Calling mobile health "one of the most significant health IT developments of the past five years" in terms of treating chronic diseases, a coalition of health IT advocates sees strong potential in mobile and wireless technologies to address the diabetes epidemic, even in "socially disadvantaged" populations.
The eHealth Initiative, a Washington-based group representing a wide range of healthcare interests, may not have broken a lot of new ground in the first of three planned issue briefs about how technology can improve diabetes care in low-income communities, but it summarizes more than a hundred findings from elsewhere.
"Research shows that the majority of patients, including those who are disadvantaged, have access to a mobile device or smartphone. These patients have tools at their fingertips to help manage their diabetes more effectively," eHealth Initiative CEO Jennifer Covich Bordenick says. "The use of mHealth tools provides a straightforward way for all populations to access information that assists in reducing risk factors."
The issue brief, produced with financial support from the California HealthCare Foundation, reviewed 107 articles published since 2005 that evaluated how e-health tools in four domains -- mobile health, telehealth, patient Web portals and social media -- help patients with diabetes monitor blood glucose and weight in order to keep glucose, systolic blood pressure and cholesterol levels in check. The articles covered everything from old-school pagers to sophisticated monitoring systems linked wirelessly to medical professionals via smartphones.
"This study shows the potential for mobile applications to improve disease management among all populations and how patients can play a central and active role in effectively managing their health," Dr. Sophia Chang, director of CHCF's Better Chronic Disease Care program, says in a press release.
Mobile health represents the fastest-growing part of what the eHealth Initiative calls the "patient-centered tools" industry.
"These technologies represent an evolution of telemedicine from the desktop to wearable technologies, which may improve the accessibility of treatment for diabetes as well as the ability of patients to actively engage their providers. Additionally, the innovations and functionality of mHealth, such as text messaging, smartphone applications and wireless sensor technology, can improve the speed, accuracy and convenience of diagnostic tests; improve medication adherence and test result delivery; improve interactive, two-way communication; and provide a simple methods for data collection, remote diagnosis, emergency tracking and access to health records," says the report.
Literature studied covered systems such as the PDA-based DiaBetNet, WellDoc's DiabetesManager coaching system and the 3G-enabled Telcare BGM wireless glucose meter, as well as a range of smartphone apps. According to the paper, the number of smartphone apps has grown by almost 400 percent in the past three years.
"The use of mHealth applications and devices may encourage patients to adhere to their monitoring regimens by encouraging self-monitoring efforts with reminders and alerts, and serving as simple repositories for information generated by the patient, which can then be shared with the patient's care team," the issue brief says.
The report was particularly optimistic about the prospects of home-based telehealth, including remote monitoring and live videoconferencing, where there is significant crossover with mobile health. A wireless home monitor showed sustained improvement in systolic blood pressure after 12 months, for example.
Predictably, patients in otherwise underserved rural communities reported higher satisfaction with telehealth technologies than those who only received traditional forms of care.