Difference between revisions of "MHealth"

Revision as of 07:44, 4 December 2012

MHealth (also m-health or mobile health) is a term used for the practice of medical and public health, using communication technology (ICT) supported by mobile devices. The term is most commonly used in reference to using mobile communication devices, such as mobile phones and PDAs, for health services and information.

Introduction

Mobile health Can help solving many problems and challenges that are always facing the medical field and health care organizations such as; offering the emergency service at the proper time without delay, difficult patient drug compliance monitoring, and direct access to EHR at anytime and anywhere, all these problems and more can be managed by the use of continuous communication through wireless networks which show great advances in the mean time.

Mobile-Health represents the revolutionary adoption of new communication patterns in health care through the use of wireless computing devices (m-Devices); mobile phones, PDAs and smart phones, patient monitoring devices and sensors, microcomputers, laptop and mobile tele-medicine. It will help transferring medical information from physician-and hospital-centered system to one that seeks to connect, coordinate and deal with this information including physicians, health care providers, payers, pharmacies and patients themselves.

M-Health field is so huge and its applications are so many and gathered in 12 m-Health application Clusters by m-Health Initiative (mHI): Patient communication, access to resources, Point of care documentation, Disease management, education programs, professional communication, administrative applications, financial applications, ambulance/EMS, public health, pharmaceutical, and clinical Trials, Body Area Network , these clusters reflects the different fields m-Health can work in to gain better health care process.

Mobile health can help health care field in many ways:

It will provide continuous communication between all health participants for creating more effective and efficient health care system through:

• Enabling the access to HER through m-Devices at any time from anywhere which will lead to reduction of medical errors and immediate dealing with emergency situation.
• It allow better access to resources such as guidelines, polices at the point of care.

-Implementing communication based disease management for chronic patients such as asthmatics and diabetics to reduce emergency visits and monitor drug compliance.

• Using an online appointment system to enable the clinicians and patients to make appointments at the proper time.
• Enabling m-Health use in the emergency ambulance units to allow medical or the paramedical team to gain the needed information from the EHRs.
• Enabling the use of tele-medicine to allow contacting qualified physicians for remote diagnosis and advice.

References

1. Towards an application framework for context-aware m-Health applications, Tom Broens, Aart van Halteren, Martin van Sinderen, Katarzyna Wac.
2. http://en.wikipedia.org/wiki/MHealth]# http://www.mobih.org/observatory/]

Submitted by (Tamer Abd El Wahab Etman)

Patient Monitoring

With the advent of smart phones in the past decade, patients can use their mobile phones to monitor their personal health and upload that information to an EHR for healthcare providers to review. For example, an iPhone 4 has the following types of sensor:

• Accelerometer • GPS • Ambient light • Dual microphones • Proximity sensor • Dual cameras • Compass • Gyroscope

An iPhone 4’s built-in accelerometer can be used to characterize the physical movements of the person carrying it, including specific movement patterns including sitting, standing, and walking (Lane, Miluzzo, Lu, Choudhury, & Campbell, 2010). The cameras and microphones can be employed to collect information about the patient’s daily routine and environment. The compass, GPS, and accelerometer can be used to collect information related to a person’s preferred mode of transport and daily activities.

Specific apps can be downloaded to improve the effectiveness of this monitoring, and also allow for community sensing. Community sensing applications allow people to access information about recent outbreaks of disease, what general area or areas those outbreaks have occurred in, and what they can do to limit exposure (Lane et al., 2010).

Apps and patient monitoring require a different approach to privacy and security to be compliant with privacy practices. HIPAA requires that electronic protected health information be encrypted at 128-bit blocks or better. Some commercial entities program to higher tolerances – Skype uses 256-bit encryption. Virtual private networks (VPNs) provide a secure way of transmitting information between authorized users (Luxton, Kavl, & Mishkind, 2012).

References Lane, N. D., Miluzzo, E., Lu, H., Peebles, D., Choudhury, T., & Campbell, A. T. (2010). A survey of mobile phone sensing. Communications Magazine, IEEE, 48(9), 140-150. Luxton, D. D., Kayl, R. A., & Mishkind, M. C. (2012). mHealth data security: The need for HIPAA-compliant standardization. Telemedicine and e-Health, 18(4), 284-288.

Submitted by (Christopher A d'Autremont)

Summary

Mobile Handheld Technology has heralded the opportunity to provide physicians with access to information, resources, and people at the right time and place. Mobility is an important component for health care delivery (1). Mobile technologies provide benefits of paper charts and desktop computers in their portability and support for information access anywhere and anytime (2). Handheld devices include tablet computers and personal digital assistants (PDAs). These devices are generally small, portable, lightweight computers with wireless network capability. A review demonstrated adoption among health care providers who are primarily hospital-based at 45% to 85% (3). Handheld devices uses include: administrative support (e.g., billing and scheduling); professional activities (e.g., patient tracking and electronic prescribing); documentation; decision support (e.g., clinical and drug references); education and research. Potentially benefits include improved productivity, increased information access, better communication, fewer medical errors, greater mobility, and improved quality and care. Another advantage of handheld devices is providing information and decision support access at the point-of -need. Disadvantages related to entering data, which is slower with a stylus, more erroneous and less satisfactory. Other limitations include smaller screen size designed for individual use so can limit collaboration, present challenges in viewing and entering data, which can lead to errors. However, the literature is limited on demonstrating that handheld devices improve outcomes and workflow efficiencies because of their mobility. Additional research needed to evaluate further the questions related to impacting these mobile devices has on work practices and outcomes (4).

References

1. JE. Activity-based computing: Support for mobility and collaboration in ubiquitous computing. Pers Ubiquit Comput 2005;9(5):312-22.
2. Kuziemsky CE, Laul F, Leung RC. A review on diffusion of personal digital assistants in healthcare. J Med Syst 2005;29(4):335-42.
3. Garritty C, El Elman K. Who’s using PDAs? Estimates of PDA use by health care providers: A systematic review of surveys. J Med Internet Res 2006;8(2):7.
4. Prgomet M, Beorgiou A, Westbrook JI, The impact of mobile technology on hospital physicians’ work practices and patient care: as systemic review. JAMIA. 2009;16:792-801.

Submitted by (Larry W. Holder)