e-Health and m-health (mobile health) come up when the digital transformation breaks into the medical sector. What do they mean and how can they help healthcare around the world? Let’s find it out together in this article of the JOurnal.
In 2018, according to Audiweb data, more than 40 million Italians spent almost 3 hours a day online, 75% of them using a smartphone.
Surely, the way people are online help us to find out more about them.
Reading online newspapers, browsing social media, playing with apps, shopping through e-commerce, booking trips or avoiding boring queues using online payment services are just some of the possibilities offered by the Internet and the digital world. Nevertheless, there are also other sectors in which smartphones and tablets can actually be used as medical devices to help people to improve their lifestyle and health.
The medical and health sectors, in fact, are increasingly affected by the digital transformation and the next future significant changes will be seen in the e-health context.
Just to give some practical examples, thanks to specific apps you can already interact directly with the doctor, monitor the progress of a therapy, of physiological parameters and receive advice and suggestions on treatments at any time and any place.
E-HEALTH AND M-HEALTH: DIGITAL HEALTH THANKS TO THE SMARTPHONE
The term e-health refers to the use of information technology and telecommunications in the health sector. Since the end of the nineties, there was a first formal definition of e-health and even then, the opportunities and challenges that the new digital technologies brought to the attention of clinicians were already clear. Many of the technologies that we now consider part of our daily lives were almost unthinkable a few decades ago. Just think about the renewal of prescriptions, the online booking and the sharing of health data through specific medical software and medical devices. The digital ecosystem encompasses a myriad of technologies and concepts and there is no real clear distinction between categories within digital health.
Just to make an example, m-Health refers to the use of mobile devices in medicine and health, it is a sub category of e-health. The term m-health is often used referring to the use of mobile technology and communication tools such as smartphones, tablets, PDAs and wearable devices like smart watches for the prevention, promotion, treatment and maintenance of health, information and data collection.
m-Health and e-health interventions are beneficial for several reasons, for example:
- availability and accessibility of the services offered, which can be used anywhere and at any time;
- favourable distribution from an economic point of view;
- possibility to customise the contents;
- ability to provide real-time strategies to the users;
- possibility to calibrate the intensity of the intervention based on the user's needs.
The growing percentage of citizens who use the mobile health technology, is leading to the development of specific solutions for mobile devices. For example, nowadays it is possible to access health services via smartphone.
e-Health, widely used in the industrialised nations, is also spreading in the developing countries and in the less developed ones and is certainly the ideal means to provide quality healthcare also for economically disadvantaged groups, being also a stimulus to improve the capacity of health systems in all countries. Through the collection of health data and the sending of healthcare information to doctors and researchers, thanks to digital tools it is possible to monitor the patient’s health in real time and propose a direct and personalised care.
THE SUPPORT OF M-HEALTH TO THE HEALTH SECTOR
Due to the economic disparities in the world, the mobile devices cannot be used anywhere to provide health care to the entire world population. Nevertheless, the proliferation of mobile devices is certainly a stimulus for the development of mobile health apps. Although the advent of global electronic health and mobile health has been going on for two decades, many people are still uncertain about the uses and benefits of these new technologies.
According to the World Health Organization (WHO), m-health is “a practice of public and medical health care supported by mobile devices, such as smartphones, patient monitoring devices, personalised digital assistance and other wireless devices”. Besides the advantage of keeping us always connected to the health workers, how else can mobile health improve our well-being? Certainly, by allowing a better therapeutic adherence and providing aggregated data on the patient’s state of health.
One of the biggest challenges for healthcare professionals is to make sure that patients follow the prescription and treatment correctly. In this sense, apps that remind patients of which medicine to assume can be very useful. The lack of therapeutic adherence is “due to the poor therapeutic result, the continuation of the pathology, and a burden in avoidable direct costs for the health system and for families”.
Various medical devices and mobile health apps already exist both on Google Play Store and Apple Store:
- apps that help people follow medical prescriptions through traceable pills;
- apps that suggest taking a certain drug or recording all the symptoms;
- apps that allow the patient to communicate with the doctor;
- apps that help prevent obesity by improving our habits and monitoring physical activity;
- apps that are able to collect the health data of the patient and of the population in general, storing them in a single place.
OPPOSITIONS IN THE USE OF MOBILE HEALTH
Every technological innovation is bearer of changes and brings with it a certain degree of mistrust. The main problems encountered are the doubts related to the data protection and the difficulty in using mobile devices.
To overcome these oppositions, it is necessary that all stakeholders of the health system, institutional bodies, health system, companies, doctors and patients, converge in the same direction. The common goal must be selecting the best tools for mobile health, establish guidelines for the management of sensitive data and create real protocols and care models.
Currently, most digital healthcare technologies are limited to single services such as the confirmation of an appointment via SMS, the sending of medical reports via email and the use of wearable apps and devices that monitor individual parameters. There are specific apps that can measure and track some parameters like blood glucose and arterial pressure, as well as physical activity in general.
The digital health sector faces substantial challenges that must be taken into account in any analysis of insurance and liability:
- regulatory and legal frameworks that fail to keep pace with innovation, adoption and use;
- consumer concerns about security and privacy;
- disruption issues and fragmented systems: both technical (software, platforms, etc.) and 'system structure';
- equity issues arising from rapid digital deployments: problems of digital literacy, digital access ('digital divide') and impact on vulnerable groups (e.g. the elderly).
E-HEALTH AND M-HEALTH: NEW OPPORTUNITIES
The reduction in the costs of health spending is certainly one of the most important points in favour of m-Health. It enables patients to easily access online health services and to make the delivery of health services more efficient, allowing the performance of remote services, such as constant monitoring, prescription of drugs or analysis and control visits. This is a crucial aspect especially for nations that have very long-life expectancies and where healthcare spending for older people has a high cost.
In addition to the practical aspects, the perspective for health professionals and patients also changes: doctors can easily communicate with colleagues and they can benefit from long life training and the new standards can be shared to improve the quality of care.
From the patient’s point of view, instead, we talk about engagement: what is taken into consideration is not only the diagnosis, but also the socio-cultural context and the behavioural, cognitive and emotional dimensions.. Indeed, the active involvement of the patient is one of the key features of e-health.
E-HEALTH AND M-HEALTH: FUTURE GOALS
The main purpose of e-health technologies is certainly their large-scale diffusion and cost containment without having to compromise on quality. Nevertheless, what are the factors that can influence the results of e-health interventions in various ways?
While computer science is running fast, the evolution of health systems is linked to bureaucratic and operational aspects that affect the implementation of these new technologies, although already approved.
The major problems encountered are related to the outdated facilities, the lack of shared protocols and lifelong training.
THE USE OF BIG DATA FOR M-HEALTH
In order to develop new and effective therapies, medicine needs data and experiments. Today, thanks to big data, it is possible to manage the large amount of data from the mobile devices used to track the medical conditions of patients. These data can be reworked to identify patterns that can lead to revolutionary breakthroughs. For example, recognising the genetic markers responsible for various chronic conditions such as diabetes, shifting the medical paradigm from treatment to prevention.
In addition, data from electronic medical records and other sources can be integrated to “train” machine learning algorithms and provide personalised answers.
CONCLUSION
E-health represents an innovation that connects new technologies, the clinical and administrative processes of healthcare companies and the skills of the people working in the sector.
Among the few Italian software houses focused on e-health, we would like to highlight IPPOCRATE AS, a company specialised in the development of digital tools for medical care and to support prevention, diagnosis and treatment.