wear your heart on your sleeve

Wearable computing has special significance for mobile healthcare solutions as smartphone technologies enable fresh innovation, though there are some risks to consider.

The promise is good: wearable devices capable of monitoring your weight, activity levels, blood chemistry, glucose levels and so forth should help hard-pressed medical professionals access timely data on your personal health. This should enable relatively small teams to cater for at least some of the needs of an aging population.

The challenge is to ensure such devices can be trusted, notes Professor Christopher James, Chair of the IEEE UKRI Engineering in Medicine & Biology Society (EMBS) Chapter and Professor of Healthcare Technology at the University of Warwick. "Compliance is a huge issue in the healthcare space; anyone can add technology to a smartphone but does that make it a certified medical device?" said James.

Information may be power, but too little information can cause problems, he notes: "Self diagnosis is another big issue. Googling a headache is a dangerous game and can lead to all sorts of Web-doctor diagnoses, and if non-medically trained people were to start using this technology to check their own health, the risks of misdiagnosis are enormous, creating unnecessary worry."

A quick search on any app store shows numerous health and wellness apps, with a particular focus on exercise and diet. A 2012 Global Healthcare report claimed 70% of available health apps are for use by consumers. The challenge when it comes to more advanced apps remains that of ensuring the software is credible, does what it claims, and can be trusted.

This makes it possible the future of wellness on mobile will be defined by trusted organizations delivering apps that reflect their existing services and expertise.

This appears to be the manner in which such applications are being applied. A recent example of such deployment comes from Cedars-Sinai hospital, which announced a new scheme, 'BabyTime', which uses iPads to help mothers keep an eye on newborn children, even if they are unable to move after giving birth using video conferencing.

But what of more advanced mobile technologies for wellness? In the US, the Food and Drug Administration (FDA) has stepped in to approve (or disapprove) apps for mobile devices. The FDA approved iOS radiology app, Mobile MIM, in 2011. The app lets physicians immediately view images and make diagnoses without use of a workstation, and without a wait for X-ray film to be developed.

This is the thin end of a growing wedge.

Medical practitioners now use apps for numerous functions: assessing vital signals, performing abdominal ultrasound studies and delivering the latest research results to doctors at the patient’s bedside. 

Physicians' use of smartphones varies from 30-80%, depending on the sources (Buijink, Evidence Based Medicine, 2012; Franko, J Med System, 2012; Manhattan Research Group, Epocrates) and nurses and physicians assistant use ranges from 31-71%.

Self-diagnosis is also increasing. As this infographic reveals, 72% of US adults went online seeking healthcare information in 2012, while one-third searched the Web to figure out certain medical issues.

When it comes to ensuring accuracy in self-diagnosis, it's possible social networks have a part to play.

  • 40% of patients have posted comments concerning personal health experiences
  • 30% already consult online reviews of healthcare services.
  • Doctors are also beginning to diagnose the good apps from the bad as they begin recommending some solutions.

The mobile healthcare market should reach $11.8 billion in value by 2018 (Global Healthcare). This suggests a potential opportunity in which to build crowd-sourced mobile apps designed to determine the efficacy - or otherwise - of those healthcare solutions which do appear.

As use and deployment accelerates, there's a growing demand among medical professionals that some form of regulation is required for these new solutions.

“It has been proposed that medical apps should be peer-reviewed by clinical experts and that regulatory measures should be increased in order to safeguard quality of care. Regulation and guidance are urgently needed. Medical professionals must be made aware that some apps contain unreliable, non-peer-reviewed content so that they can choose carefully which apps to use in clinical care," noted a report on the Evidence Based Medicine (BMJ Group).

“We are convinced that, to some degree, medical apps should be regulated, and that they need to be thoroughly peer-reviewed in order to ensure validity. Medical applications should have an assured quality, be scientifically sound and cost-effective in their use.”

There's now talk of the FDA setting up an Office of Mobile Healthcare and Medicine to plug this gap, reports MedicalAppJournal.

Of course, emerging mobile health technology is not confined to devices that you carry on you -- they will also include devices that you carry inside you.

Professor Christopher James notes: "Research into technology that could be temporarily placed inside the body is advancing too. An area that I find particularly interesting is what some call digital medication. "

Digestible microchips gained FDA approval last summer, with an aim to ensure patients take their medicine. The chips may help ensure accurate tracking of a patient's conformance to treatment plans. They react with chemicals inside a patient's stomach and produce a slight voltage, which is picked up by a patch worn by the patient which transmits data to the doctor or carer, enabling remote monitoring of compliance.

The final stumbling block to pervasive deployment of mobile health solutions is technical: power. How do you ensure your m-Health devices are active? How do you recharge the battery inside a device a patient may be wearing? In an attempt to find a solution to this, researchers are exploring how chemicals that are already present in the body can be used to power devices of this kind. "This could be the breakthrough that implanted technology needs. If we can harvest the energy for these technologies from inside our own bodies then who knows what the future could look like?" notes Professor James.


Jon Evans

Jon Evans is a highly experienced technology journalist and editor. He has been writing for a living since 1994. These days you might read his daily regular Computerworld AppleHolic and opinion columns. Jon is also technology editor for men's interest magazine, Calibre Quarterly, and news editor for MacFormat magazine, which is the biggest UK Mac title. He's really interested in the impact of technology on the creative spark at the heart of the human experience. In 2010 he won an American Society of Business Publication Editors (Azbee) Award for his work at Computerworld.