Global mobile usage is rising rapidly and the mobile industry continues to scale rapidly, with a total of 5.3 billion mobile subscribers. Half of the world’s population now have a mobile subscription—up from just one in five 10 years ago. An additional one billion subscribers are predicted by 2020, taking the global penetration rate to approximately 60 percent. There were 7.1 billion global SIM connections at the end of 2014. The mobile phone has become the most pervasive communications technology platform. When we look at the spread of mobile phones, especially smart phones, users in developed countries have the deepest penetration. This trend has not been limited to developed countries. In fact, developing countries are also seeing massive growth, with 3.8 billion mobile subscriptions in the developing world alone. Because of major developments in communications infrastructure in the past decade, mobile connections have now significantly penetrated rural areas and remote locations. Eighty percent of rural communities across the globe now have access to a mobile network.
India has more than 826 million mobile phone subscribers as of 2011. Essentially, this network serves nearly 70 percent of India’s population of 1.2 billion. Also, in India three percent of households have a computer with an Internet connection, and 69 percent of households have a mobile phone. Smartphone adoption has also increased, with shipments having risen by 167 percent. These factors drive the usage of mobile phones in healthcare.
The Rise of Mobile Health
The cost of healthcare is increasing rapidly day by day, and as a result healthcare is becoming more unaffordable without insurance. As such, there is greater public awareness of health issues and impetus for people to look closely at preventive measures they can take against avoidable medical conditions. This applies to the general populace of developing countries as much as it does to those in developed countries. Given that and the ubiquity of smart phones, more and more people are using their mobile devices to monitor, track and manage their health than ever before.
Indeed, mobile phones are the natural choice for people because they already are doing a lot, if not most, of their daily activities on them, whether at work, in business or going about personal tasks. Today, there are more than 100,000 mobile health (mHealth) apps on the market. Consumers are tracking their overall health and fitness with these apps, and becoming engaged and active participants in the monitoring and management of their health and that of their loved ones.
Clinicians also are increasing the rate at which they are adopting mHealth tools and apps. More than half of clinicians–53 percent–use a tablet to access electronic health records, take notes or send e-prescriptions, and nearly half–48 percent–use smartphones to search for information. Mobile health startups are gaining momentum, experiencing an 87 percent year-over-year growth over the same quarter in 2013. Mobile devices and apps are becoming an integral part of telemedicine. Telemedicine is now a preferred means for patients to connect and communicate with physicians remotely: 84 percent of young adults between 18 to 34 years of age said if given a choice they would choose to have a consultation via a mobile device. The most common activities being performed using mHealth (ranked by frequency) are patient enquiries, appointment reminders or requests (via SMS), telemedicine, accessing patient records, measuring treatment compliance, raising health awareness, monitoring patients and physician decision support.
North America (the US and Canada) and Europe combined have 60 percent share of the global market, whereas APAC holds 30 percent, out of which India–despite having the second highest population in the world, with 864 million mobile device customers–makes up only 8 percent. For contrast, consider that the US has 327 million mobile device customers but representing 28 percent of the mobile health market. These numbers indicate that there is a tremendous market opportunity for the APAC region, especially in India where mobile usage continues to grow rapidly because of its affordability and accessibility.
Mobile Health: Applications and Contexts
The World Health Organisation (WHO) has defined mHealth as the “provision of health services and information via mobile technologies such as mobile phones and Personal Digital Assistants (PDAs).” So it basically encompasses the delivery of healthcare services via mobile communication devices.
mHealth can be used in variety of situations, particularly those involving the point-of-care or during interactions with patients. It helps patients by giving them tools to monitor their health conditions and communicate those results to physicians. It enables health providers to connect with colleagues, and offers patients alternative sources of information. It is also an important tool to inform policymakers on health delivery and medical outcomes.
The chart below shows a higher number of people age 60 or over in developing countries than in developed countries—this means that there is a tremendous opportunity for developing countries to grow their share of the mHealth market. Major problems associated with ageing are non-communicable diseases such as cardiovascular disease, cancer and mental conditions. As the number of elderly people has increased, so have the mortality rate and the prevalence of chronic illness. The growth in the number of people suffering from chronic illness (including cardiovascular disease, hypertension and diabetes), along with the increased costs of treatment and longer recovery times, has been troubling healthcare systems around the world for years now. This trend has to be checked, and one of the most viable means to do so–efficiently and cost-effectively for healthcare systems and sufferers of chronic illness–is through mHealth.
The figure below shows some of the areas that mobile phones can address in the mHealth ecosystem. Mobile devices can connect medical professionals with senior citizens to monitor and collect information about their chronic conditions. Some technologies are available to help older adults stick to their medication, diet and exercise plans, while others can identify and alert professionals to potential health problems. For example, devices that monitor sleep behavior and toilet use can provide caregivers with the early warning signs of urinary tract infections, a common condition affecting older people.
mHealth in Rural Healthcare
Access to healthcare services is critical for rural residents. All tertiary care organizations are situated in urban areas, so the majority of people living in rural areas do not have access to their services during emergencies. The rural population often experience barriers to healthcare that limit their ability to get the care they need. However, due in part to the affordability of the mobile phone and access to cellular networks, smartphone penetration is high in rural areas. This is one area where telehealth can truly help, increasing access to quality healthcare for rural communities.
Telehealth capabilities include those that enable video conferencing for consultations, storage and forwarding of medical/health reports, data, images and other multimedia content, remote patient monitoring, and a whole host of mHealth applications. By making all these possible, telehealth actually increases the reach and quality of care, even as it reduces readmissions and unnecessary emergency department visits for the residents of rural communities.
Clinical Communication during Care Transitions
Healthcare providers must exercise special care when looking after patients with acute conditions and chronic diseases, such as congestive heart failure (CHF) or cardiovascular diseases, who have just been discharged from a hospital to a step-down care facility. Even minute mistakes in their care administration can have tragic consequences. As such, it is imperative to ensure that there is always adequate and accurate communication between nurses and doctors in charge of their care—whether it is due to with their medication, therapy or any other course of treatment.
Technology can facilitate this level and quality of communication between care givers, irrespective of their physical locations.
One application designed to enable the required level and quality of communication between care givers, irrespective of their physical locations, is Napier’s electronic Mobile Medication Administration Record (eMAR), which ultimately helps ensure the 5Rs of medication administration (i.e. Right patient, Right medication, Right time, Right dose and Right route) are followed closely.
Mobile technology can also ensure the condition of recovering or convalescing patients is constantly monitored.
Once a patient is discharged from the hospital, he requires consistent care and management. Patients in hospital are usually being watched closely onsite by caregivers, who make sure they take their medication and have their vitals taken round-the-clock. Now, that level of care can be replicated in smaller facilities and even in the home of the patients—with affordable wearable devices that can manage a lot of sophisticated tasks ranging from basic physical activity tracking to even administering blood tests that check for biomarkers.
Telemonitoring assists the patient by enabling the monitoring of key parameters associated with managing their condition. A significant number of patients get re-hospitalized due to issues arising from their not taking their medication correctly. Telemonitoring tools today can help patients adhere to their medication regimes closely, and at the same time capture their vitals—doing this on their own and having all the details and updates automatically routed electronically to their respective doctors, who can spot problems and respond to them before they become critical health issues.
The Challenges of Care Co-ordination
The coordination of care as patients move or are moved between different physical locations has always been a specially challenging task. Patient and physician connections are essential. For instance, when the patient is not directly in front of the clinician, or when clinicians are out of the office or communicating between offices—these are times when providers may well be left under-informed and ill-equipped to deliver proper care if needed. The level of care they provide will be based mostly on: a lack of patient medical information; a lack of secure and convenient tools for communicating effectively with patients and other clinicians; and, a lack of a systematic ability to quickly and comprehensively document encounters in a way that supports continuity of care.
This is where electronic mobile care systems can be a great help: enabling healthcare providers to efficiently manage patient care while on the move anytime, anywhere with real-time access to patient clinical case notes, patient diagnosis including vital symptoms, medical history and allergies, laboratory results and prescription.
REFERENCES:
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- Yu, Xiaohui and Darrel West. Mhealth In China And The United States: How Mobile Technology Is Transforming Healthcare In The World’S Two Largest Economies. Dakota: Center for Technology Innovation, 2016. Print.