Introduction to mHealth for students in Georgetown's healthcare prevention class.

1. An Introduction to mHealth
Learning about the Preventive Health IT Toolbox
Jessica Jacobs
jess.a.jacobs@gmail.com
Georgetown University
April 14th 2011

2. What is mHealth?
Current Trends
Applications
Opportunities

3. What is mHealth?: Questions to Consider
 There is not a consensus on what mHealth is.
 Questions to Consider:
1) What kind of connection does it have to have?
 Broadband? Wifi? Wired Internet?
2) What technology does it include?
 Cell phones? PDAs? Devices? Computers?
3) What’s the application?
 Clinical Data? Community Health? Personal Health?
4) What’s it part of?
 Telehealth? eHealth?
http://vimeo.com/17125591

4. What is mHealth?: Broad Definition
 All the definitions focus on mobile communications and
healthcare.
 Broader definitions seem to be gaining more steam.
“The integration of mobile technology, computing devices, and
emerging delivery system capabilities into a patient-centered
model of care.”
– Indian Health Service
US Department of Health and Human Services

5. What is mHealth?
Current Trends
Applications
Opportunities

6. Current Trends: Federal Support
•HITECH Act to spur the adoption of EHRs, HIEs, and other Health IT.
•Provisions in PPACA for telehealth and innovation in healthcare.
•Continued Presidential commitment to “the need to increase coverage of
high speed wireless networks to 98 percent of all Americans within the next
five years”: “This isn’t about faster Internet or fewer dropped calls. It’s about
connecting every part of America to the digital age. It’s about a rural
community in Iowa or Alabama where farmers and small business owners will
be able to sell their products all over the world. It’s about a firefighter who can
download the design of a burning building onto a handheld device; a student
who can take classes with a digital textbook; or
a patient who can have face-to-face video chats with her doctor.”
- President Barack Obama
2011 State of the Union Address

7. Current Trends: Technology Adoption
Utilization of Mobile Technology
Aged 18-29 Aged 30-49 Aged 50-64 Aged 65 and Over
90% 88% 86%
82%
72%
57% 59%
47%
38%
11% 15%
6%
Own a Cellphone Send/Receive Text Access Internet on a Cell
Messages Phone

8. Current Trends: Technology Adoption
SMS Utilization by Insurance Coverage
Medicaid 79%
Tricare 74%
Employer Policy 68%
Individual Policy 65%
No Insurance 63%
VA 45%
Medicare 43%
Source: Pricewaterhouse Cooper HRI
Study, 2010, http://apps4android.org/hhc/New_business_models_delivering_care_anywhere_chart_pack.pdf

9. What is mHealth?
Current Trends
Applications
Opportunities

10. Applications: Continuum
Management Promotion Surveillance
Personal Public Population

11. Applications: Management
•Patient-centered personal health
management.
•Patient or care-giver driven.
•Typically includes a device or smartphone
application.
•PHR and EHR integration is possible.
•Particularly beneficial for conditions where
continual tracking is warranted:
•Diabetes
•Asthma/COPD
•CHF
•Aging in Place
•Medication Adherence
11

12. Applications: Management - Diabetes
 Link glucose meter readings to
patient records electronically.
 This link ensures that readings are
recorded correctly and allows for
physicians to passively monitor a
patient’s blood glucose.
 Pilot studies show that this kind of
application is effective; indeed, it is
correlated to a reduction of 5
points in blood glucose readings
and a 1% reduction in HbA1c
readings over a three-month
period.
Watson et al. “Diabetes Connected Health: A Pilot Study of a Patient- and Provider-Shared Glucose Monitoring
Web Application” Journal of Diabetes Science and Technology, March 2009, Volume 3, Issue 2: Page 345-352.
http://www.connected-health.org/programs/diabetes/research-materials--external-resources/diabetes-connected-
health-a-pilot-study-of-a-patient--and-provider-shared-glucose-monitoring-web-application.aspx

13. Applications: Promotion
• Educational messages targeted at
behavior modification.
• Third Party driven (public health
depts, governments, insurance
companies)
• Usually utilizes cell phone messaging
because it’s quick, easy, and cheap.
• May be one way or two way messaging.
• Particularly beneficial for chronic.
 Smoking Cessation
 Sexual Health
 Pregnancy 13

14. Applications: Promotion – text4baby
 Free national SMS health information service.
 One way text messaging. Signup by texting “baby” to
511411.
 Large public-private partnership.
 Healthy Mothers Healthy Babies (HMHB), Voxiva, The
Wireless Foundation (CTIA), HHS/OSTP, J&J, etc.
 3 messages/week.
 Pregnancy through first year of child’s life.
2012 Million Mom Goal
Enrollees To Go
16% 84%
14
* As of April 5, 2011, Text4Baby Tuesday Newsletter

15. Applications: Surveillance
• Health tracking for timely notification.
• Health Worker and/or community driven.
• Low cost reporting mechanisms.
• Particularly useful in remote areas.
• Web and SMS based.
• Potentially Useful for:
• Disease Outbreaks
• Program Evaluation
• Contaminations
15

16. Applications: Surveillance - EpiSurveyor
 Allows people to design forms for data
collection on the internet.
 Data is entered into the forms using either a
smart phone application or SMS
messaging.
 Allows for real-time data uploads and
analysis.
"drastically cut costs while
 Been used to evaluate: facilitating quality control
and improving
 anti-malarial bednet distribution and vaccination
campaigns in sub-Saharan Africa implementation speed.“
 clean water initiatives in Vietnam
- The World Bank
 drug supplies in several African countries
 health delivery systems in Guatemala
* 2011 World Bank Report: http://siteresources.worldbank.org/INTLAC/Resources/257803-
1269390034020/EnBreve_166_Web.pdf

17. What is mHealth?
Current Trends
Applications
Opportunities

18. Opportunities
 Prepare to engage and be engaged with mHealth.
 Contribute to the growing body of knowledge.
 Review for efficacy and separate “signal” from
“noise.”
 Innovate to discover applications for new and
existing technologies.

19. In Conclusion…
 Current trends show that the utilization of mHealth will
increase.
 Its applications are numerous and widely encompassing:
 Management: Connecting mHealth applications with traditional
health IT systems will provide a groundbreaking continuum of
personal care, particularly for those with chronic
conditions, keeping them out of hospitals.
 Promotion: Wide scale education and behavior modification will
improve the health of the public due to its ability to be anywhere
the person is at anytime.
 Surveillance: Real-time health tracking and data aggregation
leads to actionable information for preventing disease outbreaks
and improving population health.
Source: http://www.healthcareitnews.com/news/mhealth-apps-forecast-increase-threefold-2012-0

20. I’d now like to welcome any questions…