By Bridget Moorman
In the rush towards mobile health adoption, many implementers are finding that their customers may not be as technically savvy and require a much simpler interface for medical device connectivity. Such is the case with the Renewing Health Project in the EU in which the initial measuring devices in many of the pilot projects used a medical device connected to a network via a mobile phone.
The Renewing Health project is using remote monitoring as one of the clinical care processes for management of three chronic diseases: cardiovascular disease, chronic obstructive pulmonary disease and diabetes. It is widely stated that 80 percent of healthcare costs in the western world are due to chronic disease management. Hence there is a desire to move to a preventive versus reactive care model coupled with a patient centered disease management approach for these chronic conditions. It is believed that the use of monitoring technologies along with patient education will decrease the occasions on which patients require hospitalization.
Additionally it is hoped that the costs to the patients of regular check-ups will decrease accompanied with a possible increase to their quality of life. The recent results of the Whole System Demonstrator project in the UK bolstered these hypotheses.
Most of the patients being monitored in the Renewing Health Project are elderly; they have less dexterity in their fingers, less acute eyesight and less familiarity with networked technical devices. Moreover their chronic disease symptoms may exacerbate these features. This has led to longer patient training sessions and wholesale change-outs of the technology to either a larger screen interface (iPads versus smartphones) and/or doing away with the mobile phone interface and embedding the telecommunications capability in the medical device doing the physiological measurement. Additionally in many cases the process has been automated such that the patient merely sees a light turn green or red and then is notified if the measurement was received at the telehealth monitoring site/application. Further assistance is also available from a traveling nurse in some cases.
In the end, these changes illustrate that the patient’s human needs have to be accounted for in the interface design: ergonomics trumps many of the other variables a company might use in their design specification. If the patient cannot use the interface easily, then they will be discouraged or unable to personally monitor the management of their chronic disease. Until the people born in the 1960s-70s and later start comprising a larger proportion of the elderly, use of embedded mobile networking technologies with medical devices will be needed as an option for a successful mHealth implementation. A second requirement will be larger profile keyboards and screens for the less nimble fingers and less acute vision associated with chronic disease patients.
Interestingly as the younger people today become elderly, the physiological changes that accompany aging (eyesight, balance and dexterity) will still lead to successful mobile health designs taking into account those variable factors. So even though the generation born in the 1960s-70s is comfortable with ubiquitous computing and networking, they will probably still appreciate embedded mobility and large keyboards and screens.
Bridget Moorman is President of BMoorman Consulting which provides medical device interoperability and connectivity expertise for the healthcare and information technology industries. She is currently supporting GSMA in their work on mobile health.
The editorial views expressed in this article are solely those of the author(s) and will not necessarily reflect the views of the GSMA, its Members or Associate Members