Go-Go-Gadget Glucose-Monitoring and Other mHealth Technology: The Future of Medicine?

Troublesome tasks such as checking your blood sugar and worrying about elderly loved ones may be alleviated by some technology initiatives currently in the works.  The so-called mobile health, or mHealth, derives from eHealth, and is defined by the World Health Organization (WHO) as “medical and public health practice supported by mobile devices, such as mobile phones, patient monitoring devices, personal digital assistants (PDAs), and other wireless devices.”  HHS has driven the mHealth technologies in recent years, ranging from health text messaging and phone apps to remote monitoring and portable sensors to assist in healthcare.  HHS claims that the mHealth initiative has the potential to create a healthier and more secure nation by improving access to health resources.

Some real-world examples of mHealth technologies in the pipeline were described in a recent CNN.com article, which stated that, according to an analysis performed by PricewaterhouseCoopers, “mobile-enabled services will become integral to healthcare delivery by 2017, creating a global market worth about $23 billion.”  Some of the items listed would have sounded like science fiction just a few short years ago, before the advent of mobile technology.

  • For loved ones of Alzheimer’s patients, there is the SIMAP (Intelligent Personal Alert Monitoring System) that helps to track and log the location of the patient via a GPS receiver affixed to the patient, and for the elderly and home-bound patients, there is the Telenor home monitoring trial which uses wireless devices to monitor the home for signs of distress or illness.
  • There is machine-to-machine (M2M) technology that can detect a fall, moisture on bed linens, or sound an alarm in the case of an epileptic seizure; health care providers would then receive a text message if an alarm is triggered.
  • There is technology that electronically dispenses pills, or, in the case of the AT&T Vitality GlowCaps, keep patients on a correct medication schedule.  The GlowCaps are medication bottle caps that light up, play ringtones, or send a call/text the patient to remind them to take the pill.
  • For areas that lack access to technology, there is the Mobisante MobiUS SP1 Ultrasound System, a mobile ultrasound wand that connects to a smartphone to bring ultrasound imaging to areas far from a facility housing an ultrasound machine.
  • Diabetics may be interested to hear about the Dexcom Seven Plus Continuous Glucose Monitoring (CGM) system that features a sensor implanted under the skin that monitors glucose levels and sends measurements to a handheld receiver or a computer.  The system is equipped with an alarm that sounds when glucose levels drop to a certain level.

HHS has focused on developing health messaging and mobile health programs, aided by the creation of the HHS Text4Health Task Force  to identify new initiatives.  Some of those initiatives launched thus far by the task force include the SmokeFreeTXT mobile smoking cessation service, a diabetes self-management education course facilitated through video streaming and accompanying text prompts and reminders, the Apps Against Abuse program to prevent dating violence and sexual assault, the Text Alert Toolkit for emergency response, and the Text4Baby initiative recently announced by the Obama Administration as a tool to bring health coverage and information to pregnant women.  HHS staff will also continue to evaluate mHealth activities throughout various departments with the health of a mHealth Community of Practice (CoP) it is establishing, to keep the ball rolling on the initiatives the task force has initiated.

Other HHS mHealth resources are available from the Agency for Healthcare Research and Quality (AHRQ), Centers for Disease Control and Prevention (CDC), Food and Drug Administration (FDA), and several departments within the National Institutes of Health (NIH), among others.

NIH’s Office of Behavioral and Social Sciences Research (OBSSR) website details an extensive list of technologies that could change “when, where, and home healthcare is provided.”  OBSSR even funds investigations into developing mobile technologies.  One such program is the Exposure Biology Program that has looked into developing technologies to measure environmental exposures, diet, physical activity, psychosocial stress, and addictive substances; biological responses that signal such mechanisms as oxidative stress, epigenetic modifications, and DNA damage; and further apply the responses to genome-wide association studies (GWAS) of gene-environment interaction.

WHO has stressed the importance of developing these technologies on an international scale, to bring needed medical resources to low- and middle-income countries.  Especially since, as WHO cites, 85 percent of the world’s population is covered by a commercial wireless signal, and five billion mobile phone subscriptions in the world, the potential exists for a major transformation of how health information and services are provided.

In this era of mobile technology, it will be interesting to see what new devices are developed in the future that make it easier to take care of ourselves and others.  No more wondering whether you took your medicine that day, you have a device that tells you when took it, and reminded you to take it in the first place.  No more worrying about your elderly loved ones, their location is monitored electronically and you are notified if they fall or are ill.  No more pricking your finger to check your blood sugar, you have a sensor that gives you the measurement.  What types of technology would you like to see developed?

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