Mobile technology and the digitization of healthcare

Abstract

The convergence of science and technology in our dynamic digital era has resulted in the development of innovative digital health devices that allow easy and accurate characterization in health and disease. Technological advancements and the miniaturization of diagnostic instruments to modern smartphone-connected and mobile health (mHealth) devices such as the iECG, handheld ultrasound, and lab-on-a-chip technologies have led to increasing enthusiasm for patient care with promises to decrease healthcare costs and to improve outcomes. This 'hype' for mHealth has recently intersected with the 'real world' and is providing important insights into how patients and practitioners are utilizing digital health technologies. It is also raising important questions regarding the evidence supporting widespread device use. In this state-of-the-art review, we assess the current literature of mHealth and aim to provide a framework for the advances in mHealth by understanding the various device, patient, and clinical factors as they relate to digital health from device designs and patient engagement, to clinical workflow and device regulation. We also outline new strategies for generation and analysis of mHealth data at the individual and population-based levels.

Keywords: Digital health; Medical technology; Patient-generated data; Sensors; mHealth.

Figure 1

Factors related to mHealth adoption across the digital device, the digital patient, and the digital clinic.

Figure 2

The mHealth data flow for clinical care. To maximize clinical care, a closed loop is necessary that involves patient- or practitioner-derived mHealth data, Internet-based data transfer interpreted by patients, practitioners, or with automated algorithms, and returned back to patients and providers for clinical decisions.

Figure 3

mHealth digital retention. A rapid and early attrition to device use (black arrow) and a low digital retention (green arrows) of 30% at 6 months with mHealth-based self-monitoring. Web denotes online and Internet-based platforms for health and fitness management. Reprinted and modified with permission from Mattila et al.

Figure 4

N-of-1 design and precision-based mHealth. (A and B) Denote different antihypertensive drug classes. Drug B (green arrows) lowers blood pressure more than drug A (black arrows). W denotes washout period and the x- and y-axes are the time (in days) and blood pressure (in mmHg), respectively. Figure courtesy of Nicholas Schork PhD and modified with permission.

Figure 5

Future mobile and digital health technologies.