Mobile health: an enabler of innovation across healthcare

David Hansen from the Australian e-Health Research Centre, which is owned by Australia's national science agency, The Commonwealth Scientific and Industrial Research Organisation (CSIRO) shares his views on mobile health and the rise of mhealth smartphone apps.

The consumerisation of Information Technology and the proliferation of mobile devices mean that we are increasingly interacting with the world through apps on our phones. We have apps for email, for sharing our lives with friends and family, for giving an opinion, following our sporting team, for ordering food – to name just a few of the apps on my smart phone. Apps are now part of our daily life – over 3.5 million Australians use smart devices to access the internet and app downloads are predicted to rise above 40 billion globally in 2013.

For healthcare, there are now new ways in which healthcare providers can provide health services to consumers, but increasingly new ways consumers can use information services to take care of their own health.

The largest difference is likely to be for people with one or more chronic diseases. A mobile app approach could completely change how a person manages with a chronic disease. Consider a Type 1 diabetic who may use an app to record information about their disease, such as the regular blood sugar levels taken regularly through the day. The app might be enhanced by incorporating a knowledge base of the carbohydrate content and glycemic index of foods that can provide a suggested insulin dose to the person. Artificial intelligence techniques could then be used to incorporate the persons' daily activity into the calculation then "learn" about the person's metabolism and predict the amount of insulin required to maintain the correct blood sugar level. Further, the app might enable blood sugar levels and insulin use to be provided to a GP for monitoring purposes – potentially allowing the GP to arrange checkups as required rather than at preset intervals.

Another group of patients who will benefit from mobile apps are those undergoing rehabilitation following a health episode, such as a heart attack or stroke. We recently completed a trial of a mobile phone based cardiac rehabilitation program. This program included some of the features described above, with patients capturing information such as daily blood pressure, smoking and drinking during the program and activity. The data was then provided to a health mentor who, through a weekly phone call, provided advice to the consumer on their progress through the rehabilitation process. Education was also provided through informational videos provided on the phone.

These examples show different aspects of mobile health – but importantly they indicate that mobile health apps can be tailored to suit the health service they are aiming to provide and the lifestyle goals of the person receiving the service.

Most current mobile health apps allow the consumer to record some information about themselves on a regular basis, such as their activity, readings from medical devices (such as blood pressure) or the food they are eating. That information can be used to track against their progress goals. Often these are combined with targets or information on a particular disease to help the patient self manage. Information about the health condition the app is aimed at will then help motivate the patient in reaching their goals. It is important that the advice given to the consumer is based on information forma trusted source.

Increasingly a level of intelligence is being added to mobile phone apps. This might include combining different types of data captured over time to learn something about the consumer's behaviour and provide personalized advice. Here, the quality of the personalized advice will depend on knowledge from a trusted source.

The above features of mobile health are aimed to provide guided self-care in the community – which will be important as chronic diseases increase in an increasingly aged community. However, mobile health will also be a growing and important tool used by health service providers to treat more people in the community and keep them out of increasingly busy hospitals.

Healthcare providers will increasingly use data that is uploaded from a mobile device to monitor, plan and treat patients. Health service providers can increase the efficiency of their healthcare while increasing the safety and quality of care given to patients. This approach intersects with the increasing use of electronic medical records by health services and national, regional or insurer summary healthcare records that are now being implemented. Data uploaded from a mobile phone app can then be combined with what the health services already knows. Computer algorithms will increasingly be used to monitor these data feeds and alert the health service when a consumer may need a check up or intervention.

The role of a research organization is to partner with health services in developing innovative ways of delivering health services and providing rigor in the development and evaluation of mobile apps in healthcare. CSIRO has now run a number of mobile health trials – from cardiac rehabilitation, COPD monitoring, aged care services and diet and nutrition – that show innovations such as these can provide a high quality and safe health service and increased efficiency.

About the author:

David Hansen is CEO of the Australian E-Health Research Centre, part of the CSIRO Computation informatics division. David leads a research portfolio developing information and communication technologies for the healthcare system. These include projects for resource planning, biomedical imaging, mobile and tele-health and technologies that will underpin the e-health architecture in Australia.

Prior to joining CSIRO, David worked for LION bioscience Ltd in the UK, developing genomic data and tool integration software that was used to publish the first human genome and is now used at over 200 pharmaceutical and biotechnology companies and research institutes worldwide.

What innovative mhealth apps have you seen recently?