How the definition of mHealth varies depending on uses cases

The definition of mobile health has never been clear-cut, but it's more muddled than ever with the increased computing power of mobile devices.

What is the definition of mHealth? If a patient uses an iPad to perform a Google search for flu symptoms and reads about fevers and aches, is the patient engaged in mHealth? The person could have done the exact same thing on a desktop computer, but that would not be considered mHealth.

There is much confusion these days about what is and is not mHealth. The capabilities of mobile devices such as smartphones and tablets overlap significantly with the capabilities of desktop computers. Laptops can essentially do everything a desktop can, but the device itself is mobile. This slight difference makes laptop computing a gray area in mHealth.

Wikipedia's definition of mHealth is "a term used for the practice of medical and public health, supported by mobile devices." Well, in today's digitally connected world of healthcare delivery, that would encompass a lot. Wikipedia continues by saying, "The term is most commonly used in reference to using mobile communication devices, such as mobile phones, tablet computers and PDAs, for health services and information, but also to affect emotional states."

Is there a framework that will help us differentiate between what is mHealth and what's not? Smartphones, tablets, laptops and desktops overlap in functionality, making it more difficult to separate and adequately segment these devices. However, patients and healthcare providers use these digital tools for different functions, so maybe we could start there.

Researching health information

If a patient uses a symptom checker app on a smartphone, is this mHealth? The same symptom checker may also exist for a desktop computer. Once again, this is an example where the mobile symptom checker demonstrates the benefit of immediate, always-accessible information. If a person feels ill while dining at a restaurant, he may not have time to run home, power on a desktop and research his symptoms. Being able to pull out his smartphone and research his symptoms while sitting at the restaurant is an example of mHealth.

Similarly, a doctor who uses a smartphone to research a medication interaction could have done the same thing on a desktop computer. However, the doctor always carries a smartphone, so he now always has access to resources that can help him be a better doctor. This is mHealth.

Accessing personal health information

What does it mean to deliver healthcare using technology? For one, we have to start by asking the question: Are we just speaking about sick patients or including healthy individuals? If we include all people, then mobile technology is playing a key role in the delivery of actual health services. If your lab results are sent to you by Short Message Service or via a mobile app, then that is an example of mobile technology facilitating the delivery of health services. You could have also received the same information on a desktop, so although the process is the same, the fact that you are receiving the information on a mobile device makes it different. We can access information faster and easier when the information is available on a mobile device because we carry that method of communication with us.

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Delivering health services

Perhaps the most compelling example of mHealth is when patients use mobile devices to receive healthcare services. If a villager in India takes a photo of his swollen toe and sends it to a physician, he can receive a diagnosis of gout and also get a prescription for treatment. This is mHealth at its best. Without the camera phone, the patient would not have been able to receive proper care.

Another example is when a paramedic arrives at the scene of an accident and transmits patient electrocardiogram (ECG) data to a remote cardiologist. The cardiologist then instructs the paramedic to give certain medications. The patient would not have received optimal care without mobile technology and a wireless infrastructure to support the two-way communication.

Communicating

Communication between a healthcare provider and a patient is not just about exchanging information. That communication changes when you enhance it with photos, videos and biometric patient data. We no longer live in a world where you can only speak to an on-call physician in the middle of the night. If your child has a fever and a rash, there is no reason why your on-call pediatrician should not be able to see that rash. If you cut your leg while camping and it is getting red and swollen, you can let your physician evaluate the condition of the cut. Digital medical devices are allowing physicians to remotely listen to patient heart sounds and lung sounds, look in patients' ears and throats, and interpret certain biometric information such as heart rate, ECG, pulse oximetry and more.

Some people insist on distinguishing among such terms as mHealth, telemedicine, telehealth, remote monitoring, digital health, wireless health and connected health. There are some clear distinctions, but we are seeing more overlap as mobile devices become ubiquitous. Soon, it will be hard to find a person who doesn't have a mobile device. When that day comes, we will not need the "m" in mHealth. We will simply be talking about health.

Joseph Kim is a physician technologist who has a passion to leverage health IT to improve public health. Dr. Kim is the founder of NonClinicalJobs.com and is an active social media specialist. Let us know what you think about the story; email editor@searchhealthit.com or contact @SearchHealthIT on Twitter.

This was first published in September 2013

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