mHealth and Mobile Technology

History of Mobile Technology

  • 1990s: Apple Newton PDA – Characterized as big, heavy, and slow.
  • 1996: Palm Pilot – Became relatively useful, especially with the introduction of Epocrates, considered a 'killer app'.
  • PDAs (Personal Digital Assistants) began incorporating phone functionality.
  • Convergence of different functionalities led to the creation of smartphones.
  • Smartphones are more accurately described as handheld computers, where the phone is essentially an application.
  • Mobile technology is regarded as a disruptive technology.

Disruptive Technology

  • A disruptive technology requires online research to define.

Technological Context: Global ICT Developments (2001-2019)

  • Review of global Information and Communication Technology (ICT) developments from 2001 to 2019.
  • The data includes mobile-cellular telephone subscriptions, individuals using the Internet, fixed-telephone subscriptions, active mobile-broadband subscriptions, and fixed-broadband subscriptions.
  • The data is presented as subscriptions per 100 inhabitants.
  • Data Highlights (2019 Estimates):
    • Mobile-cellular telephone subscriptions: 108.0 per 100 inhabitants.
    • Individuals using the Internet: 83.0 per 100 inhabitants.
    • Active mobile-broadband subscriptions: 53.6 per 100 inhabitants.
    • Fixed-broadband subscriptions: 14.9 per 100 inhabitants.
    • Fixed-telephone subscriptions: 12.1 per 100 inhabitants
  • Mobile-broadband subscriptions showing robust growth patterns.
    • Mobile-cellular subscriptions.
    • Active-mobile broadband subscriptions.
    • Fixed-broadband subscriptions.
    • Fixed-telephone subscriptions are also included for comparison.

Current Usage: Phone Users

  • Statistics:
    • 2022: 6.6 billion phone users.
    • 2025 (Predicted): 7.2 billion phone users.
  • Global and Oman Market Share (January 2025):
    • Apple: 27.3% (Oman: 14.8%).
    • Samsung: 23.4% (Oman: 26.4%).
    • Xiaomi: 11.95% (Oman: 16.6%).
    • OPPO: 5.9% (Oman: 5.1%).
    • Vivo: 5.9% (Oman: 5.8%).
    • RealMe: 4.1% (Oman: 5.8%).
    • Huawei: 2.7% (Oman: 11.6%).

Current Usage: Operating System

  • Global and Oman Market Share (January 2025):
    • Android: 72.2% (Oman: 84.9%).
    • iOS (Apple): 27.3% (Oman: 14.8%).
    • Other OS exist but are negligible.
  • Apple controls both the phone and the operating system (OS).
  • Android is an OS that can function differently based on the hardware; Samsung is a significant hardware range, holding 29% of the hardware market.

Current Usage: Profits

  • Apple captures a significant operating profit share compared to Samsung.
  • Apple’s operating profit share hit a Q2 record, with 85%, a 73% lead over Samsung

Current Usage: Apps by App Store

  • (January 2025):
    • Android: 3.95 million apps.
    • Apple: 2.1 million apps.

Killer App

  • Definition of a 'Killer App' requires online research.

Current Usage: Microsoft Windows on Mobile

  • Microsoft Windows on mobile has failed.
  • Microsoft recommends switching to iPhone or Android, ending support for Windows 10 Mobile.

Implications of Mobile Systems

  • Implications of having two dominant systems (Apple and Android).
  • Blurring definitions between mobile phone/smartphone/mini-tablet/tablet.
  • Apple no longer has the largest number of apps in the App Store.
  • Some countries leapfrog in their technology adoption.

Leap-Frogging Technology

  • Many countries have leap-frogged their mobile technology.
  • requires discussion to define leap-frogging technology.

Trends: Smartphone Users Worldwide

  • Number of smartphone users worldwide from 2016 to 2021, with predictions up to 2027.

The Medical Context

  • Medical practice involves managing ambiguity, interpreting context, and making decisions amid uncertainty.
  • Mobile technologies and clinical decision supports are appealing tools to manage ambiguity.

Definition of mHealth

  • Medical and public health practice supported by mobile devices, such as mobile phones, patient monitoring devices, personal digital assistants, and other wireless devices (WHO).

Definition of mHealth: Practitioners

  • Access clinical information (e.g., mobile health apps and mobile-enabled electronic health records).
  • Collaborate with care teams (e.g., secure text messaging).
  • Communicate with patients (e.g., patient portals and text messaging).
  • Offer real-time monitoring of patients.
  • Conduct research.
  • Provide healthcare remotely (telemedicine).

Definition of mHealth: Patients (e-patients)

  • Track their own health data through mHealth apps and devices.
  • Access their clinical records through mobile-enabled patient portals.
  • Communicate with their providers (SMS, WhatsApp, Signal, or mobile-enabled patient portals).

Current Medical Usage

  • Tools for health researchers.
  • Interventions for health researchers or patients.
  • Untargeted mass health promotion campaigns.

Some Medical/Health Apps

  • Examples include Drugs.com, Hesi Prep, Med Helper, Prognosis Cardiology, Diabetes Emergency, etc.

Some mHealth Apps

  • PubMed App (Android: PubMed mobile): Advantages and disadvantages compared to PC-based PubMed access.
  • MedLab Tutor
  • QR Code Readers: Android: QR Droid.

Other Useful Apps for Studies

  • Drugs.com Medication Guide
  • Skyscape Medical Resources (Free Registration Required)
  • Skyscape RxDrugs (Free Registration Required)

Note-Taking and Annotation Apps

  • Notability (iOS only)
  • EverNote (Android, iOS, Windows)
  • Microsoft OneNote (Android, iOS, Windows)

PDF Annotating Apps

  • PDF Expert (iOS)
  • PDFelement (Android)

Some mHealth Apps

  • Examples include PubMed Mobile, MedLab Tutor, Prognosis Pro, MedHelper, and Pharm Finder.

For Patients: My Health Apps

  • Explore healthy living and fitness apps.

For Patients: Issues

  • Hardware and software limitations.
  • Be cautious of permissions, such as services that cost money or apps requiring access to contact lists.
  • Many apps are available, but not all are free or professionally created.
  • Patient and home-carer education is a particular problem.
  • Wearable devices (Google Glass, Watches) and the Internet of Things (IoT).

Trends of mHealth Apps

  • mHealth apps are increasing.
  • Moving away from desktop computing towards mobile computing.
  • Greater use of data stored in the Cloud.

Wider Distribution of Technology

  • Beacon Technology.

Some Challenges of mHealth

  • Distraction: Mobile devices are frequently a source of distraction for health professionals.
  • Privacy/Security: (see notes from Medi2100).
  • Source of Infection: Bacteria on devices are used in a range of medical and non-medical environments.
  • Electronic Interference: Interference with some sensitive monitoring devices.
  • Quality Control: Although various standards exist, there is no single registering authority for apps.
  • Lack of Evidence: More evidence on the value of apps is required.

Conclusion

  • mHealth is a broad term covering the use of mobile devices in healthcare.
  • Devices have evolved from PDAs to smartphones and tablets.
  • Trends show great use of mHealth and continued dominance by Android and Apple.
  • App uses differ between clinicians and patients, although a massive range exists for both groups.
  • There are limitations and challenges that need to be considered.