1. Healthcare in Pocket
12HM12
Devesh Thapliyal

2. About the paper

Journal of Biomedical Informatics – Predrag Klasanja and Wanda Pratt

Research from Health Sciences and Computers.

Features of mobile phone for intervention.

Five basic intervention Strategies.

3. 
Text messaging interventions –
1) Facilitate smoking cessation
2) To provide diabetes education
3) To encourage attendance of primary care appointments

Physicians to monitor patients :
- chronic heart failure
- To detect early signs of arrhythmia or ischemia

Patients use phone applications and sensing and measurement devices to keep track of their physical
activities and to monitor physiological markers relevant to their health status.

4. Why MOBILE????
(1) The widespread adoption of phones with increasingly powerful technical capabilities.
(2) People’s tendency to carry their phones with them everywhere.
(3) People’s attachment to their phones.
Unlike desktop computers or even laptops, mobile phones are nearly always with the person.

5. 
Personal nature of mobile phones reducing barriers.

Technical capabilities :
- GPS location tracking, accelerometer-based exercise detection.
- Calendar, contacts and other personal information tells what they
are doing.

Assistance before engaging in unhealthy behaviours, as well as to provide feedback.

6. Technology behind M-health intervention

Voice, text, third party applications, sensing, Internet access, and wireless connectivity with other
devices.
1) Text messaging - penetration has reached 68% .
- Easy to process both on Computer and Phone.
- Reminders tips and educational content.
- Smoking cessation intervention for young adults uses precisely this
kind of SMS information loop.

7. 2) Cameras –
Health interventions have used cameras in these ways:
- As an alternative way to journal health-related behaviors, such as
food consumption.
- As a way to provide healthcare providers with additional information
about a condition.
3) Native Applications –
API, Open Source – developing specific apps.

8. Several different types of health applications:
-applications that enable users to log and chart data about their diet,
exercise, blood glucose levels, and other health-related behaviors and
measures
- patient terminals for tele monitoring of conditions such as
hypertension and chronic heart failure.
- applications that receive data from pedometers, blood pressure
monitors and other devices.
- games that teach health-related skills.

9. 4) Automated sensing –
last 2 years, an increasing number of mobile phones have begun to ship
with sensors such as accelerometers and GPS built in
- connect to digital scales, blood pressure monitors, glucose meters,
portable electrocardiograms (ECG), pedometers, and gym equipment,
among other sensors.
Mobile phones : receivers, transmitter and data stores for the
collection of a variety of health-intervention data.
e.g. - iPhone application RunKeeper uses built-in GPS.

10. 5) Internet access :
- Always-on connectivity means that users’ data, such as blood
glucose levels or peak flow readings, can be uploaded as soon as they
are captured, thus enabling early detection of critical events.
- The data can also be uploaded to websites where users can easily
view, chart, and edit their information.
- Real time notification.

11. Design space of mobile-phone health
interventions

Identify Intervention Strategies :

Five key intervention strategies:
(1) Tracking health information,
(2) Involving the healthcare team,
(3) Leveraging social influence,
(4) Increasing the accessibility of health information, and
(5) Utilizing entertainment.

12. Tracking health information

Native applications:
- UbiFit :Tracking of cardiovascular exercise, strength training,
different types of stretching. Daily, Weekly reports on
website.
- Wellness diary( Nokia): Food intake, weight, mood, blood pressure,
stress, and amount of sleep. Charting can be done for trend
analysis.
- Diab-Memory & Sweet talk – Monitor Glucose level.

13. 
Tracking through text messaging – Reminder, intervention at peak times.

Automated sensing for tracking – Self monitoring.
e.g. Ubifit, MSP( worn on wrist)

14. Involving the healthcare team

Keeping healthcare team aware of the patient’s symptoms, activities, and physiological
parameters.
- remote monitoring
- remote coaching
- automated feedback

15. Leveraging social influence

Importance of Social environment.

Three different ways:
(1) by facilitating social support or competition among individuals who
share the same health goal (i.e., peer-to-peer influence),
(2) by facilitating social support from family and friends, and
(3) by leveraging peer who have succeeding in accomplishing similar
health goals i.e., peer modeling).

16. Increasing the accessibility of health
information

Information at right time.
- Informational messages
- Reminders
- Glanceable displays

17. Utilizing entertainment

Fun applications

Eatwell for customizing food choices.

E.g – jokes, games, quizes

18. Limitations


Covers Individuals who are working on their own health goals not others.
Recent upgradation are not taken into account.