Dezhi Wu , Rob Robertson and Eric Freden
Mobile technologies have enabled people to access information anytime and anywhere, which makes our lives more convenient and efficient. Mobility has been greatly enhanced due to the implementation of cutting-edge mobile communications and networks. It is now common to see people on the go using their iPhones, iPads, and Android smart phones to check email, play games, and connect with friends and coworkers through the mobile version of social networking sites, such as Facebook, Twitter, and LinkedIn.
The rapid advancement of mobile technologies has made a large impact on our society; in particular, it has started to benefit the healthcare field, which is generally called mHealth. The mHealth area covers prevention, screening and diagnosis, disease management, rehabilitation and physical therapy, decision making, and so on. It creates a new emerging business model for the healthcare field through delivering care anytime and anywhere. Nowadays, the role of patients is being changed from a traditional passive receiver to an active partner with their doctors to make decisions concerning their health situations. Mobile technologies used in patient education programs empower the patients to be more knowledgeable on their health issues and to be more engaged in communicating with their doctors (Charles et al., 1999; McNutt, 2004). Mobile patient education software is playing a key role in this interactive process, creating more cost-effective, personalized, and convenient patient experiences, which improve the quality of patient care.
In practice, it was reported that over half of young medical doctors were using mobile devices in their clinics (Martin, 2003). A recent news item from 2011 (http://www.pwc.com/ ) indicates that a two-year study by the Mayo Clinic Department of Family Medicine shows mHealth systems enabled e-visits to eliminate 40% of in-office visits in 2531 cases. On average, about 40% of physicians said that using mobile health technologies such as remote monitoring, e-mail, or text messaging with patients greatly enhanced their work productivity and saved them time and money. In Europe, a mobile health application was designed for aging patients to undertake their self-diagnosis (Ahmad et al., 2008). The US army has started to design and implement mobile patient care systems for their soldiers using smart phones (Poropatich et al., 2010). Therefore, it is clear that the trend to adopt mHealth is rising, but there are still many technical barriers (www.ama-assn.org ), e.g. integration with the existing healthcare infrastructure or the capability to communicate with patients through a variety of mobile devices etc.
This paper reports a recent mobile patient education project conducted in the United States. We employed a user-centered design approach to develop and implement cross platform mobile patient education software, which is projected to greatly benefit patient care through cutting-edge mobile technologies. The mobile device technologies will enable expanded patient interaction with their doctors. All patient records and their privacy are protected according to the US Health Insurance Portability and Accountability Act (i.e., HIPAA), using cryptographic technologies through point-to-point encryption, secure protocols and secure Web servers in a private cloud.
Two focus groups with real patients were conducted in determining the design and content for this mobile patient education system. The first focus group included six patients who helped us identify the key design features, such as the interface design layout, color scheme, possible interactive content delivered through multimedia elements, such as text, images and videos, and the patient preferred navigation patterns. The second focus group, consisting of eight pregnant mothers in a local OB doctor’s office, was invited to attend a video lesson which was in line with the current stage of pregnancy. The educational videos instructed the mothers on the development of the baby/fetus and changes that occur in the mother’s body. The videos also highlighted specific weeks of baby/fetus development and what pregnant women could expect during that time frame. The mothers especially enjoyed the personalized educational content delivered in the videos, expressing that it helped them learn and better manage their own and their babies’ health during the pregnancy period.
Currently, the initial prototype developed for the iPad is working. We plan to complete the implementation of this mobile patient education system in the next six months. We will also conduct further usability studies to test and evaluate this system. In the meantime, a theoretical research framework is being developed to measure the system effectiveness, perceived patient learning outcomes, perceived patient control in terms of the users’ interface, security and privacy concerns, perceived enjoyment using the system, and potential patient behavior changes which improve their health. Research methodologies we propose to use in order to evaluate this mobile patient education system include a few longitudinal field studies in selected local physicians’ offices utilizing real patients, field observations in the doctors’ exam rooms, and a large survey in the doctors’ offices and hospitals which have adopted our system. We speculate that the mobile patient education system will greatly enhance the healthcare field, and empower patients to be more knowledgeable and capable in making better decisions to manage their personal health.
Ahmad, D., Komninos, A. and Baillie, L. (2008) Future mobile health systems: Designing personal mobile applications to assist self diagnosis, Proceedings of the 22nd British HCI Group Annual Conference on People and Computers: Culture, Creativity, Interaction, Vol. 2, published by the British Computer Society.
Charles, C., Gafni, A. and Whelna, t. (1999) Decision-making in the physician-patient encounter: Revisiting the shared treatment decision-making model, Soc. Sci. Med. 49 (Sept, 1999), 651-661.
Martin, S. (2003) More than half of MDs under age 35 now using PDAs, Canadian Medical Association Journal, Oct. 28.
McNutt, R. A. (2004) Shared medical decision making: problems, process, progress, J. Am. Med. Assoc. 292, Nov., 2516-2518.
Poropatich, R., Pavliscsak, H. H., Rasche, J., Barrigan, C., Vigersky, R., and Fonda, S. J. (2010) Mobile healthcare in the US Army, Proceedings of ACM Wireless Health Conference, Oct. 5-7, 2010, San Diego, CA, USA.
www.ama-assn.org (Accessed on Jan. 30, 2011)
http://www.pwc.com/ (Accessed on Feb. 2, 2011)