| | NOVEMBER 20199TECHNOLOGY HAS OPENED AVENUES THAT DID NOT EXIST BEFORE AND WILL CONTINUE TO DO SOToday, mobile devices and oth-er digital approaches are one of the main drivers of this revolution. In a world with a mobile penetration rate of over 62 percent, we are seeing an unprecedented opportunity to use this relatively new tool to improve the health and safety of billions around the globe. In India, UK-based Loughbor-ough University's engineers entered into a partnership with Indian ex-perts to develop a unique mobile phone health monitoring system. The system, which was first unveiled in 2005, uses a mobile phone to trans-mit a person's vital signs to a hospital or clinic anywhere in the world. The Govt. of India has also launched the National e-Health Au-thority (NeHA), which will be the nodal authority to develop an inte-grated health information system along with the application of tele-medicine and mobile health by col-laborating with various stakeholders. One of the most advanced apps for chronic disease management and remote monitoring, approved by the FDA, is the WellDoc Diabetes Man-ager software. In the initial clinical trial of WellDoc, the intervention group showed improved self-care in diet, medication, and exercise com-pared to the control group receiving usual care. The study demonstrated the possibility of improving treat-ment outcomes with mobile phone and web portal communications when used by both patients and their HCPs.The MyTherapy app by Smart-Patient is designed to not only re-mind patients to correctly take their medication on time but to also document and analyze patient val-ues. Also available is the option to schedule activities, rest periods and appointments. The app creates an individual task list with assignments to be checked off daily. An added in-centive is that users can directly see whether they have met their self-im-posed goals and thus assess their own progress. M-Health: Managing Chronic Diseases The invention of the smartphone may be the single most important development in the fight to ensure medication adherence, healthy life-style choices, and regular contact with the healthcare system. From text message reminders to calorie counters and on-the-go access to pa-tient portals, many of the strategies currently employed to keep patients on track would be impossible with-out mobile technology. There exists a general view among the population that technol-ogy is the answer to all our prob-lems. However, according to the study "Impact of M-Health Chronic Disease Management on Treatment Adherence and Patient Outcomes: A Systematic Review", published in the Journal of Medical Internet Re-search (JMIR), argues that M-Health interventions for chronic disease management can have some impact on certain patients and conditions, but more work is needed to ensure that the potential of M-Health is realized. The study goes on to state that these interventions must be well designed, comprehensive, easy to maintain and encouraging for participants to continue using it. Increasing patient adherence to their regimens is important and may produce positive results in the short term, but measuring the clinical outcomes of this improved behavior is the key to measuring whether or not a chronic disease management program is worth the investment. M-Health: The Road AheadOverall, M-Health interventions seem to be able to promote signifi-cant improvements in glycemic con-trol (for diabetes patients), as well as in physical activity, weight loss, and smoking cessation, among other outcomes. However, these benefits seem to be dependent on the char-acteristics of the intervention (e.g. bundle of features, use of behavior change theories, `stickiness') and the specific patient population (e.g. age, digital literacy). In order to improve the uptake and impact of M-Health services, the following measures should be adopted:1. Integration of M-Health into the healthcare service, and not sim-ply as a standalone service2. Bundling of features to enable action (such as decision support, fol-lowed by task support)3. Measures in place to main-tain participant interest and hence, minimize dropout4. Ensuring the fidelity of M-Health services (accurate deliv-ery and enactment of the service)Technology has opened avenues that did not exist before and will continue to do so. This perpetual advancement will continue to rev-olutionize the healthcare system. However, Medicine has also always been a human endeavor and it is this combination of technologi-cal revolution and human inge-nuity that will lead to further and greater inventions and innovations in healthcare.
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