Saturday, June 23, 2012

mHealth: So What Role Does it Have in Your Care?

This past week I’ve come across some interesting articles that relate to chronic conditions and mHealth or mobile health- the term is used when discussing mobile devices that can help in the delivery of health care. For starters, how many people actually have a chronic condition? In the United States, one author states that 3 out of 4 people 65 and older have two or more chronic conditions.(JAMA ). The President of NEHI (New England Health Institute, Wendy Everett, was quoted as saying recently “Nearly half of all American adults have at least one chronic illness.” In short, there are lots and lots of people with at least one chronic condition, and with the baby boomer generation having already started during 65, the number is only going to increase.

Around 83% of Americans have a cell phone, and from at least this study by Pew Research, we’re very dependent on them. Intel, in a study of U.S. attitudes toward travel and technology, found that vacationers feel antsy when traveling without their mobile devices and angry when they cannot access power sources to charge these devices. They also feel annoyed when others take uninvited glimpses of their computer screens, potentially compromising their personal information….Survey respondents, moreover, ranked losing these devices when traveling as more stressful than losing their wedding ring.

In summary, there are many Americans with a chronic disease who are regularly using mobile devices for any number of reasons. So how does this relate?

A few weeks ago, New England Health Institute (NEHI) identified 11 emerging technologies that could have a positive impact on chronic disease by improving care and/or lowering costs. The list includes

• Tele-stroke care
• Virtual visits
• Mobile asthma management tools
• In-car telehealth
• Extended care eVisits
• Mobile clinical decision support
• Medication adherence tools
• Social media promoting health
• Mobile cardiovascular tools
• Home telehealth
• Mobile diabetes management tools

While this sounds wonderful, an article in the July Scientific American “How to Fulfill the True Promise of “mHealth” Mobile devices have the potential to become powerful medical tools,” the author Francis Collins notes, I am convinced, however, that the real potential of mHealth lies with much more committed users, such as the children with type 1 diabetes who took part in a yearlong, case-control study of wireless technologies to monitor and manage blood glucose levels. ….Youngesters who used the automated system had significantly better glycemic control and diabetes self management skills than those who did not.”

Going to a satellite clinic where the person is hooked up to a device that transmits health data 1,000 miles away to a specialist, is a good use of mobile technology, that in one form or another, has been in place for decades. Medical providers, who are very wired group, are using them all the time to check information, deciding treatment modalities etc. However, persons with a chronic condition keeping a health notebook, or using clinical decision making or medication adherence tools, I’m not so sure about.

I’m skeptical for a variety of reasons: Google tried an on-line free health notebook, but dropped it due to lack of utilization. Eight years prior to Google’s attempt, we launched a print version of a health notebook and found that while caregivers appreciated it, those living with a chronic condition, not so much. Finally, I’ve written a number of posts on this blog about Being an E-Patient and Managing Health Information and they are not that popular

I’m the first to admit that I could be totally wrong about what people with chronic conditions might find useful to help them live well. So this week, I’m asking readers to take a few minutes and complete a survey, which you can e-mail to me at and I’ll report my findings in the coming weeks. All results will be kept anonymous.

MHealth Survey
• Using the numbers 1 (never), 2 (sometimes), or 3 (frequently) how often do you use the internet for the following:
- Support from others living with similar condition
- Finding health information
- Being an E-patient-sharing your health data at sites like “Patients Like Me.”
- Communicate with your provider via e-mail
- Maintain personal health record
- Re order prescriptions
- Other (specify)

• Do you have access to Apps?
- If yes, have you downloaded health related ones?
- What types of Apps are they?
- If yes, how often do you use them? 1 (never), 2 (sometimes), or 3 (frequently)
- Do you fine they have had an impact on your health or sense of well being?

• What type of on-line devices do you think would help you to manage your condition?

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