Mobile mHealth

At first glance, the term ‘mobile mHealth’ might seem redundant. Consider a mobile van equipped not with physicians or nurses for the homeless, runaway youth, uninsured people above the poverty level, deployed servicemen, and the incarcerated, but with a medical technician and mobile wireless devices capable of monitoring, diagnosing, and text communicating. Telehealth technology would also be included.
Potential advantages of mHealth and other wireless technologies have been discussed in many diverse forums. They have the potential to save money and improve outcomes by providing more continuity of care. The way in which these tools are and will be implemented is dependent upon business models, reimbursement strategies, and regulatory compliance. Those targeted at patients with chronic diseases will be best adopted at the point of care, either via e-prescribing at the provider’s office or at transitioning from the inpatient to outpatient setting. Those targeted at consumers will be adopted via commercial outlets or via the purchase of mHealth apps. There are needy populations, however, which do not fit into either adoption setting.
Mobile health clinics have been in existence for many years. There is currently an initiative underway, The Mobile Health Map Project which will facilitate the scientific study of the impact of mobile health clinics in the USA (http://www.mobilehealthmap.org/history.php?PHPSESSID=ub6l6vln9uuai5bcj6inf0h4b4). If wireless mHealth technologies are incorporated into mobile health clinics, it would serve multiple purposes. It can decrease the need for highly skilled clinicians (physicians, nurses), and can increase continuity of care. The patient need not carry around a mobile device for monitoring or messaging, but can ‘check in’ to the mobile health unit where these devices may reside. Alternatively, in other situations, mobile devices can be distributed and shared at places such as shelters for the homeless or abused families, or prisons. The information may be processed and directed to a more centralized mobile unit where management teams can act on significant results or interact with patients.
We talk about patient engagement, but not engaging people in healthcare who are marginally engaged in societal life in general is possible via mHealth technologies in mobile health units. The growing shortage of volunteer professionals and increasing numbers of marginalized citizens presents a great opportunity for this type of healthcare model to thrive. In addition, this model may be applicable to armed forces personnel in remote areas. Perhaps it can be a true proving ground for mHealth.