How your mobile phone could help keep you healthy

With smart-phone use on the rise, health care agencies are launching a variety of mobile applications for patients and providers.

Jonathan Cho, chief of the National Cancer Institute’s Communications Technology Branch, is the first to concede that the agency’s flagship Cancer.gov Web site isn’t designed for mobile devices with bandwidth- and screen-size constraints.

However, many people still pursue the cumbersome experience. He said nearly 150,000 users attempted to navigate the Web site with a mobile device in June. They used everything from Apple iPhones to more obscure handsets.

“The demand is there,” Cho said. “People are looking for cancer information on their mobile devices.”

Cell phones of all types are becoming conduits for health care information. But phones can do much more than access data. The smart-phone variety can run advanced applications and provide an increasingly robust set of features, such as touch screens, high-resolution cameras and Global Positioning System-based location trackers. Developers now seek to create health care applications that take advantage of those capabilities.

The public’s widespread use of mobile devices makes them a natural platform for health care information and applications. Market research firm Canalys estimates that 55.2 million smart phones shipped worldwide in the first quarter of 2010. Also, physicians are among the most eager adopters. In July, Spyglass Consulting Group reported that 94 percent of the U.S. doctors it interviewed use smart phones to “communicate, manage personal and business workflows, and access medical information.”


Related stories:

Smart phone as patient tool: A mental health application

Smart phone as clinical tool: A teledermatology pilot program


A number of government agencies are targeting mobile devices — smart phones in particular — for a range of possible health care uses. For example, the National Cancer Institute (NCI) plans to develop a set of mobile applications for its main constituents: cancer patients, health care professionals and researchers. Other agencies and government-funded initiatives seek to harness mobile technology to improve access to specialist care, treat psychiatric disorders and expand home-based health care options.

As interesting as the opportunities are, officials have a number of problems to deal with when justifying investments in mobile capabilities — from the basic effectiveness of proposed applications to worries about the security and privacy of personal health care information.

The smart phone as outreach tool

When NCI started retooling its Cancer.gov Web site, the agency polled users on what they’d like to see in the next iteration. In many cases, what they wanted was greater mobile access to information.

Cho said he wasn’t surprised. “We were somewhat expecting it,” he said. “If you look at social networking tools — Facebook, Twitter — they are being used more and more from mobile devices. The excitement was already palpable around what we could do with mobile.”

NCI kicked off the evolution of Cancer.gov last year. With user input as a guide, the agency’s project team identified a handful of objectives that it could accomplish in six months. Mobile applications made the short list. Cho said the team then divided the mobile category into three distinct user groups: patients, friends and family; health care professionals; and researchers.

The agency now plans to develop mobile app concept designs for each user group.

“We really have to delve into use-case scenarios,” Cho said, noting that the process involves determining what information users need at certain times.

The Web team has 50,000 pages of Cancer.gov content to consider as it decides which resources to include in a mobile application.

However, the apps will go beyond providing content from the Web site. Cho said they will also provide functionality geared toward a particular audience. For example, an app for researchers could contain a collaboration tool for brainstorming a new clinical trial. Another possibility is enabling Cancer.gov’s live-chat feature on mobile devices. Live chat could let users talk to an expert who can help answer their questions about cancer.

Cho said he is hopeful that the team will be able to share concept designs with users this fall, with application development beginning early next year. The plan is to build both browser-based applications and apps that run on a given mobile device. Platforms under consideration include Apple’s iPhone and iPad along with Research in Motion’s BlackBerry and phones that run Google’s Android operating system.

“We don’t want to be platform-specific,” Cho said.

The agency has resources in house to handle the initial development phase but might seek additional help to add more complex functionality later, he said.

Future prospects: Home health care

The Veterans Affairs Department, an early adopter of electronic health records, is now exploring the potential of smart phones in e-health.

Dr. Adam Darkins, chief consultant for care coordination at VA, said he believes mobile technology could find a role in home telehealth and chronic disease management.

Telehealth services are already routine at VA. The agency serves 43,000 veterans in their homes via the technology. Patients use a special computer terminal about the size of a hardcover book to relay health data to a VA care coordinator via telephone lines and broadband connections.

Darkins said he believes the existing base of mobile devices could support other telehealth applications — for example, to help veterans stay home and out of nursing homes. The next leap would be to use mobile devices to provide chronic care management.

In VA’s case, that means tracking patients with diabetes, which Darkins said 20 percent of veteran patients have, congestive heart failure, high blood pressure, chronic obstructive pulmonary disease and depression. He envisions an incremental progression toward using mobile technologies in home telehealth, with the first baby step in that direction being interactive voice response.

IVR systems prompt users to respond to a series of questions or menu options. VA has issued a request for proposals for fielding an IVR system that would let veterans call a phone number and answer a series of health questions on topics such as weight, glucose levels and blood pressure. Patients could use cell phones or smart phones to report information to VA the way they now do through the home telehealth hub.

According to the RFP, the IVR solution “must provide for veteran patients…to self-manage their chronic condition” while enabling care coordinators to manage and treat a range of symptoms and chronic conditions. The IVR approach would let VA extend home telehealth services without needing to rely on the hub device or the presence of landline service in veterans’ homes, according to the solicitation.

In addition, IVR would serve as a steppingstone toward introducing Web-based telehealth applications on smart phones, Darkins said.

But a few problems will need to be dealt with before mobile technology in telehealth becomes widespread, not the least of which are privacy and security. Harry Doyle, senior client delivery executive at Force 3, an IT solutions company, said agencies that field smart-phone applications should consider the nature of the information to be communicated. When applications involve personal health information, an agency should conduct a risk analysis, develop a risk mitigation approach, and issue policies and procedures.

In addition, as with any emerging technology, the clinical effectiveness of cell phone-based applications must be evaluated. And their use raises some difficult questions about whether mobile phones and their health care applications should be considered medical devices.

“It becomes a question of whether a regulatory agency like [the Food and Drug Administration] needs to regulate those kinds of technologies,” Darkins said.

However, he said he believes it is likely that many health care applications will appear on mobile devices during the next few years.

“It is logically where we are headed in terms of the telehealth program,” he said. “It’s not difficult to see where this is going. The real challenge is always how you get there.”

 

NEXT STORY: A cost of consolidation?

X
This website uses cookies to enhance user experience and to analyze performance and traffic on our website. We also share information about your use of our site with our social media, advertising and analytics partners. Learn More / Do Not Sell My Personal Information
Accept Cookies
X
Cookie Preferences Cookie List

Do Not Sell My Personal Information

When you visit our website, we store cookies on your browser to collect information. The information collected might relate to you, your preferences or your device, and is mostly used to make the site work as you expect it to and to provide a more personalized web experience. However, you can choose not to allow certain types of cookies, which may impact your experience of the site and the services we are able to offer. Click on the different category headings to find out more and change our default settings according to your preference. You cannot opt-out of our First Party Strictly Necessary Cookies as they are deployed in order to ensure the proper functioning of our website (such as prompting the cookie banner and remembering your settings, to log into your account, to redirect you when you log out, etc.). For more information about the First and Third Party Cookies used please follow this link.

Allow All Cookies

Manage Consent Preferences

Strictly Necessary Cookies - Always Active

We do not allow you to opt-out of our certain cookies, as they are necessary to ensure the proper functioning of our website (such as prompting our cookie banner and remembering your privacy choices) and/or to monitor site performance. These cookies are not used in a way that constitutes a “sale” of your data under the CCPA. You can set your browser to block or alert you about these cookies, but some parts of the site will not work as intended if you do so. You can usually find these settings in the Options or Preferences menu of your browser. Visit www.allaboutcookies.org to learn more.

Sale of Personal Data, Targeting & Social Media Cookies

Under the California Consumer Privacy Act, you have the right to opt-out of the sale of your personal information to third parties. These cookies collect information for analytics and to personalize your experience with targeted ads. You may exercise your right to opt out of the sale of personal information by using this toggle switch. If you opt out we will not be able to offer you personalised ads and will not hand over your personal information to any third parties. Additionally, you may contact our legal department for further clarification about your rights as a California consumer by using this Exercise My Rights link

If you have enabled privacy controls on your browser (such as a plugin), we have to take that as a valid request to opt-out. Therefore we would not be able to track your activity through the web. This may affect our ability to personalize ads according to your preferences.

Targeting cookies may be set through our site by our advertising partners. They may be used by those companies to build a profile of your interests and show you relevant adverts on other sites. They do not store directly personal information, but are based on uniquely identifying your browser and internet device. If you do not allow these cookies, you will experience less targeted advertising.

Social media cookies are set by a range of social media services that we have added to the site to enable you to share our content with your friends and networks. They are capable of tracking your browser across other sites and building up a profile of your interests. This may impact the content and messages you see on other websites you visit. If you do not allow these cookies you may not be able to use or see these sharing tools.

If you want to opt out of all of our lead reports and lists, please submit a privacy request at our Do Not Sell page.

Save Settings
Cookie Preferences Cookie List

Cookie List

A cookie is a small piece of data (text file) that a website – when visited by a user – asks your browser to store on your device in order to remember information about you, such as your language preference or login information. Those cookies are set by us and called first-party cookies. We also use third-party cookies – which are cookies from a domain different than the domain of the website you are visiting – for our advertising and marketing efforts. More specifically, we use cookies and other tracking technologies for the following purposes:

Strictly Necessary Cookies

We do not allow you to opt-out of our certain cookies, as they are necessary to ensure the proper functioning of our website (such as prompting our cookie banner and remembering your privacy choices) and/or to monitor site performance. These cookies are not used in a way that constitutes a “sale” of your data under the CCPA. You can set your browser to block or alert you about these cookies, but some parts of the site will not work as intended if you do so. You can usually find these settings in the Options or Preferences menu of your browser. Visit www.allaboutcookies.org to learn more.

Functional Cookies

We do not allow you to opt-out of our certain cookies, as they are necessary to ensure the proper functioning of our website (such as prompting our cookie banner and remembering your privacy choices) and/or to monitor site performance. These cookies are not used in a way that constitutes a “sale” of your data under the CCPA. You can set your browser to block or alert you about these cookies, but some parts of the site will not work as intended if you do so. You can usually find these settings in the Options or Preferences menu of your browser. Visit www.allaboutcookies.org to learn more.

Performance Cookies

We do not allow you to opt-out of our certain cookies, as they are necessary to ensure the proper functioning of our website (such as prompting our cookie banner and remembering your privacy choices) and/or to monitor site performance. These cookies are not used in a way that constitutes a “sale” of your data under the CCPA. You can set your browser to block or alert you about these cookies, but some parts of the site will not work as intended if you do so. You can usually find these settings in the Options or Preferences menu of your browser. Visit www.allaboutcookies.org to learn more.

Sale of Personal Data

We also use cookies to personalize your experience on our websites, including by determining the most relevant content and advertisements to show you, and to monitor site traffic and performance, so that we may improve our websites and your experience. You may opt out of our use of such cookies (and the associated “sale” of your Personal Information) by using this toggle switch. You will still see some advertising, regardless of your selection. Because we do not track you across different devices, browsers and GEMG properties, your selection will take effect only on this browser, this device and this website.

Social Media Cookies

We also use cookies to personalize your experience on our websites, including by determining the most relevant content and advertisements to show you, and to monitor site traffic and performance, so that we may improve our websites and your experience. You may opt out of our use of such cookies (and the associated “sale” of your Personal Information) by using this toggle switch. You will still see some advertising, regardless of your selection. Because we do not track you across different devices, browsers and GEMG properties, your selection will take effect only on this browser, this device and this website.

Targeting Cookies

We also use cookies to personalize your experience on our websites, including by determining the most relevant content and advertisements to show you, and to monitor site traffic and performance, so that we may improve our websites and your experience. You may opt out of our use of such cookies (and the associated “sale” of your Personal Information) by using this toggle switch. You will still see some advertising, regardless of your selection. Because we do not track you across different devices, browsers and GEMG properties, your selection will take effect only on this browser, this device and this website.