With the emergence of m-health, the notion that technology can actually be good for healthcare seems to have definitively taken a hold. It may seem obvious to many, given the enormous progress in life expectancy gained in Western countries since the advent of modern medicine, but this is not the case. Distrust of science and institutions has spread like wildfire, contaminating what until recently were considered achievements (from vaccines to fast mobile internet technologies).
However, connection and data sharing are essential components of the daily lives of billions of people, and the perfect tool for these purposes is the smartphone. For some years now, institutions, scientists, governments, companies and hospitals have been wondering whether this type of device can be used for medical research and healthcare. This has led to the development of m-health, a set of knowledge and technologies that makes use of smartphones and other mobile devices with the aim of improving the quality and efficiency of healthcare systems.
Another way to address the issue of m-health is: what if we, as users, no longer had to follow technology’s latest innovations, but technology followed us? What if tech systems monitored our health, prevented illness and even treated us wherever we were?
The first definition of m-health, fifteen years ago, was very general: the use of “emerging mobile and networked communication technologies in healthcare” (Istepanian, 2006). A second definition, used in 2010 by the US National Institutes of Health’s ‘m-Health Summit’, already marks a step change: ‘The provision of health services through mobile communication devices’. Subsequent interpretations tend to emphasise the interest of m-health in medical research.
The World Health Organisation (WHO) in 2018 spoke of m-health simply as ‘the use of wireless mobile technologies for public health’. The deliberately vague phrase seems to have a dual purpose: to highlight the infinite potential of m-health while simultaneously excluding the self-care apps proliferating on app stores.
The WHO goes on to define m-health as “an integral part of e-health” and mobile technologies as “particularly relevant because of their ease of use, broad reach and wide acceptance”.
A growing segment of the global population is increasingly turning to their mobile devices to access health information and services.
Mobility, no longer just digitalisation or dematerialisation, is m-health’s answer to the health needs of a citizenry on the move: you don’t necessarily need to be at a medical centre at all stages of an illness or its prevention, because the health services provided through your smartphone are always with you. The ability to carry a device in your pocket through which you can book a doctor’s appointment, receive blood test results, request a consultation, monitor and correct your harmful habits and receive alerts on health emergencies is an undoubted advantage for both individual and collective health.
Much emphasis is placed on wireless communication technologies for healthcare and medical research in remote locations or emerging countries where the use of m-health can save time and money.
The UK’s National Institute for Health and Care Excellence (NICE), in a study in collaboration with the National Health System (NHS), categorised m-health apps into three different types:
The first ones are especially relevant in cases of emergency triage, when symptoms are most evident. Advances in image-recognition software have made apps for diagnostics through photographs and movement recordings particularly efficient.
The second type has more to do with prevention and information, partly through the use of smartwatches and other wearable devices that can monitor diet, physical activity and blood sugar levels and is the one that has produced the least results so far from a clinical point of view. In all likelihood, this is because these applications are closely related to patients’ personal habits and perceptions, and because there is often a lack of standards at state level that developers should aim for. At the same time, developers are often under pressure from their funders to deliver operational applications quickly.
Finally, digital therapy applications are particularly suitable for the treatment of depression, stress, insomnia, chronic pain and for facilitating in certain circumstances the meeting – even anonymously – of patients with the same condition, as in the case of HIV patients.
Another area where m-health is finding enormous potential is in monitoring and surveillance of the spread of diseases around the world. M-health applications collect aggregate data, while digital health technologies compute and correlate these data, making assumptions about causal and correlative relationships between diseases and environmental factors. In addition, m-health technologies are already being used to contain epidemics by exploiting the clustering and case-tracking capabilities of mobile devices.
The need to exploit this aspect has been made more evident than ever by the coronavirus pandemic.
Several studies, from 2014 to March 2020, underlined the multiple positive effects of using m-health during an epidemic or pandemic: tele-visits, real-time information for healthcare professionals, educational, diagnostic and treatment programmes, and population monitoring.