eHealth and mHealth (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 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-commerces, 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 eHealth 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 physical activity in general and receive advice and suggestions on treatments at any time and any place.
EHEALTH AND MOBILE HEALTH: DIGITAL HEALTH THANKS TO THE SMARTPHONE
The term eHealth 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 eHealth 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 softwares and medical devices.
mHealth refers to the use of mobile devices in medicine and health, it is a sub category of eHealth. The term mhealth 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.
mHealth and eHealth interventions are beneficial for several reasons, for example:
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.
eHealth, widely used in the industrialised nations, is also spreading in the developing countries and in the less developed ones. eHealth is certainly the ideal means to provide quality healthcare also for economically disadvantaged groups and it is 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 the digital tools it is possible to monitor the patient’s health in real time and propose a direct and personalised care.
THE SUPPORT OF MHEALTH 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, mHealth 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 mHealth 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, the 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 – from billions of dollars a year – 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:
OPPOSITIONS IN THE USE OF HEALTH FURNITURE
Every technological innovation is bearer of changes and inevitably 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.
One of the best-known examples is the Tinnitracks app which allows you to heal tinnitus (an auditory disturbance consisting of noises such as whistles, hums, etc.) without using drugs, but listening to music (using the app) for 90 minutes a day and for at least 12 months.
To enable the growth of mHealth, there is a need for serious regulation that goes beyond the socio-political and health boundaries for the provision of health care. The future of healthcare is all around the patient, but the patient has no decision-making power. Insurance companies, large pharmaceutical companies, doctors, managers, suppliers, manufacturers, governments and many other forces influence the future of health.
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 great potential of mobile technology in the health field, however, does not seem to be enough for an organisational and administrative update: in fact, the reduction of costs and the implementation of adequate tools should go hand in hand with an adequate training of the health professionals.
eHealth can be an excellent support to traditional healthcare to monitor patients’ psychophysical conditions and their vital parameters in real time. In this way, the patient becomes an active part of the healing and therapy management process.
EHEALTH AND MOBILE HEALTH: NEW OPPORTUNITIES
The reduction in the costs of health spending is certainly one of the most important points in favour of mHealth. 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. Especially in the case of chronic diseases, the intervention must also include psychological support. Indeed, the active involvement of the patient is one of the key features of eHealth.
It is not easy to combine health information sharing, self-monitoring instructions and patient’s active involvement. Precisely for these reasons, mHealth appears to be the most valid answer to create new protocols and manage the treatment in a more functional manner.
EHEALTH AND MHEALTH: FUTURE GOALS
The main purpose of eHealth 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 eHealth interventions in various ways?
Obviously, 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. Even the lack of a direct relationship with the patient and the fear that a reduction in costs corresponds to an impoverishment of the quality of services generate many doubts.
THE USE OF BIG DATA FOR MHEALTH
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. This 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.