mHealth leverages the power and ubiquity of mobile technologies to assist individuals and their care providers in monitoring and managing symptoms, side effects and treatment for chronic illnesses outside the clinical setting, and to assess and address the lifestyle factors that can bring on or exacerbate these conditions. By empowering individuals to track and manage their key health-related behaviors and outcomes, this approach has the potential to greatly improve people's health and quality of life, while simultaneously reducing society's overall healthcare costs.
mHealth can incorporate a variety of techniques, including automated activity logs, as well as care plan adherence reminders, and prompted symptom and side-effect self-reports. Employed by individuals, mHealth data can provide insights into what might be contributing to the recurrence of a chronic problem, or help individuals track and sustain a plan to become healthier through better diet, exercise, sleep, and stress management. The software and methodologies for designing and evaluating mHealth are adaptable to a wide variety of chronic disease interventions. For example: a pre-diabetic woman using an application to keep tabs on how her eating and exercise habits affect her weight and energy levels; a soldier returning to civilian life with PTSD working with his clinician to identify the most effective treatment plan by self-reporting on the number, duration and severity of episodes he experiences; a young man and his clinician struggling to find an effective treatment plan for his depression using a mHealth application to determine why the current regimen isn't improving the patient's mood and the role played by his erratic sleep habits.
From a research perspective, four technology-themed issues are key to the impact of mHealth interventions.
Establishing and sustaining engagement among participants is critical to the success of any mHealth intervention. Applications must ensure that participants can see the impact of their contributed data as well as aspects of other community members' contributions. Potential innovations in this area also include building social-media game mechanics into the application experience by offering incentives such as badges and data-driven live wall-papers.
The greatest need for advancement is in the development, evaluation, and continuous improvement of how we make sense of these data streams. mHealth data analysis methods range from simple analysis and graphing applications to mashup-like spatial visualization of fused data sources. The analysis and visualization tools must be designed along with the applications, with clinicians and participants able to view and interact with data — presented in a useful and engaging way — during the collection process.
Particularly when contributing data about their health and living patterns, many participants are understandably concerned about privacy issues. The challenge for system designers is to balance mHealth's inherent benefits - sharing, collaboration, and ease of use - against the risk of revealing too much personal information to third parties. For example, rather than automatically uploading all raw data to a third party, privacy mechanisms such as personal data vaults (where the individuals data is encrypted and stored) would enable participants to specify what information is shared, with whom and for how long.
Increasingly, mHealth will become supportable by commercially available tools on people's everyday smartphones. As the technology is shaped in this nascent period, an open, shared architecture is essential. Just as the iPhone and Android App Stores and Firefox browser have made it easy for third-party developers to innovate and proliferate, an open architecture paves the way for rapid exploration and innovation, as well as continuous iterative improvement, particularly in the area of data analysis, visualization, and interpretation.
There are many opportunities for applying mHealth technology within the CTSI community. Starting this September, we will begin an informal working group to gather and share needs and experiences with mHealth and to promote the development and use of best practices, applicable methodologis, and open software tools.
Please join us at our monthly upcoming meet-ups in the Bel Air Room, 17-323 CHS on Thursdays at 3:00PM.
If you have particular topics you would like to discuss, please send us your suggestions. And if you are interested in using mHealth in an upcoming or ongoing project, please contact destrin@cs.ucla.edu.
