-time intervention module mediated by an optogenetic engineered bacteria system. Recombinant Escherichia coli Nissle 1917 (EcN) secreted interleukin-10 (IL-10) could downregulate inflammatory cascades and matrix metalloproteinases; it is a candidate for use in the therapeutic intervention of UC. The results showed that the Detector was able to analyze, report, and share the detection results in less than 1 min, and the limit of detection was 15 ng·mL-1. Besides, the IL-10-secreting EcN treatment suppressed the intestinal inflammatory response in UC mice and protected the intestinal mucosa against injury. The optotheranostic nanosystems enabled solutions to diagnose and treat disease at home, which promotes a mobile health service development.

The implementation cost of a safety-net hospital program addressing social needs in Atlanta.

To describe the cost of integrating social needs activities into a health care program that works toward health equity by addressing socioeconomic barriers. Costs for a heart failure health care program based in a safety-net hospital were reported by program staff for the program year May 2018-April 2019. Additional data sources included hospital records, invoices, and staff survey. We conducted a retrospective, cross-sectional, case study of a program that includes health education, outpatient care, financial counseling and free medication; transportation and home services for those most in need; and connections to other social services. Program costs were summarized overall and for mutually exclusive categories: health care program (fixed and variable) and social needs activities. Program cost data were collected using a activity-based, micro-costing approach. In addition, we conducted a survey that was completed by key staff to understand time allocation. Program costs were approximately $1.33million, and the annual per patient cost was $1455. Thirty percent of the program costs was for social needs activities: 18% for 30-day supply of medications and addressing socioeconomic barriers to medication adherence, 18% for mobile health services (outpatient home visits), 53% for navigating services through a financial counselor and community health worker, and 12% for transportation to visits and addressing transportation barriers. Most of the program costs were for personnel: 92% of the health care program fixed, 95% of the health care program variable, and 78% of social needs activities. Historically, social and health care services are funded by different systems and have not been integrated. We estimate the cost of implementing social needs activities into a health care program. This work can inform implementation for hospitals attempting to address social determinants of health and social needs in their patient population.

Youth Experiencing Homelessness During the COVID-19 Pandemic: Unique Needs and Practical Strategies From International Perspectives

Youth Experiencing Homelessness During the COVID-19 Pandemic: Unique Needs and Practical Strategies From International Perspectives

Mobile Health (mHealth) in the Developing World: Two Decades of Progress or Retrogression

Mobile healthcare, or mHealth, is one of the key pillars of information and communication technologies for healthcare that consists of telemedicine, telehealth, eHealth, and mHealth. In the past two decades, mobile health has become a transformative concept for healthcare delivery innovations on a global scale. The success was based on the market-driven strategies that utilised the advances in mobile communications, computing, and sensor technologies, especially in recent years. Those market-driven mobile health systems were also closely associated with the global proliferation of smartphones, and based on the correlated usage principle of the smartphone applications for healthcare and wellbeing. However, the global commercial success of the smartphone-based mHealth model was not widely translated into successful scaled-up and tangible healthcare benefits, especially in low- and-middle income countries, compared to the consumer mobile health markets. The numerous healthcare challenges in the developing world remained largely untackled by the existing mobile health systems and models. The much-hyped transformative benefits of these systems remain largely unfulfilled. For two decades since the inception of this concept, the majority of the population in resource-limited healthcare settings still remain in poorer health and live in worsened conditions, with limited if any access to basic healthcare services. The much-hyped mobile health services that promised transforming these fragile and limited healthcare conditions, did not come to wider fruition globally. The COVID-19 pandemic, with its devastating human and economic impact worsened this status. An overview of the origin and the basic principles of mobile health, its current landscape and status in the developing world is presented. The impact of the smartphone-centric model that dominated the landscape of mobile health systems in these countries is discussed, and a critical view on the limitation of this mobile health model adopted widely in these settings is provided.

Social Capital and Digital Divide: Implications for Mobile Health Policy in Developing Countries.

Digital divide has been a major obstacle for mobile health services for the elderly in developing countries; to assess the potential solution to narrow digital divide among the elderly, we use data from the China Health and Retirement Longitudinal Study (CHARLS) and test for a causal role of social capital in digital access among elderly individuals in China. To handle endogenous problems associated with social capital, we introduce instrumental variable (IV) estimates in our models. Our data analysis shows that social capital facilitates increased digital access. We distinguish between two digital access patterns, an infrastructure pattern and a personal device pattern, and find that the causal effect of social capital is determined by the personal device pattern. Therefore, since family members and relatives increase digital access among elderly people, we propose a family-centered mobile health policy in developing countries.

Towards the Use of Blockchain in Mobile Health Services and Applications.

With the advent of cryptocurrencies and blockchain, the growth and adaptation of cryptographic features and capabilities were quickly extended to new and underexplored areas, such as healthcare. Currently, blockchain is being implemented mainly as a mechanism to secure Electronic Health Records (EHRs). However, new studies have shown that this technology can be a powerful tool in empowering patients to control their own health data, as well for enabling a fool-proof health data history and establishing medical responsibility. Additionally, with the proliferation of mobile health (m-Health) sustained on service-oriented architectures, the adaptation of blockchain mechanisms into m-Health applications creates the possibility for a more decentralized and available healthcare service. Hence, this paper presents a review of the current security best practices for m-Health and the most used and widely known implementations of the blockchain protocol, including blockchain technologies in m-Health. The main goal of this comprehensive review is to further discuss and elaborate on identified open-issues and potential use cases regarding the uses of blockchain in this area. Finally, the paper presents the major findings, challenges and advantages on future blockchain implementations for m-Health services and applications.

Trust and elderly users' continuance intention regarding mobile health services: the contingent role of health and technology anxieties

PurposeMobile health (mHealth) services are considered an important means of relieving the problems of the aging population. The efficiency of mHealth services can be enhanced by engaging more elderly users and guaranteeing their continued use. However, limited attention has been directed toward investigating elderly users' continuance intention regarding mHealth services. The purpose of this paper is to explain elderly users' continuance intention by investigating the contingent role of technology anxiety and health anxiety on affective trust and cognitive trust.Design/methodology/approachSurvey data were collected from 232 elderly users to verify the research model and hypotheses based on structural equation modeling (SEM).FindingsThis study revealed that both affective and cognitive trust enhance elderly users' continuance intention regarding their use of mHealth services. Health anxiety strengthens the effect of cognitive trust but weakens the effect of affective trust with regard to continuance intention. Furthermore, technology anxiety strengthens the effect of affective trust but not the effect of cognitive trust with regard to continuance intention.Originality/valueThis study is one of the first to examine elderly users' continuance intention regarding mHealth services use from the perspective of affective and cognitive trust, thus enriching the extant literature on the use of mHealth services. Additionally, this study sheds light on the contingent effects of technology anxiety and health anxiety on affective and cognitive trust, which have been neglected by previous research.

Modeling mobile health service delivery to Syrian migrant farm workers using call record data

A significant number of Syrian refugees under temporary protection in Turkey work in agriculture seasonally in various rural areas during several months a year. These migrant farm workers and their families are deprived of access to the regular health care system and preventive services due to their remote locations. The government supports the delivery of different types of mobile health care services, such as vaccination for children, reproductive health and screening services. While planning the mobile health care service delivery, it is critical to know where the refugees will work during what time frame; hence the demand for the services. By analyzing the call record data of a major mobile network operator in Turkey, we quantify the increase in the volume of calls made by Syrian refugees in various agricultural areas during the harvesting season of local crops. This information helps us to forecast spatial and temporal distribution of demand for mobile health care services at a fine granularity. Taking demand over multiple periods as input into a mathematical programming model, we optimize the routing of mobile clinics that visit locations close to where refugees are concentrated over the given planning horizon. We consider three hierarchical objectives. Given the availability of a number of mobile clinics at community health centers in the districts, the first objective aims to maximize the percentage of refugees that can benefit from each service type within pre-defined close distances. The second objective minimizes the number of clinics needed while covering the maximum percentage of refugees. The third objective minimizes the total travel distance of the clinics, while keeping the maximum coverage level using a minimum number of clinics to achieve this level. We quantify the benefits of centralized planning (by the province directorate) over decentralized planning (by each district separately). We also show the trade-off between the required number of clinics and coverage of potential patients.

Beneficiary satisfaction with mobile medical units in the state of Andhra Pradesh

Background: Mobile health services in India have gained significant attention recently. However, there is little information regarding the beneficiary satisfaction of such services. Beneficiaries’ satisfaction and perception plays significant role in utilization of services. We assess the program beneficiaries’ satisfaction of using mobile health services in rural Andhra Pradesh.Methods: We used a cross-sectional study design to survey the mobile health services program beneficiaries in rural Andhra Pradesh (October 2016 to October 2018). Beneficiaries availing the mobile health services from 277 mobile medical vans across 13523 villages were selected using multistage sampling. Exit interviews (using Likert-scale questions) were used to reveal the ease of access in utilising mobile health services and satisfaction among the program beneficiaries.Results: A total, 1080 exit interviews were conducted. Above ninety percent of beneficiaries completed the exit interviews (response rate: 95%). More than two-thirds (72%) of the respondents were females and aged >45 years (71%). Of all respondents, the majority were Hindu (89%), belonging to socially disadvantaged groups (80%), and illiterate (56%). Nearly all (95%) program beneficiaries found mobile health services easily accessible and building their knowledge and awareness (94%) on key health issues. Ninety-five percent of the program beneficiaries strongly favoured recommending the use of mobile health services to others. The overall satisfaction rate was 95% (Cronbach alpha 0.925).Conclusions: Mobile health services in rural areas are effective in meeting the beneficiaries’ expectations. High beneficiary satisfaction and trust in mobile health services strongly favours such services in other rural geographies.

Building Standardized and Secure Mobile Health Services Based on Social Media

Mobile devices and social media have been used to create empowering healthcare services. However, privacy and security concerns remain. Furthermore, the integration of interoperability biomedical standards is a strategic feature. Thus, the objective of this paper is to build enhanced healthcare services by merging all these components. Methodologically, the current mobile health telemonitoring architectures and their limitations are described, leading to the identification of new potentialities for a novel architecture. As a result, a standardized, secure/private, social-media-based mobile health architecture has been proposed and discussed. Additionally, a technical proof-of-concept (two Android applications) has been developed by selecting a social media (Twitter), a security envelope (open Pretty Good Privacy (openPGP)), a standard (Health Level 7 (HL7)) and an information-embedding algorithm (modifying the transparency channel, with two versions). The tests performed included a small-scale and a boundary scenario. For the former, two sizes of images were tested; for the latter, the two versions of the embedding algorithm were tested. The results show that the system is fast enough (less than 1 s) for most mHealth telemonitoring services. The architecture provides users with friendly (images shared via social media), straightforward (fast and inexpensive), secure/private and interoperable mHealth services.

Do mobile health (mHealth) services ensure the quality of health life? An integrated approach from a developing country context

ABSTRACT Though the acceptance behavior of health technology has been investigated by several studies from different theoretical perspectives, a unified understanding is still lacking in the literature particularly addressing the Generation Y (Gen Y). Thus, the current study aims to explore the factors affecting the adoption of mHealth services among Gen Yers and how does mHealth adoption influence their quality of health life along with trust and satisfaction. With this intention, the conceptual framework was developed integrating UTAUT2 and D&M IS Success Models to predict the mHealth adoption and consequently trust, satisfaction, and quality of health life. Data were collected from existing mHealth users in Bangladesh. Results demonstrate that performance expectancy, effort expectancy, facilitating condition, social influence, hedonic motivation, system quality, and services quality had a significant impact on mHealth adoption which in turn leads to building trust, satisfaction, and improve quality of health life. Research implications are also provided for the mHealth services providers, top marketing communication managers, and policymakers in formulating and implementing effective marketing strategies to increase the acceptability of mHealth.

Effects of a home blood pressure monitoring by mobile phone-based and health service (continuous antihypertensive treatment) in mild hypertension : The wakayama health promotion study

Effects of a home blood pressure monitoring by mobile phone-based and health service (continuous antihypertensive treatment) in mild hypertension : The wakayama health promotion study

Bibliometric Analysis and Methodological Review of Mobile Health Services and Applications in India

PurposeThe purpose of this research is to analyze the literature published on mobile health (mHealth) in the Indian context. It also reviews the most important research works and presents various methodologies adopted by the researchers in this domain. Design/methodology/approachThe SciVerse SCOPUS database was used for extracting the literature on mobile health. The study used articles published between January 2008 to 28th June 2019. The keyword used is ‘mHealth’ and journal articles with studies or interventions carried out in India were selected for bibliometric analysis and methodological review. FindingsFor the keyword search, a total of 7,874 documents have been extracted, of which only 158 have been considered for the analysis. There is an exponential increase in the number of publications from the year 2015 to 2019. The keywords used for representing their articles have been grouped as mobile health devices, gender and age groups, system and software, health and disease condition, management, evidence-based practices (outcome), methods, and importance of the study. The journal PLOS One (87) has the highest number of citations, followed by The Lancet (63). The bibliometric analysis of the literature revealed seven clusters classified as individual’s individual’s mobile health applications adoption characteristics, need for mobile health and its governance, mobile phone application with the internet of things based framework for healthcare monitoring, mobile health for primary healthcare systems, authentication and security protocol for mobile healthcare, development and experimentation of mobile health application, and development and mobile health for adherence support intervention. Originality/ValueThe study contributes in analyzing the bibliometrics and provides a methodological review for the journal articles published on mobile health. Previous articles considered systematic analysis of the bibliometric for mHealth, and mobile technology but less adequately discussed specifically towards Indian context which this study has embraced.

Mobile Population Based Care Solutions from Canada and Finland

This paper investigates creative, mobile population-based medical solutions with integrated care delivery strategies in two different contexts. British Columbia’s two-truck mobile medical unit operates in both remote and highly urban environments in Canada, serving at-risk Canadian populations in areas ranging from remote First Nations communities to downtown Vancouver homeless people suffering from overdoses in the deadly Fentanyl crisis. The highly adaptable unit can mobilize at a day’s notice and can travel by road or by ferry. The other investigated mobile care solution is located in depopulating South Karelia in Finland, where a highly customized social and healthcare service for seniors has been created as part of the EKSOTE initiative. (EKSOTE stands for Etelä-Karjalan sosiaali- ja terveyspiiri – the South Karelia social and health district). The service provides public health services, urgent primary care, mental health services, chronic disease management, psychosocial rehabilitation, life skills training and assessment as well as home health support for seniors, populations at risk and clients in remote communities. Based on interviews with experts (clinical planners, public health managers) and an exploration of statistics and policy documents, we argue that both examples demonstrate different but exceptionally versatile mobile services with integrated care strategies provided by staff with broad-based competencies. Importantly, these units cover services that have been identified as significant gaps in care in rural or hard-to-reach populations that otherwise would remain untreated. Moreover, as accelerating urbanization is resulting in the depopulation of other areas, mobile services are a viable option in areas experiencing migration losses that no longer can support regular clinics. Income polarization and de-industrialization have increased homelessness, disenfranchisement, addictions and misery in urban areas. The approach of mobile services is by definition patient-centered care as the service is physically brought to the service user, and not the service user to the practitioner. The multi-disciplinary care offered automatically shifts towards a holistic direction as opposed to ‘pay for service’ systems where users can be limited on how many issues can be discussed during one consultation. Case management improves as different members of the care teams may all see the user on the same visit. We conclude that as a planning opportunity, by providing platforms and service networks that tie into existing (even diminishing) infrastructures, mobile, integrated care services provide important surge capacity and opportunities for highly customized services for clinics tailored to complex events and populations (refugees, outbreaks, events). Like humanitarian relief organizations such as Médecins Sans Frontières <https://www.google.ca/url?sa=t&rct=j&q=&esrc=s&source=web&cd=&ved=2ahUKEwisvovV1u_qAhWL_qQKHYsdCYsQFjAAegQIARAB&url=https%3A%2F%2Fwww.msf.org%2F&usg=AOvVaw1wofliiSKPaBTvJzXXAVND> (MSF), local mobile health services are also relevant in response to emergencies, natural disasters and adverse weather events.

Using mHealth to Provide Mobile App Users With Visualization of Health Checkup Data and Educational Videos on Lifestyle-Related Diseases: Methodological Framework for Content Development.

BackgroundThe number of people with lifestyle-related diseases continues to increase worldwide. Improving lifestyle behavior with health literacy may be the key to address lifestyle-related diseases. The delivery of educational videos using mobile health (mHealth) services can replace the conventional way of educating individuals, and visualization can replace the provision of health checkup data.ObjectiveThis paper aimed to describe the development of educational content for MIRAMED, a mobile app aimed at improving users’ lifestyle behaviors and health literacy for lifestyle-related diseases.MethodsAll videos were based on a single unified framework to provide users with a consistent flow of information. The framework was later turned into a storyboard. The final video contents were created based on this storyboard and further discussions with leading experts and specialist physicians on effective communication with app users about lifestyle-related diseases.ResultsThe app uses visualization of personal health checkup data and educational videos on lifestyle-related diseases based on the current health guidelines, scientific evidence, and expert opinions of leading specialist physicians in the respective fields. A total of 8 videos were created for specific lifestyle-related diseases affecting 8 organs: (1) brain–cerebrovascular disorder, (2) eyes–diabetic retinopathy, (3) lungs–chronic obstructive pulmonary disease, (4) heart–ischemic heart disease, (5) liver–fatty liver, (6) kidneys–chronic kidney disease (diabetic kidney disease), (7) blood vessels–peripheral arterial disease, and (8) nerves–diabetic neuropathy.ConclusionsProviding enhanced mHealth education using novel digital technologies to visualize conventional health checkup data and lifestyle-related diseases is an innovative strategy. Future studies to evaluate the efficacy of the developed content are planned.

Interdisciplinary Application of Smart Technology in Psychiatric Care

The popularization of smart technology is a global phenomenon. The increasing ubiquity of smartphones offers the potential to apply smart technology in areas such as healthcare and behavioral change interventions. Mobile health services may enhance the effectiveness and resolve the shortcomings of traditional medical services, which cannot continuously and instantly track changes in disease symptoms. The popularity of mobile phones has led to the emergence of mobile health applications. Mobile health applications use active and passive methods to collect data and transmit information. Studies have confirmed the feasibility and acceptance of these applications in assessing and detecting diseases and in mental health interventions. In this article, the limitations of traditional psychiatric medical diagnosis and the opportunity to develop mobile health using information and communication technology are discussed, and related empirical research on using smart technology to evaluate and detect symptoms is explored using the example of bipolar disorders. In addition, the benefits and future prospects of onset alert and the development of healthcare models for action are highlighted. In the future, we look forward to developing mobile health applications that meet the needs of healthcare in Taiwan. Furthermore, we recommend more research and investment in related fields to accumulate more extensive empirical evidence.