mHealth: Healthcare at your fingertips

Mobile health (mHealth) involves the use of mobile devices, sensing technologies and mobile apps for providing healthcare related services. It is one of the most important segments of eHealth, which is constantly gaining momentum due to the proliferation of low-cost mobile devices (i.e. smart-phones, tablets), as well as due to the advancement of computational and sensing capabilities of such devices. As part of the mHealth movement there are already thousands of healthcare applications, which provide location-aware and pervasive monitoring functionalities in order to facilitate disease prevention, detection and treatment.

The advent of mHealth enables healthcare organizations and governments to offer advanced disease management functionalities at a low cost, while at the same time reducing needs for hospitalization and facilitating patients to live healthier and longer independently. In such ways, mHealth alleviates the extreme pressure faced by the national healthcare systems worldwide as they have to cope with an ever increasing number of patients on constrained budgets. Overall, mHealth is and will gradually transform healthcare and will deliver benefits to multiple stakeholders. A sound understanding of mHealth’s benefits and capabilities is the key to developing novel applications and services, which will essentially improve healthcare delivery along with the patients’ quality of life.

Taxonomy of mHealth Applications and Services

There are different ways for classifying and analyzing healthcare apps. The most prominent one is the classification based on the disease or the chronic condition that they are targeting. Also, there are mobile apps dedicated to supporting patients that suffer from specific diseases such as dementia (e.g., MindMate and CleverMind), cardiac/heart-related diseases (e.g., Cardiio), respiratory diseases (e.g., ResApp solutions) and more. There are numerous apps in each one of such disease categories, which makes it possible to define additional sub-groupings based on the specific functionalities, symptoms and health-risks addressed by each app. For example, in the case of dementia apps it is possible to introduce additional classifications depending on whether the app supports the patients in their memory, orientation or language problems. Furthermore, there are dementia-related apps that put emphasis on cognitive training in addition to supporting its users in every day tasks. Likewise, in the case of apps for respiratory diseases, there are specialized apps that target different types of asthmatic patients, such as patients suffering from COPD (Chronic Obstructive Pulmonary Disease). Note that there are also apps providing integrated functionalities targeting multiple risk-factors and disease support functionalities however, the majority of the apps tend to focus on a few vertical functionalities as a means of being simple to use, energy efficient to operate and ultimately more accepted by end users.

Another classification of the various apps can be based on its purpose. There are apps focusing on prevention, others on detection and others on treatment of a specific disease. However, there are also apps that aim to provide end-to-end management of a specific disease. The latter operate in conjunction with back-office applications, which are operated by healthcare services providers.

Healthcare apps can be also classified based on the mobile platform and device they run on. In principle, most applications are developed for one or both of the mainstream mobile platforms i.e. iOS and Android. Moreover, some of the apps are operational on smartphones and others on tablets, depending on their computational and user interface needs. The target device has also an impact on the market penetration of the apps. For example, older adults make a more extensive use of tablet devices, rather than smart phones. Nevertheless, these numbers are bound to change for future generations.

Special Characteristics of Healthcare Apps

Healthcare apps come with special characteristics that differentiate them from the mass of conventional mobile apps. These characteristics stem directly from the fact that the apps address special audiences (e.g., elderly, patients, disabled individuals) and include:

• Ergonomic user interfaces: The user interface of healthcare apps tends to be radically different from the interfaces of conventional apps. Achieving ergonomic design and user-friendliness for elderly or patients requires special design considerations, including features such as large buttons and other user interface elements, high audio volumes for notifications and alerts, fancy colors and more.
• Energy efficient I/O operations: The majority of healthcare apps take advantage of the sensing capabilities of the mobile device. Sensing incurs energy-savvy I/O operations, which challenge the energy autonomy of the device and are likely to lead to the need for (re)charging the battery frequently. As a result, healthcare apps designers need to make sure that their apps are as power efficient as possible.
• Special functionalities: Healthcare apps implementers should think of features that enhance the usability and acceptance of the apps by their users. Think, for example, about the implementation of reminders about charging the device, which could be a salient feature for users with memory problems or cognitive decline. Similarly, functionalities like helping users to locate their device are much more important in this context.

Challenges Ahead

Despite the rapid growth of the mHealth ecosystem there are still several challenges that need to be addressed to enable a radical transformation of healthcare delivery based on mobile devices. These include:

• Privacy and data protection: Healthcare apps impose privacy risks for their users as they enable access to and sharing of their personal data. Therefore, mHealth apps developers need to include proper privacy controls while respecting privacy regulations such as the GDPR regulation in the EU.
• Interoperability: Currently different apps form disaggregated data silos which are used by various users and healthcare providers. A wave of new opportunities could emerge based on the integration and interoperability of different apps that collect and process similar data. For example, data collection from many dementia apps could provide a sound basis for extracting relevant medical knowledge.
• Viable business models: Beyond conventional mobile apps business models (e.g., licensing & using an app from a marketplace), healthcare stakeholders seek for lucrative business models that will lead to cost-savings for citizens, revenues for healthcare services providers, as well as increased stakeholders’ engagements. Such business models could, for example, motivate healthcare services providers to provide content and functionalities inside a mobile app.
• Technical advancements: Healthcare apps take advantage of advances in mobile devices capabilities and in low-cost multi-purpose sensors. In addition to these advances, future apps should expose integrated functionalities, use of more sensors and increased power efficiency. Thereore, significant research and development in these areas is needed in the coming years.

mHealth is already transforming healthcare and delivering benefits to all stakeholders. For example, doctors and other health professionals are provided with rich and accurate data for disease management. Clinical researchers exploit mobile devices for their trials in a way that enhances accuracy and reduces costs. Health Insurance companies can nowadays design personalized services for their customers taking into account factual data about their lifestyles and needs. Finally, patients are able to live longer independently while saving money spent on their carers. Given these tangible benefits, “mobile-first” e-health will disrupt the industry in the years to come leading to a better quality of life for citizens and also resulting in unprecedented innovation opportunities for businesses in the healthcare sector.