It is estimated that around three and a half billion people will have a smart phone in 2017. Half of them will use the device to take care of their health, among other functions. There are already thousands of applications available for users to measure physiological parameters, including heart rate, the number of calories burnt or sleep cycles. In the past, these needed to be measured by a professional. The range of features offered by mobile phones is expected to expand to include even more technical, specific parameters. So we will only need to visit doctors when their involvement or the use of hospital equipment is absolutely essential. The technology resources that make remote healthcare possible are called mHealth or mobile health.
What is mobile health?
A few months ago, the European Union published the Green paper on mobile health, in which it defined mHealth as “medical and public health practice supported by mobile devices, such as mobile phones, patient monitoring devices, personal digital assistants (PDAs), and other wireless devices”. The US Food and Drug Administration also defined mHealth in the document Mobile Medical Applications. Guidance for Industry and Food and Drug Administration Staff. There, medical apps are considered all kinds of software that “meet the definition of a medical device and are an accessory to a regulated medical device or transform a mobile platform into a regulated medical device”.
This definition includes programs designed exclusively for mobile use, as well as web-based platforms that are hosted on servers but can be used from phones, tablets or other smart terminals. It distinguishes between accessory applications (for example, an app that records and monitors blood pressure that has been measured by a cuff) and those that convert the mobile platform itself into a medical device (for example, an application that can measure heart rate without having to use an external device).
Some applications are designed to connect users and establish a fast, easy communication channel between them. In healthcare, the doctor–patient relationship is fundamental. In this case, apps can be used to express and address concerns, pass on information and give advice. Consequently, much of the activity that now forms part of doctors’ visits could take place online, which would save time for all involved. However, the communication opportunities provided by apps go beyond establishing online doctors’ surgeries. Apps could also be used as a vehicle for knowledge exchange between healthcare professions, to connect patients who want to form communities to address a particular disorder and share experiences, and to put patients in contact with experts for a second opinion.
The monitoring of certain vital signs is essential to evaluations of a patient’s clinical status. Technological progress has meant that this procedure can now be carried out from a distance, in what is known as Remote Patient Monitoring. For example, people with heart disease and pace-makers needed to go to hospital periodically to check their health and the device. Now, such patients can have a transmitter at home that communicates with the pace-maker, collects data on its operation, and sends them to the relevant department. Likewise, patients can measure their blood pressure and weight and send their doctors the results without having to leave their homes. This will lead to more comprehensive monitoring of health status, as check-ups at health centres are periodic, whilst monitoring can be constant at home, and, above all, it is more convenient.
Some apps on the market can be used to add reminders to calendars so that patients take their medication
Mobile applications can also be used to improve treatment compliance; particularly that of chronic patients, many of whom do not comply with medical recommendations. Some apps on the market can be used to add reminders to calendars so that patients take their medication as prescribed and attend scheduled doctors’ visits. Other applications give healthcare professionals access to their patient’s files, if previously authorized, so that they can check in real-time how the patient is managing their disease.
To be even more active in the management of your own health, it is essential to have access to the right information. Some platforms compile, organize and provide data on specific diseases, and guarantee the quality and reliability of their information sources. Others provide users with programs that have been developed specifically to facilitate the treatment of a specific illness. Some platforms even combine both these aspects, which contributes significantly to consolidating patient empowerment. Access to resources that patients can use to find out about and monitor what is happening to them is a key factor in tackling an illness.
Finally, we should mention apps that promote well-being and healthy lifestyles. These recommend habits that will improve the user’s quality of life, and provide tools for monitoring health status more generally. For example, a person can record and compare the number of steps they take every day, their heart rate when running, the number of calories they have consumed and burnt, and how regularly and how well they sleep. All of these data can help people to correct their habits and adopt new ones. Users can also receive encouragement through alerts, rewards or motivational messages that encourage them to do physical exercise, eat a balanced diet or nurture their social relations.
Remote health could contribute to making healthcare more universal, effective and sustainable
The increasingly widespread use of these resources will be of great benefit. Probably the most highly valued by public authorities, it will free professionals from tasks that can be automated through mobile devices. The optimization of health workers’ time will save human resources and money. Medical apps also contribute to improving the diagnosis and treatment of certain disorders and will give users greater control over their health. Furthermore, they provide an opportunity for inhabitants of developing countries to access healthcare, although in a limited and insufficient way. Such countries have inadequate healthcare services, but do have high rates of mobile phone users. Consequently, remote health could contribute to making healthcare more universal, effective and sustainable.