Mobile Health (mHealth) opportunities
Although ACEBR’s main focus is on investigating biological effects of electromagnetic energy used in modern technologies, the technologies themselves offer exciting new possibilities in the delivery of healthcare, particularly in remote and rural regions. The following is a brief introduction to the ways that the technology behind hand-held mobile devices can be employed in Mobile Health (mHealth) initiatives and the opportunities and drawbacks that exist at the moment, particularly in relation to Australia, but also worldwide.
Within ACEBR we have skills in a number of areas of relevance to mHealth: physiological measurement techniques; knowledge of the characteristics of mobile signals & networks; modelling signal strengths & coverage; predicting human behaviours in relation to the uptake and use of mobile technologies and so on. We also, via our association with international health bodies such as WHO, and with various industry organisations, are well placed to blend health with technical know-how, particularly as it relates to rural and remote areas. In particular, the Swinburne ACEBR group have skills in understanding of mobile networks, data formats, encryption and data security techniques and smartphone handset capabilities, especially in the realms of biomedical measurement. We also have access to phone base-station site specifications and data on subscription patterns and we have links with carriers in other countries.
Aspects of mHealth
Diagnosis: Modern smartphone handsets have a number of built-in features (depending on the model) which can be used to aid diagnosis of illness.
- Camera and light: these can be accessed by apps to estimate physiological functioning such as heart rate and blood oxygen levels. High definition colour photographs can aid in assessing wounds, examining the mouth and throat, etc
- The accelerometer (which normally records changes in orientation of the phone, so that the display can be rotated): this can be used to analyse activities such as walking patterns, distance walked, and sleep activity
- GPS/base station information: this can give accurate data on location, speed of travel, location of nearby health centres, etc
- 3D Magnetic field sensor, which is used to orient maps on the phone to N: can be used for assistance in locating trapped or missing individuals
Medical diagnosis can also be achieved by connecting the phone to another device:
- Microscopy: using clip-on additional lenses or connecting to a traditional microscope via an adaptor. Images can be immediately transmitted via mobile or wireless network.
- Lung function: Bluetooth or cable connection to a spirometer, for example
- Heart function (ECG and Heart Rate): wireless connection to activity trackers, wrist-worn or via electrode belts
- Biochemical tests: Simple blood centrifuges or urine/saliva sampling with biochemical marker reading and analysis via the phone camera
- Genetic analysis using simple kits with on-phone analysis software
Treatment and patient management
- Monitoring and response to therapy: via simple texting or webpage-based dialogs
- Linking to clinical care centres: patient clerking and data logging; pre-admission forms adapted for phone formats
- Collection of patient data for long term planning and epidemiology: including patient consent and confidentiality provisions
- Triaging and on-line response: already in use in major emergency departments, but can be adapted for rural and remote areas
- Tracking patient compliance with recommended medications and treatments: from simple text reminders to ‘electronic pillboxes’
Disease control and elimination
- Mapping of outbreaks using GPS: to give information to optimise deployment of medical interventions
- SMS alerts for vaccination and other health interventions: from simple reminders to suggested time and location
- Logistics of supplies & personnel to health centres to meet demand: especially relevant to epidemics with delivery of vaccines or other medications to relevant centres
- SMS to give basic information regarding, for example, birth control and immunization
- General health and hygiene information targeted for particular settings, cultural and population groups
- Simple health messages via social media
- Information on screening and surveillance of epidemics specifically for remote populations
State of Play - some of the weaknesses
- Many projects are still in the pilot or exploratory stage, with only a modest level of uptake so far. One study reports on responses from a few thousand people from a total target population of 20 million. To have any real effect the uptake needs to be far higher
- Access of mobile networks involves a cost. In many developing countries the only realistic way to make mHealth generally acceptable is to subsidise data download/upload costs. Cost-benefit analyses are needed to convince governments that subsidies represent a good investment.
- Data availability and security: many of the ‘apps’ or activity trackers collect data which is then ‘owned’ by the app or device developers. The data are often not in a common format and therefore difficult to interface with other, more familiar, database programs. For use in health services, clients need assurance of data security.
Opportunities: ACEBR will
- Promote the use of mobile and wireless networks in the delivery of fast, efficient and cost-effective healthcare, particularly in remote and rural areas.
- Assemble a database of relevant research papers which will be accessible via this webpage.
- Consider what the current gaps in knowledge are and how these might be filled, particularly in relation to Australia and the Pacific region.
- Endeavour to test some of the diagnostic apps and devices to validate them against standard hospital or clinic equipment.