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

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• 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

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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

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• 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