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March 19, 2011 presentation at the Annual conference for the Association for Prevention Teaching and Research on opportunities for students to be engaged with mHealth.
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Student mHealth Engagement
Jessica JacobsGeorgetown University
Association for Prevention Teaching and Research - Annual ConferenceMarch 19th 2011
Learning about the Preventive Health IT Toolbox
What is mHealth?
Current Trends
Applications
Why Education?
What is mHealth?: Questions to Consider
There is not a consensus on what mHealth is.
Questions to Consider:
1) What kind of connection does it have to have? Broadband? Wifi? Wired Internet?
2) What technology does it include? Cell phones? PDAs? Devices? Computers?
3) What’s the application? Clinical Data? Community Health? Personal Health?
4) What’s it part of? Telehealth? eHealth?
What is mHealth?: Broad Definition
All the definitions focus on mobile communications and healthcare.
Broader definitions seem to be gaining more steam.
“The integration of mobile technology, computing devices, and emerging delivery system capabilities into a patient-centered
model of care.”
– Indian Health Service US Department of Health and Human Services
What is mHealth?
Current Trends
Applications
Why Education?
Current Trends: Technology Adoption
90% 86%
59%
88%
72%
38%
82%
47%
15%
57%
11% 6%
Own a Cellphone Send/Receive Text Messages
Access Internet on a Cell Phone
Utilization of Mobile TechnologyAged 18-29 Aged 30-49 Aged 50-64 Aged 65 and Over
Current Trends: Federal Support
•HITECH Act to spur the adoption of EHRs, HIEs, and other Health IT.
•Provisions in PPACA for telehealth and innovation in healthcare.
•Continued Presidential commitment to “the need to increase coverage of high speed wireless networks to 98 percent of all Americans within the next five years”: “This isn’t about faster Internet or fewer dropped calls. It’s about connecting every part of America to the digital age. It’s about a rural community in Iowa or Alabama where farmers and small business owners will be able to sell their products all over the world. It’s about a firefighter who can download the design of a burning building onto a handheld device; a student who can take classes with a digital textbook; or
a patient who can have face-to-face video chats with her doctor.”
- President Barack Obama 2011 State of the Union Address
What is mHealth?
Current Trends
Applications
Why Education?
Applications: Continuum
Management Promotion Surveillance
Personal PopulationPublic
Applications: Management
10
•Patient-centered personal health management.
•Patient or care-giver driven.
•Typically includes a device or smartphoneapplication.
•PHR and EHR integration is possible.
•Particularly beneficial for conditions where continual tracking is warranted:
•Diabetes•Asthma/COPD•CHF•Aging in Place•Medication Adherence
Applications: Management - Diabetes
Link glucose meter readings to patient records electronically.
This link ensures that readings are recorded correctly and allows for physicians to passively monitor a patient’s blood glucose.
Pilot studies show that this kind of application is effective; indeed, it is correlated to a reduction of 5 points in blood glucose readings and a 1% reduction in HbA1c readings over a three-month period.
Watson et al. “Diabetes Connected Health: A Pilot Study of a Patient- and Provider-Shared Glucose Monitoring Web Application” Journal of Diabetes Science and Technology, March 2009, Volume 3, Issue 2: Page 345-352. http://www.connected-health.org/programs/diabetes/research-materials--external-resources/diabetes-connected-health-a-pilot-study-of-a-patient--and-provider-shared-glucose-monitoring-web-application.aspx
Applications: Promotion
12
• Educational messages targeted at behavior modification.
• Public Health department/federally driven.
• Usually utilizes cell phone messaging because it’s quick, easy, and cheap.
• May be one way or two way messaging.
• Particularly beneficial for chronic. Smoking Cessation Sexual Health Pregnancy Depression
Applications: Promotion – text4baby
13
Free national SMS health information service. One way text messaging.
Large public-private partnership. Healthy Mothers Healthy Babies (HMHB), Voxiva, The
Wireless Foundation (CTIA), HHS/OSTP, J&J, etc. 3 messages/week.
Pregnancy through first year of child’s life.
0% 20% 40% 60% 80% 100%
“1 Million Moms” 2012 Goal
Current Enrollment To Go
* As of February 2012, http://www.text4baby.org/news/mothers_are_getting_message.html
Applications: Surveillance
14
• Health tracking for timely notification.
• Health Worker and/or community driven.
• Low cost reporting mechanisms.
• Particularly useful in remote areas.• Web and SMS based.
• Potentially Useful for: • Disease Outbreaks• Program Evaluation• Contaminations
Applications: Surveillance - EpiSurveyor
Allows people to design forms for data collection on the internet.
Data is entered into the forms using either a smart phone application or SMS messaging.
Allows for real-time data uploads and analysis.
Been used to evaluate: anti-malarial bednet distribution and vaccination
campaigns in sub-Saharan Africa clean water initiatives in Vietnam drug supplies in several African countries health delivery systems in Guatemala
* 2011 World Bank Report: http://siteresources.worldbank.org/INTLAC/Resources/257803-1269390034020/EnBreve_166_Web.pdf
"drastically cut costs while facilitating quality control
and improving implementation speed.“
- The World Bank
What is mHealth?
Current Trends
Applications
Why Education?
Why Education?
Prepare to engage and be engaged with mHealth.
Contribute to the growing body of knowledge.
Review for efficacy and separate “signal” from “noise.”
Innovate to discover applications for new and existing technologies.
Opportunity
In Conclusion…
Current trends show that the utilization of mHealth will increase.
Its applications are numerous and widely encompassing: Management: Connecting mHealth applications with
traditional health IT systems will provide a groundbreaking continuum of personal care, particularly for those with chronic conditions.
Promotion: Wide scale education and behavior modification will improve the health of the public.
Surveillance: Real-time health tracking and data aggregation leads to actionable information for population health.
There is significant opportunity for educators to inform and engage students with these technologies.
Source: http://www.healthcareitnews.com/news/mhealth-apps-forecast-increase-threefold-2012-0
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