Mobihealth: mobile health services based on body area networks

In this chapter we describe the concept of MobiHealth and the approach developed during the MobiHealth project (MobiHealth, 2002). The concept was to bring together the technologies of Body Area Networks (BANs), wireless broadband communications and wearable medical devices to provide mobile healthcare services for patients and health professionals. These technologies enable remote patient care services such as management of chronic conditions and detection of health emergencies. Because the patient is free to move anywhere whilst wearing the MobiHealth BAN, patient mobility is maximised. The vision is that patients can enjoy enhanced freedom and quality of life through avoidance or reduction of hospital stays. For the health services it means that pressure on overstretched hospital services can be alleviated

A Personalization-Privacy Paradox in Usage of Mobile Health Services: A Game Theoretic Perspective

As health information privacy concern of the public raises, people are hesitant on disclosure of their private health information for personalized health services from using mobile health. The tension between personalization and privacy hinders users’ adoption of mobile health services. In this study, we draw on game theory to explain the personalization-privacy paradox in the usage of mobile health services. The results show that: (1) In a one-shot game, the strategy set of mobile health marketers and users will be contrary to their original motivations. (2) In a repeated game, collecting users’ private health information in a friendly way and disclosing private health information will be dominant strategies for both players. Managers need to pay attention to these scenarios in promoting usage of mobile health services

FNP led Mobile Health Services for the Homeless population

A small percentage of the U.S. population uses the greatest portion of the healthcare services. Homeless people are often such a group of “super-utilizers” of the healthcare system. Due to multiple medical and psychosocial conditions, people experiencing homelessness face numerous barriers to accessing healthcare, thus leading increased utilization of hospitals and emergency departments (EDs) services. Many of these events are preventable through improved primary care interventions. The literature on Respite/Recuperative Care, Transitional Care, and Mobile Health interventions have shown effectiveness in providing safe and quality care to homeless individuals during the critical transitional period post hospital discharge while also reducing the readmission rates to hospitals and EDs. The goal of this DNP project was to establish a Mobile Health Services program and function as a part of a larger Recuperative Care pilot program for Marin County\u27s homeless population. The partnership between the University of San Francisco School of Nursing and Health Professions (USF-SONHP) and local organizations in Marin endeavored to improve the quality of care for the homeless population and reduce rehospitalizations and ED visits. This goal was accomplished through the successful implementation of the pilot project. Outcome evaluation demonstrated that the project team was able to prevent rehospitalization in all eight patients that enrolled in the program. These results also showed a potential for a significant positive financial impact on the overall healthcare system by reducing utilization rates of EDs and hospitals and costs associated with i

How Environmental Uncertainty Moderates the Effect of Relative Advantage and Perceived Credibility on the Adoption of Mobile Health Services by Chinese Organizations in the Big Data Era

Despite the importance of adoption of mobile health services by an organization on the diffusion of mobile technology in the big data era, it has received minimal attention in literature. This study investigates how relative advantage and perceived credibility affect an organization's adoption of mobile health services, as well as how environmental uncertainty changes the relationship of relative advantage and perceived credibility with adoption. A research model that integrates relative advantage, perceived credibility, environmental uncertainty, and an organization's intention to use mobile health service is developed. Quantitative data are collected from senior managers and information systems managers in 320 Chinese healthcare organizations. The empirical findings show that while relative advantage and perceived credibility both have positive effects on an organization's intention to use mobile health services, relative advantage plays a more important role than perceived credibility. Moreover, environmental uncertainty positively moderates the effect of relative advantage on an organization's adoption of mobile health services. Thus, mobile health services in environments characterized with high levels of uncertainty are more likely to be adopted because of relative advantage than in environments with low levels of uncertainty

Building standardized and secure mobile health services based on social media

Mobile devices and social media have been used to create empowering healthcare services. However, privacy and security concerns remain. Furthermore, the integration of interoperability biomedical standards is a strategic feature. Thus, the objective of this paper is to build enhanced healthcare services by merging all these components. Methodologically, the current mobile health telemonitoring architectures and their limitations are described, leading to the identification of new potentialities for a novel architecture. As a result, a standardized, secure/private, social-media-based mobile health architecture has been proposed and discussed. Additionally, a technical proof-of-concept (two Android applications) has been developed by selecting a social media (Twitter), a security envelope (open Pretty Good Privacy (openPGP)), a standard (Health Level 7 (HL7)) and an information-embedding algorithm (modifying the transparency channel, with two versions). The tests performed included a small-scale and a boundary scenario. For the former, two sizes of images were tested; for the latter, the two versions of the embedding algorithm were tested. The results show that the system is fast enough (less than 1 s) for most mHealth telemonitoring services. The architecture provides users with friendly (images shared via social media), straightforward (fast and inexpensive), secure/private and interoperable mHealth services

Application of Mobile Health Services to Support Patient Self-Management of Chronic Conditions

Background: Chronic conditions are the leading cause of ill-health, disability and premature death, adding huge health and socioeconomic burden to the healthcare system. Although mobile health (mHealth) services have the potential to provide patients with a timely, ubiquitous, and cost-effective means to access healthcare services, to date, much remains to be revealed for their application in chronic condition management. Aim: This doctoral project aims to comprehensively understand the application of mHealth services to support patient self-management of chronic conditions. This aim is achieved through four objectives: (1) to synthesise research evidence about health outcomes of applying mHealth services to support patient self-management of chronic conditions and the essential components to achieve these outcomes, (2) to determine the mechanism for applying mHealth services to support patient self-management of chronic conditions, (3) to explore critical factors and how these factors influence patients\u27 intention to continuously use mHealth services, and (4) to apply the above findings to guide the design of a prototype mHealth service. Methods: To increase the generalisability of the findings, three chronic conditions that could benefit from mHealth services were purposively studied to address the research objectives within the feasibility of available study sites and resources at different stages of the project. First, two literature review studies were conducted to achieve Objective 1. One was a systematic review to investigate health outcomes of mHealth services to support patient self-management of one chronic condition, unhealthy alcohol use, and the essential components to achieve these outcomes. The other was a rapid review on using behavioural theory to guide the design of mHealth services that support patient self-management of another chronic condition, hypertension. Second, two field studies were conducted to achieve Objectives 2 and 3, respectively. One was an interview study that explored patients\u27 perceptions of a mHealth service to support their self-management of hypertension in China. The other was a questionnaire survey study conducted on the same site that explored critical factors influencing patients\u27 intention to continuously use the mHealth service. Third, a clinician-led, experience-based co-design approach was implemented to apply the above-mentioned learning experience to the development practice of a mHealth service that supports patient self-management of obesity before elective surgery in Australia, achieving Objective 4. Results: Literature reviews identify five structural components - context, theory, content, delivery mode, and implementation procedure - which are essential for mHealth services to achieve three health outcomes - behavioural, physiological, and cognitive outcomes. Inductive synthesis of the interview findings lead to a 6A framework that summarises the mechanisms for mHealth services: access, assessment, assistance, awareness, ability, and activation. Mobile health services provide patients with easy access to health assessment and healthcare assistance to increase their self-management awareness and ability, thereby activating their self-management behaviours. Questionnaire survey study finds that patients\u27 intention to continuously use mHealth services can be influenced by the information quality, system quality and service quality by influencing their perceived usefulness and satisfaction with the mHealth services. Guided by Social Cognitive Theory, the developed prototype mHealth service provide patients with functions of automatic push notifications, online resources, goal setting and monitoring, and interactive health-related exchanges that encourage their physical activity, healthy eating, psychological preparation, and a positive outlook for elective surgery. The patients\u27 requirements in two focus group discussions enabled the research team to improve the mHealth service design. Conclusion: Mobile health services guided by behavioural theories can provide patients with easy access to health assessment and healthcare assistance to increase their self-management awareness and ability, thereby activating their self-management behaviours. The effort for designing mHealth services needs to be placed on crafting content (to improve information quality), developing useful functions and selecting a proper delivery mode (to improve system quality), and establishing effective implementation procedures (to improve service quality). These will ensure patients\u27 perceived usefulness and satisfaction with mHealth services, increase their intention to continuously use such services, thus supporting long-term patient self-management of chronic conditions. As demonstrated by the design case, the findings of this PhD project can be generalised to guide the design of other mHealth services that aim to support patient self-management of chronic conditions

MobiHealth-Innovative 2.5/3G mobile services and applications for health care

MobiHealth aims at introducing new mobile value added services in the area of healthcare, based on 2.5 (GPRS) and 3G (UMTS) technologies, thus promoting the use and deployment of GPRS and UMTS. This will be achieved by the integration of sensors and actuators to a Wireless Body Area Network (BAN). These sensors and actuators will continuously measure and transmit vital constants along with audio and video to health service providers and brokers, improving on one side the life of patients and allowing on the other side the introduction of new value-added services in the areas of disease prevention and diagnostic, remote assistance, para-health services, physical state monitoring (sports) and even clinical research. Furthermore, the MobiHealth BAN system will support the fast and reliable application of remote assistance in case of accidents by allowing the paramedics to send reliable vital constants data as well as audio and video directly from the accident site

The E-health Strategic Research Orientation at the Centre for Telematics and Information Technology

This report gives an overview of research themes, research groups and research partners of the E-Health Strategic Research Orientation (SRO) at the University of Twente

Study on the Continuance Usage of Mobile Health Management Application based on Uses and Gratifications Theory

In order to examine the influence effect of uses and gratifications of mobile health services. A research model was developed to study the influence of users’ utility gratification, hedonic gratification and social gratification from the perspective of Uses and Gratifications theory. SPSS and Smart PLS were employed to verify the research hypotheses using the empirical data collected via survey questionnaires. Research results show that utility gratification, hedonic gratification and social gratification all exert significant and positive effects on users’ continuance usage intention. Especially, gratification of health management, perceived fantasy, social image play important roles in users’ uses and gratifications. Providers of Mobile health management application should design and take personalized operating strategies and marketing strategies according to different needs

IMPROVING MOBILE SERVICE DELIVERY WITHIN ILEMBE HEALTH DISTRICT: A BATHO PELE PERSPECTIVE

Everything associated with wealth, happiness and long life depends on good health. Adept policy-makers must understand linkages between Government priorities, interfacing with the public. Health policy initiatives ought to be implemented effectively, efficiently and economically within local communities’ proximity demonstrating results. Contextually, mobile health services are extensions of Primary Health Care (PHC) systems. The Department of Health (DoH) and iLembe Health District must ensure Batho Pele (People First) Principles maintain service standards. Mobile health services are not rendered in accordance with the policy framework and implementation strategy aimed at transforming public services, as stipulated in the White Paper on Transforming Public Service Delivery (Batho Pele White Paper, 1997). The purpose of this study therefore, was to evaluate the influence of mobile health services operationalising these principles to the district. The methodological approach included questionnaires administered to management, health care workers and clients within Maphumulo sub-district in iLembe. The quantitative approach utilising the post positivist worldview was applied through survey research and random sampling with a complement of 286 respondents. Data was interpreted for statistical significance of relationships amongst key variables through Factor Analysis and Cronbach’s Alpha for score reliability. Data analysis illustrated that most health care workers (HCW) are considerate, offer required information to clients regardless of resource and infrastructure limitations. Empirically, managers, HCW and clients agreed mobile health services are delivered in relation to some of Batho Pele Principles. However, this does not imply that challenges do not exist. The study revealed that efficient, economic and effective delivery of health services warrants multi-disciplinary and coordinated approaches involving clients’ participation and feedback, including health service management and health care workers. Emphasis was on instilling a spirit of diakonia and culture of ensuring high quality service delivery mandates of Health and Government Departments. The authors conclude that necessary health care policies must be implemented properly. The need is to systematically institutionalise functional monitoring and evaluation systems to deliver quality services to citizens in an equitable manner through all possible means