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mHealth: Get a monitoring app with a doctor’s prescription

 


Wouldn’t it be most comfortable to pee at home? Nevertheless, we usually go to the hospital when we need a urine test. Then, while the nurse is waiting outside the door, use the hospital bathroom to provide a urine sample. Alternatively, you can bring your urine sample in a small plastic bottle. By combining the scale sensor and app, you may soon be able to comfortably test at home. This is still , but a shift is underway. Monitoring of health parameters can be performed more often and effectively from home.

Use the so-called mHealth application. This is an abbreviation for Mobile Health and is associated with eHealth. It uses information and communication technology to devise applications that can support or improve health and healthcare. mHealth, for example, refers to home monitoring. An example of this is how diabetics use the app to track their blood glucose and carbohydrate intake. You can also share it with your doctor or diabetes nurse if you wish. There are also applications available for people suffering from lung and heart conditions. Belgian start-up FibriCheck has developed an app that measures heart rate and heart rhythm from home.

327,000 health apps

mHealth first appeared as a term 10 years ago. The UK organization ORCHA (Organization for the Review of Care and Health Applications) collects and reviews new and updated versions of eHealth applications. Earlier this year, we published a report on mHealth. This shows, among other things, that 327,000 health apps have been created and 5 million health apps are downloaded daily over the last decade. This increase is especially noticeable in the fitness sector. According to the report, mHealth is now not an integral part of healthcare, but rather provides value.

The corona crisis could boost more home monitoring to ease the burden on hospitals. For example, a team of students from Eindhoven University of Technology (TU / e, The Netherlands) [email protected]Allows home rehabilitation of former corona patients in the intensive care unit. Basshorn, a training general practitioner, is involved in this development.

Monitor diabetics at home

Prior to studying medicine, he earned a bachelor’s degree in biomedical technology from Eindhoven. Horn wants to use technology to further develop healthcare. He has been treating patients for the past year and a half. His master’s thesis studies the potential for home monitoring of diabetics. The urinalysis example is from one of the projects he was involved in during medical research. “You can use the automatic link between the scale and the app to find out if someone is urinating properly. Then you can share that information with your doctor via an online platform. I will. “

In Horn’s view, the key to the power of home surveillance is primarily the ongoing process by which it takes place. “Recently, patients often go to the doctor once a month to check their blood pressure. If it’s too high, they say,” You need to exercise more and eat healthier. ” After that, when the patient left and returned a month later, it is uncertain whether he actually followed the advice. Daily monitoring of weight, steps, and blood pressure reveals a more comprehensive situation. Patients can also gain insights on how more exercise and weight loss affect blood pressure in this way. Horn argues that then their behavior will change sooner. “And these parameters can be easily tracked at home.”

“White coat hypertension”

Anyway, when you see your doctor, your blood pressure will be a little higher, says Horn. “That’s what we call” white coat hypertension. ” Doctors are no longer wearing lab coats, but sitting in the GP’s office is not a natural situation and creates a bit more tension, Horn explains.

Similarly, tracking your daily blood pressure and sleep habits will give you a more objective picture of your situation. Horn: “People tend to give subjective answers about how they are doing.”

Smartphones can deliver objective data and collect it for a long period of time. For example, the time to call or chat with someone. That information may be used in the future, for example, as an indicator of brain damage. Martien Kas, a professor of behavioral neurobiology at the University of Groningen (RUG, The Netherlands), used mHealth in his work to map behavior more objectively and over time.

Open to interpretation

Scientists primarily use interviews and questionnaires to assess people’s behavior. Subjectivity is a risk here. Interviewers and patients have their own interpretation of the question. In addition, such questionnaires are often one-off, Kas says. Observational studies are also an option and are usually done only in clinical settings. This is not a natural situation for the patient.

Data on your smartphone can reveal something about how often someone communicates with others, or how often someone visits a new location. “Measuring this data over time may indicate changes in social behavior. A research group led by Professor Kas has developed a digital platform to use to understand raw data collected from smartphones. Kas: “It’s like distinguishing between different aspects of social behavior. This is important for early detection of brain disease and a better understanding of social behavior.”

This type of investigation immediately raises privacy issues. That’s why Kas’s research group spent so much time investigating these issues, the professor emphasizes. “All privacy-friendly data, such as phone numbers and names, is encrypted. Researchers don’t know who they’re talking to, and they don’t even register the content of conversations or text messages. . “

reliability

You can also get a lot of information from fitness wearables such as Fitbit, such as steps per day and sleep patterns. The data from Fitbit is not intended for medical purposes. The app or online platform must be CE marked in Europe and the United States and must be FDA approved. This proves that you can make reliable and accurate measurements. Horn: “I don’t want an inaccurate reading of blood pressure to lead to drug changes, which in turn leads to even greater problems.”

Doctors usually don’t use information from devices like Fitbit at this stage, Horn says. “For example, if that information indicates that someone’s heart rate is increasing, a heart scan will be done as part of the subsequent treatment procedure. Horn expects this to change within the next decade. I have.

Horn says some doctors and nurses are still reluctant to rely on technology. It is also difficult to say who is responsible for what. “If the patient automatically checks his blood pressure every day, is the doctor legally obliged to check his blood pressure every day?”

Health supplement

This is primarily related to the provision of information, said Colette Kypers, an associate professor at the University of Applied Sciences (Netherlands) and a lecturer in law and digital technology. “If a doctor prescribes an app and acts as if it were a complete alternative to consultation, the doctor may be held liable.” In that case, according to Cuijpers, they are the right type. Does not provide information about. “If you clearly explain to the patient that it is purely a tool, not a substitute for a medical examination, that is, if something changes, you need to contact your doctor, then what the patient does. You are responsible for it. “

Cuijpers also recognizes physicians’ fears of the potential lack of reliability in technology. “What is their role if the technology is flawed?” Finding the answer to this is a joint effort involving different disciplines, Cuijpers continues. “Behavioral scientists are studying when they are confident enough in technology, and what if we rely too much on it? Current technology: How far is technology going? You What can you do with it? Incorporate legal and guarantees into it and write it down on paper. And, of course, the medical part: what can technology contribute to the human side of healthcare? For example, cancer. Recognizes specific patterns of illness. Algorithms can identify these patterns much better than the human eye. “

Severe warning

Obviously, Cuijpers points out that a doctor is always needed to verify everything. Just as you can scan bruises with the app. “This is a predictor, not a medical diagnosis. If you have a prediction that something might be wrong, it’s a harsh warning to go see your doctor and have them see it.”

mHealth has the potential to lead to more efficient healthcare in the future, Cuijpers says. “This is also necessary as we are aging and fewer and fewer staff are available to provide care. If it can be done in a cheaper, more efficient and responsible way, I would I definitely support it. As a lawyer, I see the legal framework. What are the potential consequences and how can I limit the risk as much as possible?

After 10 years, self-monitoring and telemedicine will be normal, according to an ORCHA report. But before that, there’s still a lot to do “together.”

Also interesting: (not) desirable: an app that not only saves your life, but also shares your data with commerce

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