Design and usability ealuation of social mobile diabetes management system in the Gulf Region

BACKGROUND: The prevalence of diabetes in the Gulf States is one of the highest globally. It is estimated that 20% of the population in the region has been diagnosed with diabetes and according to the International Diabetes Federation (IDF), five of the IDF's "top 10" countries for diabetes prevalence in 2011 and projected for 2030 are in this region. In recent years, there have been an increasing number of clinical studies advocating the use of mobile phone technology for diabetes self-management with improved clinical outcomes. However, there are few studies to date addressing the application of mobile diabetes management in the Gulf region, particularly in the Kingdom of Saudi Arabia (KSA), where there is exponential increase in mobile phone usage and access to social networking. OBJECTIVE: The objective of this paper is to present the design and development of a new mobile health system for social behavioral change and management tailored for Saudi patients with diabetes called Saudi Arabia Networking for Aiding Diabetes (SANAD). A usability study for the SANAD system is presented to validate the acceptability of using mobile technologies among patients with diabetes in the KSA and the Gulf region. METHODS: The SANAD system was developed using mobile phone technology with diabetes management and social networking modules. For the usability study the Questionnaire for User Interaction Satisfaction was used to evaluate the usability aspect of the SANAD system. A total of 33 users with type 2 diabetes participated in the study. RESULTS: The key modules of the SANAD system consist of (1) a mobile diabetes management module; (2) a social networking module; and (3) a cognitive behavioral therapy module for behavioral change issues. The preliminary results of the usability study indicated general acceptance of the patients in using the system with higher usability rating in patients with type 2 diabetes. CONCLUSIONS: We found that the acceptability of the system was high among Saudi patients with diabetes, and ongoing work in this research area is underway to conduct a clinical pilot study in the KSA for patients with type 2 diabetes. The wide deployment of such a system is timely and required in the Gulf region due to the wide use of mobile phones and social networking mediums

Mobile Health (mHealth) in the Developing World: Two Decades of Progress or Retrogression

Mobile healthcare, or mHealth, is one of the key pillars of information and communication technologies for healthcare that consists of telemedicine, telehealth, eHealth, and mHealth. In the past two decades, mobile health has become a transformative concept for healthcare delivery innovations on a global scale. The success was based on the market-driven strategies that utilised the advances in mobile communications, computing, and sensor technologies, especially in recent years. Those market-driven mobile health systems were also closely associated with the global proliferation of smartphones, and based on the correlated usage principle of the smartphone applications for healthcare and wellbeing. However, the global commercial success of the smartphone-based mHealth model was not widely translated into successful scaled-up and tangible healthcare benefits, especially in low- and-middle income countries, compared to the consumer mobile health markets. The numerous healthcare challenges in the developing world remained largely untackled by the existing mobile health systems and models. The much-hyped transformative benefits of these systems remain largely unfulfilled. For two decades since the inception of this concept, the majority of the population in resource-limited healthcare settings still remain in poorer health and live in worsened conditions, with limited if any access to basic healthcare services. The much-hyped mobile health services that promised transforming these fragile and limited healthcare conditions, did not come to wider fruition globally. The COVID-19 pandemic, with its devastating human and economic impact worsened this status. An overview of the origin and the basic principles of mobile health, its current landscape and status in the developing world is presented. The impact of the smartphone-centric model that dominated the landscape of mobile health systems in these countries is discussed, and a critical view on the limitation of this mobile health model adopted widely in these settings is provided

Mobile health (m-Health) for diabetes management

Diabetes is a major health challenge with a global impact regardless of age, country or economic condition. The increased prevalence of diabetes is reaching alarming levels. The necessity and urgency to find innovative care delivery solutions is becoming more important, particularly in the digital age. It is expected in the near future that more people with diabetes, especially the younger generations will be empowered by their smartphones and relevant mobile health (m-Health) innovations, to take more responsibility of their condition. Clinicians and healthcare providers are increasingly likely to assume the role of ‘navigators’ and ‘advisors’ rather than simply the medical gatekeeper for their patients. In this article, we describe the general architecture of current m-Health systems and applications for diabetes management. We also discuss the clinical evidence for impact from these important and innovative approaches to diabetes self-care and management and likely future trends in their usage. The latest statistics indicate that there are more than 1200 diabetes smartphone ‘apps’ and this area is growing exponentially in terms of ideas, technologies, devices and the associated industry. M-Health for diabetes care is now a major business stream for the medical device, mobile phone and IT telecommunication industries with high expectations arising from the potential benefits to be gained by both patients and healthcare providers. However, this potential has not yet been fully developed on the clinical side. This may be due to many factors including the reluctance of clinicians to engage with these technologies due to the lack of clinical evidence for their efficacy, poor adherence of people with diabetes to long-term use of these apps and the reluctance of healthcare funders to reimburse mobile diabetes

Feasibility and acceptability of text messaging to support antenatal healthcare in Iraqi pregnant women: a pilot study

Objective: To determine the feasibility and acceptability of mobile health technology and its potential to improve antenatal care (ANC) services in Iraq. Methods: This was a controlled experimental study conducted at primary health care centers. One hundred pregnant women who attended those centres for ANC were exposed to weekly text messages varying in content, depending on the week of gestation, while 150 women were recruited for the unexposed group. The number of ANC visits in the intervention and control groups, was the main outcome measure. The Mann-Whitney test and the Poisson regression model were the two main statistical tests used. Results: More than 85% of recipients were in agreement with the following statements: “the client recommends this program for other pregnant women”, “personal rating for the message as a whole” and “obtained benefit from the messages”. There was a statistically significant increase in the median number of antenatal clinic visits from two to four per pregnancy, in addition to being relatively of low cost, and could be provided for a larger population with not much difference in the efforts. Conclusions: Text messaging is feasible, low cost and reasonably acceptable to Iraqi pregnant women, and encourages their ANC visits

Monitoring Heart Disease and Diabetes with Mobile Internet Communications

A telemedicine system is described for monitoring vital signs and general health indicators of patients with cardiac and diabetic conditions. Telemetry from wireless sensors and readings from other instruments are combined into a comprehensive set of measured patient parameters. Using a combination of mobile device applications and web browser, the data can be stored, accessed, and displayed using mobile internet communications to the central server. As an extra layer of security in the data transmission, information embedded in the data is used in its verification. The paper highlights features that could be enhanced from previous systems by using alternative components or methods

Microarray image enhancement by denoising using stationary wavelet transform

Microarray imaging is considered an important tool for large scale analysis of gene expression. The accuracy of the gene expression depends on the experiment itself and further image processing. It's well known that the noises introduced during the experiment will greatly affect the accuracy of the gene expression. How to eliminate the effect of the noise constitutes a challenging problem in microarray analysis. Traditionally, statistical methods are used to estimate the noises while the microarray images are being processed. In this paper, we present a new approach to deal with the noise inherent in the microarray image processing procedure. That is, to denoise the image noises before further image processing using stationary wavelet transform (SWT). The time invariant characteristic of SWT is particularly useful in image denoising. The testing result on sample microarray images has shown an enhanced image quality. The results also show that it has a superior performance than conventional discrete wavelet transform and widely used adaptive Wiener filter in this procedure

Provisioning of medical quality of services for HSDPA and mobile WiMAX in healthcare applications

Mobile healthcare, or m-health, is an evolutionary concept that provides both mobility and an 'always connected' healthcare functionality. The development of this concept depends on how best the available bandwidth in (HSDPA/HSUPA) and emerging (Mobile WiMAX) networks can be correlated with the relevant medical quality of services issues. In this paper we address and discuss some of these issues and challenges. We also provide an example of a bandwidth demanding application to verify such provision mechanisms

Mobile Health (m-Health) in Retrospect: The Known Unknowns

For nearly two decades, mobile health or (m-Health) was hailed as the most innovative and enabling area for the digital transformation of healthcare globally. However, this profound vision became a fleeting view since the inception and domination of smart phones, and the reorientation of the concept towards the exclusivity of global smart phone application markets and services. The global consumerization of m-Health in numerous disciplines of healthcare, fitness and wellness areas is unprecedented. However, this divergence between ‘mobile health capitalism’ and the ‘science of mobile health’ led to the creation of the ‘m-Health schism’. This schism was sustained by the continued domination of the former on the expense of the latter. This also led to increased global m-Health inequality and divide between the much-perceived health and patient benefits and the markets of m-Health. This divergence was more evident in low and middle income (LMIC) countries compared to the developed world. This powerful yet misguided evolution of the m-Health was driven essentially by complex factors. These are presented in this paper as the ‘known unknowns’ or ‘the obvious but sanctioned facts’ of m-Health. These issues had surreptitiously contributed to this reorientation and the widening schism of m-Health. The collateral damage of this process was the increased shift towards understanding ‘digital health’ as a conjecture term associated with mobile health. However, to date, no clear or scientific views are discussed or analyzed on the actual differences and correlation aspects between digital and mobile health. This particular ‘known unknown’ is presented in detail in order to provide a rapprochement framework of this correlation and valid presentations between the two areas. The framework correlates digital health with the other standard ICT for the healthcare domains of telemedicine, telehealth and e-health. These are also increasingly used in conjunction with digital health, without clear distinctions between these terms and digital health. These critical issues have become timelier and more important to discuss and present, particularly after the world has been caught off guard by the COVID-19 pandemic. The much hyped and the profiteering digital health solutions developed in response of this pandemic provided a modest impact, and the benefits were mostly inadequate in mitigating the massive health, human, and economic impact of this pandemic. This largely commercial reorientation of mobile health was unable not only to predict the severity of the pandemic, but also unable to provide adequate digital tools or effective pre-emptive digital epidemiological shielding and guarding mechanisms against this devastating pandemic. There are many lessons to be learnt from the COVID-19 pandemic from the mobile and digital health perspectives, and lessons must be learnt from the past and to address the critical aspects discussed in this paper for better understanding of mobile health and effective tackling of future global healthcare challenges

Technical and compliance considerations for mobile health self-monitoring of glucose and blood pressure for patients with diabetes

Self-monitoring of blood glucose is an integral part of diabetes care which may be extended to other biometrics. Cellular and short range communication technologies will be important for the routine usage of these systems. However, the issues of follow-up and patient compliance with these emerging systems have not been yet studied evaluated but could be critical to the adoption of these technologies. We evaluated the impact of mobile telemonitoring on the intensification of care on blood pressure control and exposure to hyperglycaemia in patients with diabetes. We randomised 137 patients with diabetes to either mobile telemonitoring (n = 72) or usual care patients (n = 65) for 9 months. In this paper we present some of the clinical results with focus on blood pressure control hypertension and highlight some of the technical and compliance issues that were encountered