Mobile Health - Hope for Next Generation of Health Care
Time and space is a barrier between health care providers and their patients. Patients in rural areas, on a space shuttle flight, at accident scenes, en route to a hospital, in a submarine, and so forth, are often physically remote to the needed care providers.
Mobile telecommunication technologies have presented themselves as a powerful tool to break such barrier of time and space. With the introduction of high-bandwidth, digital communication technologies, it is possible to deliver audio, video, and waveform data to wherever and whenever it is needed.
Mobile telemedicine is a new and evolving area of telemedicine that exploits recent development in mobile technologies for telemedicine applications. According to Professor Robert Istepanian, an expert in telemedicine from Kingston University, mobile health (m-Health) will be the 21st century evolution of the 20th century “telemedicine”.
Advances in mobile telecommunication technologies will enhance the telemedicine area by integrating cellular digital mobile systems and telemedicine applications. The healthcare industry is poised to adopt these wireless devices and applications in large numbers. A rapidly increasing number of healthcare professionals now believe that wireless technology will provide improved data accuracy, reduce errors, and result in an overall improvement of patient care. The number of wireless devices in healthcare will triple by 2005, according to a new study by Technology Assessment Associates. Wireless-enabled handheld usage by U.S. physicians will climb to 55 per cent by 2005, up from the current 18 percent.
The benefits of the wireless technology can be illustrated in a number of different examples. Patient information can be obtained by health care professionals from any given location because they can be connected wirelessly to the institution’s information system. Physicians’ access to patient histories, lab results, pharmaceutical information, insurance information and medical resources would be enhanced immeasurably, thus drastically improving the quality of patient care. Handheld devices can also be used in home healthcare, for example, to fight diabetes through effective monitoring.
From these examples, some important benefits of integrated wireless telemedicine can be summarised as follows:
- m-Health provides rapid response to critical medical care regardless of geographic barriers. Hence, severely injured patients can be managed locally and access to a trauma specialist obtained by m-Health even when the specialist is out of his/her office hours.
- Flexible and swift access to expert opinion and advice at the point of care without delay and better management of medical resources. Patients would benefit from locally provided services especially when they have ready access to a second opinion. Thus, if they are in a remote location, they would expect to be able to call their specialist on their mobile phone and show him/her an image of the part of their body that they were worried about or discuss the management of an existing chronic condition that has been exacerbated.
- Interactive medical consultation and communication links of medical images and video data such as the videophones over Internet links in complete mobility and in global coverage and connectivity.
- Increased empowerment and management of medical expertise especially in rural and under-served areas could be improved using these technologies.
- Swift medical care can be made available in emergency and management of medical data in catastrophes or natural disasters where conventional communication links may be disrupted.
Challenges of m-health:
The benefits of mobile health are obvious. However, a nation’s health service is fashioned by its economy, demography, culture, and medical tradition, among other factors. This identity poses a challenge to telemedicine. For the current mobile communication networks, the increased equipment cost (such as satellite-based systems) and the limited bandwidth of the current generation of mobile telecommunication systems, have restricted the wider use of these systems within the most promising segments of the health care structures in general.
Other challenges faced by the current mobile telemedicine systems include:
- The lack of a flexible and integrated telemedical linkage of the different mobile telecommunication options. This lack of linkage exists due to the difficulty of achieving operational compatibility between the telecommunication services and the current mobile standards.
- The limited availability of mobile Internet connectivity and information access due to the current bandwidth limitations.
- Healthcare is a very complex industry and difficult to change.
- The short term and long-term economic consequences and working conditions for physicians and healthcare systems are not yet fully understood.
- The methods of payment for such mobile telemedicine are not yet fully developed and standardised.
- There is a lack of incentive for busy specialists to practice mobile telemedicine because it is seen as yet another imposition for which they are not paid.
- The currently available telemedicine equipment can sometimes be difficult to handle.
- There is a lack of integration between mobile telemedicine systems and other information systems e.g. referral and ordering systems, medical records etc.
- There are not enough numbers of demonstration projects that show mobile telemedicine’s real savings potential.
The above are some of the factors that have hindered the wider applications of mobile telemedicine technologies thus far across healthcare systems and on critical medical applications. However, in recent years some emerging 2.5G- and 3G-based m-health systems with Bluetooth medical wireless technologies have started to break the technical barriers.
It is expected that the 4G mobile system will focus on seamlessly integrating the existing wireless technologies including GSM, wireless LAN, Bluetooth, and other newly developed wireless systems. So 4G system benefits from all those wireless technologies, as currently there is no single system that is good enough to replace all the other technologies. 4G networks provide some great features such as:
1. High usability. 4G networks are all IP based heterogeneous networks that allow users to use any system at anytime and anywhere. Users carrying an integrated terminal can use a wide range of applications provided by multiple wireless networks.
2. Support for multimedia services at low transmission cost. 4G systems provide multimedia services with high data rate, good reliability and at low per-bit transmission cost.
3. This new-generation network will provide personalised service, in order to meet the demands of different users for different services.
4. 4G systems also provide facilities for integrating services. Users can use multiple services from any service provider at the same time.
The future 4G service can provide communication with realistic sensation, in which 3D sound, light, and pressure fields are sent to another party to reproduce a situation. The m-Health systems based on 4G technology will provide both mobile patients and normal working end users the choices that will fit their lifestyle and make easier for them to interactively get the medical attention and advice they need. When and where is required and how they want it regardless of any geographical barriers or mobility constraints. The concept of including high-speed data and other services integrated with voice services is emerging as one of the main points of the future telecommunication and multimedia priorities with the relevant benefits to citizen-centred healthcare systems. These creative methodologies will support the development of new and effective medical care delivery systems into the 21-Century. The new wireless technologies will allow both physicians and patients to roam freely, while maintaining access to critical medical information.
The challenge for the mobile industry from the healthcare perspective will be convincing the healthcare industry to adopt emerging wireless technology and in getting the devices to a manageable size that is compatible with the required healthcare services targeted by these technologies. This kind of application works best when inconvenience to the patient is minimized. Once new innovations make the load a bit easier to carry, and once a new generation of technology-friendly doctors start rebuilding their profession, there are myriad ways wireless technology could take over serious roles in medicine.
Hope for Next Generation m-Health Systems
The next few years will witness a rapid deployment in both wireless technologies and mobile Internet based m-health systems with pervasive computing technologies. The increasing data traffic and demands from different medical applications and roaming application will be compatible with the data rates of 3G systems in specific mobility conditions. The implementation and penetration of 4G systems is expected to help close the gap in medical care. Specifically, in a society penetrated by 4G systems, home medical care and remote diagnosis will become common, check-up by specialists and prescription of drugs will be enabled at home and in under-populated areas based on high resolution image transmission technologies and remote surgery, and virtual hospitals with no resident doctors will be realised. Preventive medical care will also be emphasised: for individual health management, data will constantly be transmitted to the hospital through a built-in sensor in the individual’s watch, accessories, or other items worn daily, and diagnosis results will be fed back to the individual. However, it is well known that current Healthcare systems are stuck with the equation:
Current Organisation + New Technology = Expensive Current Organisation.
Hence, the expectations are for these new generation mobile and wireless technologies to be acceptable for sort of examples that represent challenges for these technologies such as:
1. Citizens become customers
2. Input measures are replaced by output measures
3. Citizen relationship costs fall
4. Taxes are lowered because of competition.
In addition there is hope for the wider deployment of mobile telemedicine system because of some global changes, which are likely to have a major effect on the healthcare industry. Those changes are:
- Increasing numbers of older adults and fewer young people so as to sustain the economy, the elderly will have to be persuaded to continue working longer. To be able to do this, a greater emphasis on the health of the elderly will mean an increase in demand for healthcare. At the moment an obstacle to the implementation of telemedicine is that commercial organisations do not regard the health economy as large enough to invest time and research. The growing demand for healthcare services and the reduced supply of service providers and caregivers will mean that telemedicine suddenly acquires a heightened importance.
- Fragmentation of care caused by the twin pulls of generalisation to push down costs and specialisation to meet the increasing needs of rapid advances. Co-operation in healthcare, which has been anathema to healthcare workers, will have to be achieved by patient power rather than central directive.
- Increased patient expectation because of easier access to information will mean that the pre-eminence of the physician will be challenged. Patient lifestyles will mean that at least affluent ones will demand treatment wherever they are at the time because of a new leisure-oriented lifestyle. On the other hand, patients at the lower end of the socio-economic scale may have to settle for lower expectations.
- Increased complexity of assessment, diagnosis, investigations and treatment will mean a knowledge explosion and the falling short of the quick dissemination of the knowledge and expertise. Again, telemedicine may serve a useful function of rapid dissemination of the skills and knowledge.
With the advances of new mobile technology and the convenience it brings to the customers, m-Health will be finally integrated into the current healthcare system and thus improve the quality of life for the citizens.