Can a text message or a smartphone app make you a better patient or keep you out of the ER? The rise of mHealth — the catchall term for medical services delivered via mobile devices — is showing promise for people who struggle to manage an array of health and lifestyle challenges. Mobile technology can be used to remotely monitor and report data on patient indicators such as blood pressure, oxygen levels, cholesterol and other vitals. Data streams fed into tracking software can help doctors detect problems when they start, leading to earlier intervention. And for patients, smartphones can relay physician feedback and promote healthy behavior.
Nearly 100,000 health-related smartphone apps are testament to the interest in using mobile devices to improve health. To date, millions of consumers have downloaded self-tracking programs intended to remind, cajole and even nag them to adopt habits that lead to better health. The data collection apps, along with equipment used for self-monitoring, are behind the surge in the quantified self movement to incorporate beneficial information technology into everyday life. For instance, a user can wear a wireless heart-rate monitor during a run, record the intensity and the length of the workout with a smartphone and then analyze his or her performance over time.
If you could scale up one remarkable health care idea, what would it be?
"There is now ample evidence about the value of leveraging mobile technologies for simple things such as text-message support to improve health behaviors and avoid unnecessary health care visits."
- Kevin Patrick, M.D., M.S., professor of preventive medicine, University of California, San Diego and adjunct professor of public health at San Diego State University
Dr. Kevin Patrick, a professor of preventive medicine at the University of California, San Diego (UCSD), is among researchers gathering evidence that suggests mobile technologies can be useful tools for promoting healthy habits. Patrick’s studies indicate that automated delivery of customized text messages is an effective means of driving desirable behavior, such as making sure patients take medication properly and exercise regularly.
Patrick’s work at UCSD in 2006 produced the first randomized controlled trial that found texting can help obese adults lose an average of two kilograms more than study participants who didn’t receive text messages. The messages encouraged adherence to simple behaviors, such as reminding patients to take prescribed medication or to eat more vegetables — important first steps for many patients. Building on that work, in 2011 Patrick collaborated with two partners to found Santech, Inc., a for-profit business that uses text messages as well as e-coaching, phone support, incentives and screenings to encourage program participants to eat healthier food, to quit smoking and to exercise.
Mobile health services allow health providers to monitor patient behavior and vitals and send text-message prompts. Researchers have analyzed the efficacy of SMS reminders on patients, and the results are positive. Published studies indicate text messaging is a promising adjunct therapy to support the management of chronic diseases such as asthma and diabetes.
Patrick expects mHealth to grow well beyond SMS reminders, and says that the “simplicity and ease of text messaging can be considered baby steps toward increasingly sophisticated care delivery using mobile devices.” With the same technologies that spurred the development of consumer apps, researchers at the nonprofit Center for Connected Health in Boston are using remote monitoring, wireless devices and online communication platforms to improve treatment for cardiac care, pregnancy and diabetes. The program received a grant in November 2013 to create a smartphone app to study adherence for the growing number of cancer patients who receive chemotherapy in a pill form.
The growing evidence supporting mHealth is also a promising development for American insurance companies, hospitals, governments and other stakeholders keen on finding new opportunities to manage health care delivery costs while improving outcomes. A 2008 study by economist Robert Litan estimated that widespread use of remote technology, including text messaging, could save the U.S. $197 billion over the next 25 years.
In-depth studies on the efficacy of smartphone apps have not yet been completed and released because the technology is too new (the first apps didn’t exist until 2007); however many health providers believe the upside to mobile tracking is too great to wait. The Center for Connected Health, for example, recently launched Wellocracy, a site that aims to be a source of impartial, easy-to-understand information on new, personal “self-health” technologies and mobile apps.
Conditions conducive to coaching via mHealth are seemingly limitless. Text messages can help patients with preventive care, such as sending sun-protection reminders to reduce skin cancer risk, reminding parents to get children immunized and warning those with food allergies if a package is mislabeled. Studies show that even simple applications for messaging, such as reminding patients of upcoming appointments, can reduce health care costs.With over 95 million Americans already reaching for their phones for health-related uses in 2013, mHealth proponents are optimistic. They see a digital future that better connects providers and patients while improving outcomes and increasing care efficiency. “As with banking and shopping,” says Patrick, “there is little question that we will move more and more of the services related to health care into the convenient and ever-smarter world of mobile apps and services.”
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