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Building the future of mobile healthcare

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The combination of mobile devices with diagnostic tools offers new possibilities to test, track and treat infectious diseases as well as improve health systems, according to a new review published today in Nature.

The review, led by i-sense researchers from Imperial College London in collaboration with University College London, Africa Health Research Institute (AHRI), University of KwaZulu-Natal and the London School of Hygiene and Tropical Medicine, discusses how mobile health (mHealth) solutions combined with connected diagnostics could increase access to testing and care for patients, and improve the ability of public health authorities to monitor outbreaks and intervene to stop them.

“Today more than half the world’s population have a mobile phone connection and a growing fraction of this is made up of smartphones,” says Molly Stevens, Professor of Biomedical Materials and Regenerative Medicine at Imperial, i-sense Deputy Director, Flagship 4 (HIV and Ebola) lead and senior author of the Nature paper.

“By 2020, GSMA forecast that one in two mobile phone connections in the region will be via smartphone – a similar figure to worldwide smartphone adoption.”

By using the existing built-in sensors in mobile phones and exploiting their computational and connective power, diagnostic test results can be securely sent and interpreted to local clinics or healthcare workers, supporting virtual follow up appointments and rapid treatment in a simple, cost-effective way.

As part of the review, PhD student in the i-sense McKendry group at UCL and co-author on the paper, Jobie Budd (UCL Division of Medicine and London Centre for Nanotechnology), has used publicly available data to plot smartphone adoption globally and in Sub-Saharan Africa, against the capabilities of ‘high end’ and ‘low costs’ models. The findings show a continued growth in adoption of smartphones in both resource-rich and resource-limited settings, and suggests that low cost devices are reducing the barrier for adoption, while still offering devices of similar sensing and processing capabilities.

“We are now seeing how simple diagnostic devices can be complimented by the processing power and connectivity of modern mobile phones to produce portable devices with the potential to match the performance of traditional expensive and cumbersome laboratory diagnostic equipment” says Dr Michael Thomas, co-lead author and Postdoctoral Research Associate in the i-sense Stevens group at Imperial.

“When this new generation of diagnostic technologies is successfully implemented into care pathways, they will have the potential to lead to major health and economic benefits for millions of people all over the world,” adds Rachel McKendry, Professor of Biomedical Nanotechnology at UCL and Director of i-sense.

The review outlines the benefits that such mHealth solutions could have for various groups.

  • Individuals benefit from increased access to healthcare outside of traditional care settings, along with more rapid access to diagnoses and results, allowing them to better understand and manage their own health
  • Healthcare workers benefit from improved efficiencies in service delivery, through automated decision trees and reduced paperwork, reducing workload and freeing up time
  • Clinics benefit from improved data management, better stock control and more cost-effective, user-friendly services
  • Public health systems benefit from the closer to real-time reporting of health data, allowing them more efficient surveillance of outbreaks, to implement control measures that can limit the spread of infection, and target public education

 “The development of mHealth interventions have addressed a number of challenges in healthcare and public education, and connected tests have the ability to improve and build on this in new and exciting ways,” says Dr Christopher Wood, co-lead author and Postdoctoral Research Associate in the Stevens group.

The implementations of such solutions, however, do not come without challenges. While rapid advances in technologies have the potential to widen access to testing, still more than 35 per cent of the world’s population do not have access to a mobile phone. Concerns also arise in age and gender gaps in relations to the use of digital technologies as well as privacy and confidentiality of test results.

To demonstrate the challenges for mHealth solutions as a result of the digital divide, Jobie has also used open source data to map out network coverage and distance to healthcare facilities in Uganda.

It was shown that one in five of the population in this part of Africa have no access to cellular networks. However, of the 22 per cent that live more than 5 km from the nearest health centre, approximately two in three people are in range of a cell tower, meaning that they could benefit from mobile health interventions. 

“In addition to the digital divide, connectivity standards and regulatory science have not kept pace with technological advances, making it challenging for the adoption and implementation of mHealth solutions” says Rosanna Peeling, Professor and Chair of Diagnostics Research at the London School of Hygiene and Tropical Medicine, and i-sense Flagship 1 lead (system needs).

Regulatory challenges arising from the rapidly evolving types of mobile device and their associated hardware need to be overcome before we establish how these technologies will interface to clinical pathways and how they will allow escalation to face-to-face care and referral when needed.

“The future of this digital revolution brings promise for better connectivity and rapid changes in the way healthcare is delivered and received, for instance outside of clinics and hospitals,” says Deenan Pillay, Director of Africa Health Research Institute, Professor in Virology in the UCL Division of Infection & Immunity, and i-sense Deputy Director.

“Indeed, such approaches are being rapidly scaled up in resource-limited settings.”

This is an exciting opportunity for researchers and policy makers to develop new tools and systems that could drastically improve human health and wellbeing in the future.

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