March 19, 2011 presentation at the Annual conference for the Association for Prevention Teaching and Research on opportunities for students to be engaged with mHealth.

1. Student mHealth Engagement
Learning about the Preventive Health IT Toolbox
Jessica Jacobs
Georgetown University
Association for Prevention Teaching and Research - Annual Conference
March 19th 2011

2. What is mHealth?
Current Trends
Applications
Why Education?

3. What is mHealth?: Questions to Consider
 There is not a consensus on what mHealth is.
 Questions to Consider:
1) What kind of connection does it have to have?
 Broadband? Wifi? Wired Internet?
2) What technology does it include?
 Cell phones? PDAs? Devices? Computers?
3) What’s the application?
 Clinical Data? Community Health? Personal Health?
4) What’s it part of?
 Telehealth? eHealth?

4. What is mHealth?: Broad Definition
 All the definitions focus on mobile communications and
healthcare.
 Broader definitions seem to be gaining more steam.
“The integration of mobile technology, computing devices, and
emerging delivery system capabilities into a patient-centered
model of care.”
– Indian Health Service
US Department of Health and Human Services

5. What is mHealth?
Current Trends
Applications
Why Education?

6. Current Trends: Technology Adoption
Utilization of Mobile Technology
Aged 18-29 Aged 30-49 Aged 50-64 Aged 65 and Over
90% 88% 86%
82%
72%
57% 59%
47%
38%
11% 15%
6%
Own a Cellphone Send/Receive Text Access Internet on a Cell
Messages Phone

7. Current Trends: Federal Support
•HITECH Act to spur the adoption of EHRs, HIEs, and other Health IT.
•Provisions in PPACA for telehealth and innovation in healthcare.
•Continued Presidential commitment to “the need to increase coverage of
high speed wireless networks to 98 percent of all Americans within the next
five years”: “This isn’t about faster Internet or fewer dropped calls. It’s about
connecting every part of America to the digital age. It’s about a rural
community in Iowa or Alabama where farmers and small business owners will
be able to sell their products all over the world. It’s about a firefighter who can
download the design of a burning building onto a handheld device; a student
who can take classes with a digital textbook; or
a patient who can have face-to-face video chats with her doctor.”
- President Barack Obama
2011 State of the Union Address

8. What is mHealth?
Current Trends
Applications
Why Education?

9. Applications: Continuum
Management Promotion Surveillance
Personal Public Population

10. Applications: Management
•Patient-centered personal health
management.
•Patient or care-giver driven.
•Typically includes a device or smartphone
application.
•PHR and EHR integration is possible.
•Particularly beneficial for conditions where
continual tracking is warranted:
•Diabetes
•Asthma/COPD
•CHF
•Aging in Place
•Medication Adherence
10

11. Applications: Management - Diabetes
 Link glucose meter readings to
patient records electronically.
 This link ensures that readings are
recorded correctly and allows for
physicians to passively monitor a
patient’s blood glucose.
 Pilot studies show that this kind of
application is effective; indeed, it is
correlated to a reduction of 5
points in blood glucose readings
and a 1% reduction in HbA1c
readings over a three-month
period.
Watson et al. “Diabetes Connected Health: A Pilot Study of a Patient- and Provider-Shared Glucose Monitoring
Web Application” Journal of Diabetes Science and Technology, March 2009, Volume 3, Issue 2: Page 345-352.
http://www.connected-health.org/programs/diabetes/research-materials--external-resources/diabetes-connected-
health-a-pilot-study-of-a-patient--and-provider-shared-glucose-monitoring-web-application.aspx

12. Applications: Promotion
• Educational messages targeted at
behavior modification.
• Public Health department/federally
driven.
• Usually utilizes cell phone messaging
because it’s quick, easy, and cheap.
• May be one way or two way messaging.
• Particularly beneficial for chronic.
 Smoking Cessation
 Sexual Health
 Pregnancy
 Depression 12

13. Applications: Promotion – text4baby
 Free national SMS health information service.
 One way text messaging.
 Large public-private partnership.
 Healthy Mothers Healthy Babies (HMHB), Voxiva, The
Wireless Foundation (CTIA), HHS/OSTP, J&J, etc.
 3 messages/week.
 Pregnancy through first year of child’s life.
“1 Million Moms” 2012 Goal
0% 20% 40% 60% 80% 100%
Current Enrollment To Go
13
* As of February 2012, http://www.text4baby.org/news/mothers_are_getting_message.html

14. Applications: Surveillance
• Health tracking for timely notification.
• Health Worker and/or community driven.
• Low cost reporting mechanisms.
• Particularly useful in remote areas.
• Web and SMS based.
• Potentially Useful for:
• Disease Outbreaks
• Program Evaluation
• Contaminations
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15. Applications: Surveillance - EpiSurveyor
 Allows people to design forms for data
collection on the internet.
 Data is entered into the forms using either a
smart phone application or SMS
messaging.
 Allows for real-time data uploads and
analysis.
"drastically cut costs while
 Been used to evaluate: facilitating quality control
and improving
 anti-malarial bednet distribution and vaccination
campaigns in sub-Saharan Africa implementation speed.“
 clean water initiatives in Vietnam
- The World Bank
 drug supplies in several African countries
 health delivery systems in Guatemala
* 2011 World Bank Report: http://siteresources.worldbank.org/INTLAC/Resources/257803-
1269390034020/EnBreve_166_Web.pdf

16. What is mHealth?
Current Trends
Applications
Why Education?

17. Why Education?
Opportunity
 Prepare to engage and be engaged with mHealth.
 Contribute to the growing body of knowledge.
 Review for efficacy and separate “signal” from
“noise.”
 Innovate to discover applications for new and
existing technologies.

18. In Conclusion…
 Current trends show that the utilization of mHealth will
increase.
 Its applications are numerous and widely encompassing:
 Management: Connecting mHealth applications with
traditional health IT systems will provide a groundbreaking
continuum of personal care, particularly for those with chronic
conditions.
 Promotion: Wide scale education and behavior modification
will improve the health of the public.
 Surveillance: Real-time health tracking and data aggregation
leads to actionable information for population health.
 There is significant opportunity for educators to inform
and engage students with these technologies.
Source: http://www.healthcareitnews.com/news/mhealth-apps-forecast-increase-threefold-2012-0