Tuesday, August 29, 2017

The mHealth Data Deluge

Victoria L. Tiase, MSN, RN-BC
PhD Student, College of Nursing 
University of Utah

   With the advent of the smartphone, we have more data at our fingertips than ever before.  According to the Pew Research Center, 95% of Americans now own a cellphone of some kind and just over one-in-ten American adults are “smartphone-only” internet users - meaning they own a smartphone, but do not have traditional home broadband service. Android users have access to over 2.8 million apps and it’s estimated that there are over 165,000 health-related smartphone apps available for public use.  Health care apps are used for a variety of reasons such as health promotion, disease management and communication with providers.  However, for as ‘smart’ as we’ve become, there are still many unanswered questions worthy of research:  
        
1) Are users interested in using health apps and if so, how will they be used?  

2) Are providers prepared to receive another source of data?  What are the integration and visualization needs? 

3)  Can mHealth data help us understand more about populations?  What is the role of mHealth data in the co-production of health?



 The Supplier
            
           Health related applications are used for a variety of purposes.  Users are armed with data to make decisions, track vital signs or refill prescriptions from the palm of their hand.  Apple’s HealthKit and Google Fit allow users to bring together health data from multiple apps to be collated and organized for easy view.   The movement towards consumer-directed exchange is encouraging the development of methods to pull data from your medical records from your provider to an app on your phone allowing for sharing to chosen family members or providers.  All allowing users to have a vast amount of health data.
            However, very few apps are evidenced based. Additionally, a method to certify or credential health apps does not exist today.  It is unclear to what extent users understand the associated privacy and security issues with mHealth data; exactly what is being collected on their smartphone and who has access to it.   In addition, little work has been done to examine the health literacy issues; whether they are the same or different when it comes to mHealth data.   With these issues in mind, it is important to research the use aspects of health apps considering the development of new education strategies may be needed.  

The Translator

            Providers are still recovering from the transition from paper to electronic medical records and are left making sense of the sea of data that is constantly produced.  However, mHealth data can be an additional rich source of data that may not be captured during a visit assessment due to lack of time or poor recall. Some mHealth apps can serve as powerful tools to enhance the patient-provider dialogue and support shared decision making and thus add value to the relationship by allowing for communication that extends beyond the visit. But many providers are not prepared to collect and analyze mHealth data.   A recent study by PricewaterhouseCoopers found that the ability for providers to integrate data from mHealth devices is lacking.  Work is needed to understand how to make mHealth data actionable at the point-of-care in accordance with clinical workflows for greatest leverage.

  ....................................... 


                                                               
 
 













The Co-Production Future

            According to Dr. David Nash, “85 percent of a population’s well-being, its quality of life, is due to factors other than medical care” which means that only about 15% of healthcare occurs inside the four walls of a hospital or practice setting.  Ubiquitously, mHealth data allows for the collection of data anywhere, anytime.  It has potential to put patients in control of their personalized data and potentially, their health.  This can lead to a shift to the co-production of health by which patients and providers partner together, both experts armed with data, allowing healthcare to become relationship centered.

The deluge of mHealth data provides many opportunities to study ways to encourage behavior change, foster healthy lifestyles and support better management of chronic conditions.  Research is needed in the areas of usability, education and health care outcomes.  Ultimately the use of mHealth apps has the potential to encourage and empower patients, reduce workload on the system and improve health.  Our data research strategies should anticipate this future.

Links to Hyperlinked Text:


Apple’s HealthKit: https://www.apple.com/ios/health/





Additional Reading:

Batalden, M., Batalden, P., Margolis, P., Seid, M., Armstrong, G., Opipari-Arrigan, L., & Hartung, H. (2015). Coproduction of healthcare service. BMJ Quality Safety, bmjqs-2015.

Lobelo, F., Kelli, H. M., Tejedor, S. C., Pratt, M., McConnell, M. V., Martin, S. S., & Welk, G. J. (2016). The wild wild west: A framework to integrate mhealth software applications and wearables to support physical activity assessment, counseling and interventions for cardiovascular disease risk reduction. Progress in cardiovascular diseases, 58(6), 584-594.

Schnall, R., Rojas, M., Bakken, S., Brown, W., Carballo-Dieguez, A., Carry, M., ... & Travers, J. (2016). A user-centered model for designing consumer mobile health (mHealth) applications (apps). 
Journal of biomedical informatics, 60, 243-251.

Woldeyohannes, H. O., & Ngwenyama, O. K. (2017, July). Factors Influencing Acceptance and Continued Use of mHealth Apps. In International Conference on HCI in Business, Government, and Organizations (pp. 239-256). Springer, Cham.


No comments:

Post a Comment