Laing SS (2018) Affordable and Effective Healthcare Might Simply be Mobile Health Care. Ann Community Med Pract 4(1): 1029.

Effective healthcare delivery might just be Smart phone driven health care. Citizens in the US are attached to their smart phones; according to a recent PEW Research Center, Internet and Technology report, 77% of Americans own smart phones. Ownership is 64% for individuals earning less than $30k/year and now reach 42% for adults 65 years and older. Most relevant is the fact that majorities of low income communities are using their devices to look up and self-manage health. How can mobile technology make a real difference in people’s lives? Mobile phones, apps and wearable devices enable remote monitoring of health status such as heart rate and blood pressure; permit access to health education and health-based resources; increase patient connectivity with healthcare providers via remote transmission of patient data and texting of clinical recommendations; and, allow patients to self-manage health via behavioral changes linked to health status monitoring. Support for patient engagement in their health and wellness by leveraging resources to which they already have access can be a model for helping to improve the healthcare system and lower healthcare costs.

Research on the potential health benefits of mobile technology offers promising results. A population-based study out of Northwestern University’s Feinberg School of Medicine demonstrated the effectiveness of texting to manage diabetes. Researchers deployed text messages to diabetic patients in India, which reminded respondents to engage in healthy lifestyle practices that can curb incidence of diabetes - regular physical activities; uptake of fruits and vegetables; reduction of sugar intake. The study reported a 40% improvement in fruit, vegetable and fat consumption for the group receiving text messages relative to that not receiving the intervention. A second study used lifestyle-focused text messaging to provide motivation, reminders and advice to 710 Australian patients to engage in positive lifestyle behaviors shown to be risks associated with cardiovascular disease. Investigators reported reductions in patients’ bad cholesterol (low-density lipoprotein), systolic blood pressure, smoking and body mass index, with a corresponding increase in patients’ physical activity engagement.

In the United States, leading healthcare institutions have noticed and have integrated mobile technologies into existing healthcare practices. The Mount Sinai Icahn School of Medicine recently developed and implemented Prescription Universe – RxUniverse. The program is a ‘digital healthcare delivery system’ that allows physicians to ‘digitally prescribe’ evidence-based mobile apps to patients. The approach enables doctors to include digital-based health information into current practices, which means capturing patients’ health information in real-time, while simultaneously obtaining feedback about what does and does not work, and then tailoring treatment for the patient accordingly. A pilot program in which physicians were expected to prescribe apps as part of patient care, delivered digital health to more than 2,000 patients.

The ongoing research showing positive health outcomes and the steps taken by leading healthcare institutions to integrate mobile technology into patient care demonstrate the potential value of mobile health innovation to increase healthcare access and improve health outcomes. More research is needed to show the long-term health value and sustainability of the innovation. As researchers, there are still more questions that must be tackled as we consider full integration of digital healthcare into the day-to-day lives of all members of our communities, including low-income populations-How might we help low-resource communities sustain engagement with digital health technology so that positive benefits for chronic diseases management can be realized over the long-term? How do we support low-resource, older adults to feel confident in engaging in the technology to help manage multiple health conditions? What are ways to integrate the experiences of family caregivers in caring for older adult family members by reducing ‘hands-on’ support, gradually returning independence to the care-receiver, and freeing up the caregiver to meet his or her personal needs? Answers to these questions require taking an approach that continues to put the patient first in his/her healthcare decision-making and self-management; this is the genius of smart phone driven healthcare and it is up to researchers and health communities to actualize its fullest potential.