Mobile Technology In Healthcare Research Articles

Digital Technology Healthcare Solutions in an Era of Moving Populations and Chronic Illnesses: Are We Being Realistically Smart?

In 2015, the world recorded its highest numbers of international migrants and forced displacement since World War II. With this historic rise in migrants, refugees, and displaced persons around the world, there is a huge risk of chronic illness burden on healthcare systems. Thus, healthcare systems may need to incorporate innovative digital healthcare solutions into their processes and procedures. The purpose of this article is to present the argument that for effective prevention and management of chronic illnesses in ever-increasing migrant societies to be achieved, mobile digital healthcare technologies must be realistically smart and strategically adopted. Beginning with an overview of the current global migration trend, this article considers the implications of this trend for chronic illnesses and the potential for mobile health technologies to support achievement of healthcare outcomes. It highlights three core reasons why digital innovations may be limited as tools for helping to address the global chronic illness challenge and identifies important directions for mobile health technology developers, healthcare professionals, researchers, government and funding agencies, and public health ministries, with a focus on the strategic development and adoption of ‘realistically smart’ phones. The article concludes with recommendations for research and public health education.

Mobile Healthcare Technologies – “Wearables” for objective measures of motor symptoms in Parkinson's disease

Mobile Healthcare Technologies – “Wearables” for objective measures of motor symptoms in Parkinson's disease

Mobile health care in promoting health management adherence of patients with chronic disease

The type of chronic diseases and number of patients with chronic disease are increasing all over the world. The adherence of health management in patients with chronic disease has directly impact on their health outcomes, quality of life and related health cost. The benefit of improvement in adherence of health management is even more than the improvement in treatment. Mobile health is a new way of health care to provide convenient, accessible and effective health management support. Additionally, mobile health care has been used in the health management of patients with chronic diseases. The aim of this study is to review the studies focus on using mobile health care technology in improving health management adherence, including the characteristics of participants, the intervention tools, the diseases have been managed and the outcome evaluation. Key words: Chronic disease; Health management; Mobile health care; Adherence

Mobile Technology in the Perioperative Arena: Rapid Evolution and Future Disruption.

Throughout the history of medicine, physicians have relied upon disruptive innovations and technologies to improve the quality of care delivered, patient outcomes, and patient satisfaction. The implementation of mobile technology in health care is quickly becoming the next disruptive technology. We first review the history of mobile technology over the past 3 decades, discuss the impact of hardware and software, explore the rapid expansion of applications (apps), and evaluate the adoption of mobile technology in health care. Next, we discuss how technology serves as the vehicle that can transform traditional didactic learning into one that adapts to the learning behavior of the student by using concepts such as the flipped classroom, just-in-time learning, social media, and Web 2.0/3.0. The focus in this modern education paradigm is shifting from teacher-centric to learner-centric, including providers and patients, and is being delivered as context-sensitive, or semantic, learning. Finally, we present the methods by which connected health systems via mobile devices increase information collection and analysis from patients in both clinical care and research environments. This enhanced patient and provider connection has demonstrated benefits including reducing unnecessary hospital readmissions, improved perioperative health maintenance coordination, and improved care in remote and underserved areas. A significant portion of the future of health care, and specifically perioperative medicine, revolves around mobile technology, nimble learners, patient-specific information and decision-making, and continuous connectivity between patients and health care systems. As such, an understanding of developing or evaluating mobile technology likely will be important for anesthesiologists, particularly with an ever-expanding scope of practice in perioperative medicine.

The Future of Mobile Health Applications and Devices in Cardiovascular Health

Mobile health (mHealth) is the utilisation of mobile technologies in healthcare and has particular relevance in improving lifestyle behaviours which may ultimately reduce cardiovascular disease risk. Various intervention studies for example integrate self-monitoring of diet and physical activity with text messaging systems to improve intermediate outcomes. Currently the future progress of mHealth technologies in formal diagnostic and therapeutic roles is pending and includes the need to validate and standardise accelerometer and heart rate data from various devices. Data also needs to be integrated from such devices into the medical record system to facilitate communication between providers and patients. Although short-term behaviour changes have been found with technologies such as Fitbit® (Fitbit, Inc., San Francisco, California, USA), whether such technologies/interventions lead to sustained behaviour change and reduced risk of myocardial infarction and death remains to be seen.

Mobile Technologies in Healthcare: Approaches and Architecture

Mobile Technologies in Healthcare: Approaches and Architecture

Rapid, label-free CD4 testing using a smartphone compatible device.

The most recent guidelines have called for a significant shift towards viral load testing for HIV/AIDS management in developing countries; however point-of-care (POC) CD4 testing still remains an important component of disease staging in multiple developing countries. Advancements in micro/nanotechnologies and consumer electronics have paved the way for mobile healthcare technologies and the development of POC smartphone-based diagnostic assays for disease detection and treatment monitoring. Here, we report a simple, rapid (30 minutes) smartphone-based microfluidic chip for automated CD4 testing using a small volume (30 μL) of whole blood. The smartphone-based device includes an inexpensive (<$5) cell phone accessory and a functionalized disposable microfluidic device. We evaluated the performance of the device using spiked PBS samples and HIV-infected and uninfected whole blood, and compared the microfluidic chip results with the manual analysis and flow cytometry results. Through t-tests, Bland-Altman analyses, and regression tests, we have shown a good agreement between the smartphone-based test and the manual and FACS analysis for CD4 count. The presented technology could have a significant impact on HIV management in developing countries through providing a reliable and inexpensive POC CD4 testing.

TextWithSurgeryPatients - A Research Hypothesis in Enhancing Education and Physical Assessment for Abdominal Surgical Patients.

Medical surgical nurses may not have the time or resources to provide effective pre- and post-operative instructions for patients in today's healthcare system. And, making timely physical assessments following discharge from the hospital is not always straightforward. Therefore, the risk for readmission associated with post-surgical complications is a concern. At present, mobile healthcare technologies and patient care are precipitously evolving and may serve as a resource to enhance communication between the healthcare provider and patient. A mobile telephone text message (short message service [SMS]) intervention for abdominal surgical patients may foster effective education (communication) and timely self-reported physical assessment in the home environment hence preventing deleterious outcomes. The aim of this research proposal is to identify the feasibility of using a SMS intervention via smart phones to improve health outcomes via timely communication, reach large numbers of at-risk surgical patients and, establish and sustain uniform protocols in a cost-efficient manner.

Strengthening pharmaceutical systems for palliative care services in resource limited settings: piloting a mHealth application across a rural and urban setting in Uganda.

BackgroundMedicine availability is improving in sub-Saharan Africa for palliative care services. There is a need to develop strong and sustainable pharmaceutical systems to enhance the proper management of palliative care medicines, some of which are controlled. One approach to addressing these needs is the use of mobile technology to support data capture, storage and retrieval. Utilizing mobile technology in healthcare (mHealth) has recently been highlighted as an approach to enhancing palliative care services but development is at an early stage.MethodsAn electronic application was implemented as part of palliative care services at two settings in Uganda; a rural hospital and an urban hospice. Measures of the completeness of data capture, time efficiency of activities and medicines stock and waste management were taken pre- and post-implementation to identify changes to practice arising from the introduction of the application.ResultsImprovements in all measures were identified at both sites. The application supported the registration and management of 455 patients and a total of 565 consultations. Improvements in both time efficiency and medicines management were noted. Time taken to collect and report pharmaceuticals data was reduced from 7 days to 30 min and 10 days to 1 h at the urban hospice and rural hospital respectively. Stock expiration reduced from 3 to 0.5 % at the urban hospice and from 58 to 0 % at the rural hospital. Additional observations relating to the use of the application across the two sites are reported.ConclusionsA mHealth approach adopted in this study was shown to improve existing processes for patient record management, pharmacy forecasting and supply planning, procurement, and distribution of essential health commodities for palliative care services. An important next step will be to identify where and how such mHealth approaches can be implemented more widely to improve pharmaceutical systems for palliative care services in resource limited settings.

Future of Psychiatry: Mobile Health and Social Sensing

Mobile technologies are transforming our lives. Utilizing the mobile technologies in health care has developed into a new interdisciplinary field called mobile health (mHealth). Data about an individual's moods, cognitions, physical and social activities can be collected and can be used to track mental health of individuals, or make other predictions about their lifestyle such as eating habits and obesity. The smartphone accelerometers and GPS localization systems give information on the overall level of activity. The microphone is used for activity recognition, based on the sound sensed. The social interaction can be tracked by the log of calls, the number of people contacted. Voice analysis is a way of tracking the mood by analyzing the patient's speech during voice calls. The mental health professional must recognize the increasing availability of mobile phones however patient’s motivation to use the applications must also be taken into account. Mobile sensors can assist users to monitor their emotions and behaviors. Mobile technology has the potential to transform mental health care.

Using informatics to engage patients and healthcare providers.

This issue of JAMIA focuses on the many “meaningful uses” of mobile health (mHealth) and health information technology in healthcare. An editorial by Tang et al. introduces nine articles (see pages 5, 12, 19, 29, 38, 48, 60, 74, 80, 88, 94, 105, 110, 119, 129, 137, 149) that compose the special focus issue on “Interactive Systems for Patient-Centered Care to Enhance …

An integrative review of the impact of mobile technologies used by healthcare professionals to support education and practice.

AimThe aim of this study was to provide evidence of the impact of mobile technologies among healthcare professionals in education and practice settings.DesignIntegrative literature review.MethodsElectronic databases including MEDLINE, CINAHL, PsycINFO, EMBASE, ERIC and Web of Science were searched for papers published between 2002–2012. Quantitative studies were critically evaluated based on Thomas et al.'s framework, while the consolidated criteria for reporting qualitative research was used to appraise the rigour of the qualitative studies.ResultsSeventeen quantitative and three qualitative studies were included. The findings suggest a largely positive influence of mobile technologies on various clinical practice and educational outcomes. However, robust evidence was limited. Use of mobile technologies in health care are associated with improvements in access to information, accuracy and efficiency, evidence‐based decision making at the point of care and enhancement in performance, confidence and engagement in different contexts.

An extension of the UTAUT 2 with a focus of age in healthcare: What do different ages want?

Introduction: The objective of this study was to understand the factors that affect the adoption and acceptance of technology, in particular to analyse the underlying mechanisms by which age affects acceptance of mobile IT in a healthcare context. Understanding how and why people accept or reject technologies has been the subject of a large body of information systems research including the Technology Acceptance Model [2] [3]. The Unified Theory of Acceptance and Use of Technology model 2 [4] combines the dispersed literature into a unified model and looks at technology acceptance from a consumer use context thus making it of particular use for the public health environment. The authors of the model describe the moderating effect of age on each of the seven constructs [4], and show empirically that age does have an impact using longitudinal studies; however the rationale behind the underlying mechanisms of this is scant. Age is often an important consideration, especially with technologies introduced in healthcare. Individuals show declines in psychomotor skills [5], processing capacity, and increased distraction by side issues when using technologies with increased age; however, they can continue to use technology to a high level [6]. Methods: A review of the current literature on mobile technology was conducted, in addition to qualitative primary data collection. Focus groups were conducted for three different age groups, 15-30, 31-50, and 51+ in order to explore views on acceptance of mobile technology in healthcare and the factors that affect the adoption of technology. Thematic analysis was performed to analyse focus group responses. A mobile web application for recording Patient Reported Outcome Measures was used as an example for focus group participants to interact with. Patient reported outcome measures are validated questionnaires, completed by patients to measure their perceptions of their own functional status and wellbeing. They are currently collected in a paper format, but an application has been created to improve response rates. We used our finding to make recommendations to the current Patient Reported Outcome Measures application to improve user acceptance. Results and Discussion: Our results from the literature review and primary data collection extend the Unified Theory of Acceptance and Use of Technology 2 model from a healthcare perspective. Our findings confirm that age does moderate the seven constructs of user acceptance but shows that it does so via the 17 mechanisms that we indentified. These 17 mechanisms are outcome expectancy, convenience expectancy, time expectancy, base ease of use, ease of learning, impact of disability, practitioner influence, support, security and confidentiality, prompts, usage enjoyment, novelty enjoyment, hardware costs, software costs, technology preference, location preference and reminders. The model highlights the factors that need to be considered when developing mobile IT in healthcare. We used our finding to make recommendations on how to improve uptake of the current Patient Reported Outcome Measures App with respect to age with a view on improving response rates.

Examining a Model of Mobile Healthcare Technology Acceptance by the Elderly in Taiwan

“Graying of the globe” is an increasing phenomenon worldwide, accompanied with the expanding healthcare costs of long-term care and hospitalization. To deal with this issue, previous medical literature has suggested that the ultimate success of telemedicine depends not only on the technology itself but also on users’ acceptance of the technology. Differing from past healthcare studies which focused on physicians’ viewpoints, the current study investigates the use intention of mobile healthcare devices from the perspectives of elderly people in Taiwan. Meanwhile, this study proposes a model of mobile healthcare technology acceptance, and provides a theoretical and empirical assessment including sociological, technological, and individual variables. To achieve the research purpose, elderly people in the community were invited to participate in the study, with 338 effective questionnaires eventually collected for analysis using the structural equation modeling technique. The empirical results support the inclusion of perceived ubiquity, personal health knowledge, and perceived need for healthcare in the technology acceptance model. In sum, the mobile healthcare technology acceptance model provides researchers and practitioners with in-depth understanding of the introduction of new mobile healthcare technology devices. Further discussion is provided.

Towards a workflow driven design for mHealth devices within temporary eye clinics in low-income settings.

Only a small minority of mobile healthcare technologies that have been successful in pilot studies have subsequently been integrated into healthcare systems. Understanding the reasons behind this discrepancy is crucial if such technologies are to be adopted. We believe that the mismatch is due to a breakdown in the relation between technical soundness of the original mobile health (mHealth) device design, and integration into healthcare provision workflows. Quantitative workflow modelling provides an opportunity to test this hypothesis. In this paper we present our current progress in developing a clinical workflow model for mobile eye assessment in low-income settings. We test the model for determining the appropriateness of design parameters of a mHealth device within this workflow, by assessing their impact on the entire clinical workflow performance.

Mobile Technology Applications in the Healthcare Industry for Disease Management and Wellness

Technology is an unavoidable fact of today's life. Attractive advantages of wireless technology accelerated the rapid development of mobile applications. With the increase of the usage of mobile devices in the recent years, new solutions come to mind including mobile technologies to fulfill requirements or suggest better solutions in the vast area of medical informatics to the existing ones. Augmentation in the area of wireless technology positively affects the medical applications. In the healthcare industry, mobile applications provide better personalized health care, disease management and services to patients and their relatives, as well as a better and flexible way of communicating with physicians, patients and medical suppliers. It is obvious that the applications using mobile technologies has the potential to bring better conditions both for the patients for their disease management and for the humanity for checking their self wellness. In this paper, the current mobile technology utilized in healthcare such as relapse prevention in schizophrenia, aged people's care and wellness, diagnosis and management of attention-deficit etc. is reviewed in detail outlining the current mobile technologies and wireless revolution of today and examining some of the outstanding applications using these technologies in the clinical area. The results of this study can provide clues to researchers to further the mobile technology in healthcare.

Usefulness of FaceTime to Improve Medication Adherence in Adolescents and Young Adults with Systemic Lupus Erythematosus: A Case Series

Poor adherence to medications is a ubiquitous problem in patients with chronic diseases such as systemic lupus erythematosus (SLE), and can be associated with higher risk of disease flare and mortality. With the increasingly accessible use of mobile technology in health care, a novel application has emerged: the use of mobile technology to improve medication adherence in patients with chronic disease. We report the use of video-conferencing via FaceTime to improve medication adherence in childhood-onset SLE patients treated with mycophenolate mofetil. All of the patients had an undetectable mycophenolic acid (MPA) level prior to remote directly observed therapy (remote DOT) with FaceTime. The primary outcome was achievement of a therapeutic MPA level after remote DOT with FaceTime, and was met in all patients. This suggests an important role for video-conferencing in the improvement of medication adherence and disease outcomes not only in SLE patients, but in young adults with other chronic diseases.

Short message service can be a promising tool for psychiatric patients and clinicians.

Short message service (SMS), commonly referred to as text messaging, allows instantaneous communication between mobile telephones and other systems via 160-character messages. SMS has a wide reach, and thus researchers and public health officials have considered using this platform for health-related communication. Today, as our society continues to integrate components of automation in various forms and levels of human interaction, and with the increasing ubiquity of mobile technology in health care, technology-delivered health interventions such as SMS offer a creative alternative that can be a valuable tool to assist mental health patients in their own treatment and recovery and for the mental health clinicians who are responsible for providing care and its delivery.

A model for improving quality of decisions in mobile health

The rapid and wide-scale introduction of mobile technologies in healthcare is resulting in an emerging area of mobile health. m-Health has major implications for patients, healthcare professionals, developers, infrastructure providers and regulators in both developed and developing countries. Mobile technologies can not only support instant and ubiquitous access to information, healthcare professionals and patients, but can also create many interesting challenges, including additional complexity and potential for various errors. In this paper, we address how mobile health can be more effectively supported by mobile technologies. More specifically, we present two sets of enhancements: (a) context-awareness and processing and (b) improved presentation of information to healthcare professionals. These enhancements are then applied in the conceptual design of a mobile health alert generation and processing system. To evaluate the effectiveness of the proposed enhancements, we develop and utilize an analytical model. Using multiple metrics, including the number of alerts generated and probability of error in alert-response, we show that the proposed enhancements can improve the quality of mobile health. We hope that other researchers design, implement and evaluate additional enhancements in mobile technologies for m-health. While we do not present any prototypes of the systems, the work presented in the paper can lead to prototypes and testing of systems in the future for mobile health.

Mobile health use in low- and high-income countries: an overview of the peer-reviewed literature

The evolution of mobile phone technology has introduced new possibilities to the field of medicine. Combining technological advances with medical expertise has led to the use of mobile phones in all healthcare areas including diagnostics, telemedicine, research, reference libraries and interventions. This article provides an overview of the peer-reviewed literature, published between 1 August 2006 and 1 August 2011, for the application of mobile/cell phones (from basic text-messaging systems to smartphones) in healthcare in both resource-poor and high-income countries. Smartphone use is paving the way in high-income countries, while basic text-messaging systems of standard mobile phones are proving to be of value in low- and middle-income countries. Ranging from infection outbreak reporting, anti-HIV therapy adherence to gait analysis, resuscitation training and radiological imaging, the current uses and future possibilities of mobile phone technology in healthcare are endless. Multiple mobile phone based applications are available for healthcare workers and healthcare consumers; however, the absolute majority lack an evidence base. Therefore, more rigorous research is required to ensure that healthcare is not flooded with non-evidence based applications and is maximized for patient benefit.