mHealth Apps Empower Individuals

How are sensor-enabled mobile health apps such as Fitbit changing the landscape for patients, the healthcare system in general, and behavioral health in particular? In this first of a series of three editorials, we explore how sensorenabled mHealth apps are transforming submissive patients into empowered healthcare consumers. The definition of mHealth is evolving with the technology, and here is a new one we like: ‘‘Mobile health (mHealth) components of eHealth span a broad spectrum of technologies. mHealth includes technology that is wireless, mobile, or wearable (e.g., sensors, medication pumps, or wristbands that monitor physical activity). mHealth also includes thousands of health apps designed for mobile devices. The market for mHealth apps is anticipated to grow 25% per year with no foreseeable end in sight. mHealth is a ‘disruptive innovation’ providing entrée to Internet-based health resources. ’’ Researchers and policy makers agree that the need for such a disruptive technology is acute, citing the fact that many countries, including the United States, have trouble providing adequate healthcare. Depending on the country, barriers to such care may include physical distance between the doctor and the patient, not enough healthcare professionals, or lack of knowledge about how to navigate a complex healthcare system. ‘‘In addition, the current epidemic of chronic illnesses, in both developed and developing economies, illustrates the need for innovative, efficient, technology-supported interventions. ’’ What is the market size, and what can mHealth tools be used for? We know that venture capital funding of wearables and other biosensors quintupled from 2011 to 2013, that the market for micro-electro-mechanical systems (MEMS) sensors is expected to grow to one trillion units per year within the next decade, and that ‘‘mHealth tools can enhance diagnostics, improve treatment, increase access to services, and lower costs. ’’ However, evidence-based research is sparse, and those studies that exist focus primarily on the use of mHealth for treatment purposes, including all the self-management activities performed by patients. Increasingly, the use of sensors combined with Bluetooth technology and Internet sites allows consumers to track their own health behaviors and conditions. Recent advances in sensor technologies have enabled sensors to become more comfortable, more reliable, more transparent, and less invasive to consumers. ‘‘In this framework, progress in the direction of high performance computing, cloud computing, big data analyses, and so on will provide the key tools to make those [energy consumption and integration] scientific and technological breakthroughs possible. ’’ One place that sensors can be used for healthcare monitoring is in the home. These applications can be divided into two broad categories: behavioral and characteristic. Behavioral sensors observe actions such as walking into a room (motion detector), steps taken (pedometer), or falling down (camera with pattern recognition software). Characteristic sensors measure physiology such as ‘‘body temperature, blood pressure, stress levels, blood-glucose levels, etc.— with the sensor system storing or reacting to this data as required by the particular reading and application. ’’ The ‘‘quantified self’’ movement we wrote about in a previous editorial is heightening consumers’ consciousness of their health status. This movement is supported by social networks that encourage behavior change, and the personalized apps and wearable sensors that interact with these networks. ‘‘The old entitlement mindset of ‘I’m broken, fix me’ is giving way to ‘I want to stay out of trouble’— a focus on prevention by positive changes in lifestyle and behavior. ’’