Mobile technology and the digitization of healthcare.

The convergence of science and technology in our dynamic digital era has resulted in the development of innovative digital health devices that allow easy and accurate characterization in health and disease. Technological advancements and the miniaturization of diagnostic instruments to modern smartphone-connected and mobile health (mHealth) devices such as the iECG, handheld ultrasound, and lab-on-a-chip technologies have led to increasing enthusiasm for patient care with promises to decrease healthcare costs and to improve outcomes. This 'hype' for mHealth has recently intersected with the 'real world' and is providing important insights into how patients and practitioners are utilizing digital health technologies. It is also raising important questions regarding the evidence supporting widespread device use. In this state-of-the-art review, we assess the current literature of mHealth and aim to provide a framework for the advances in mHealth by understanding the various device, patient, and clinical factors as they relate to digital health from device designs and patient engagement, to clinical workflow and device regulation. We also outline new strategies for generation and analysis of mHealth data at the individual and population-based levels.

[1]  J. Piette,et al.  Mobile Health Devices as Tools for Worldwide Cardiovascular Risk Reduction and Disease Management , 2015, Circulation.

[2]  M. Rosenqvist,et al.  Mobile-phone dispatch of laypersons for CPR in out-of-hospital cardiac arrest , 2015 .

[3]  G. Hillis,et al.  Effect of Lifestyle-Focused Text Messaging on Risk Factor Modification in Patients With Coronary Heart Disease: A Randomized Clinical Trial. , 2015, JAMA.

[4]  V. Ajay,et al.  A Cluster-Randomized, Controlled Trial of a Simplified Multifaceted Management Program for Individuals at High Cardiovascular Risk (SimCard Trial) in Rural Tibet, China, and Haryana, India , 2015, Circulation.

[5]  Joel J. P. C. Rodrigues,et al.  Mobile-health: A review of current state in 2015 , 2015, J. Biomed. Informatics.

[6]  C. Gidengil,et al.  Evaluation of symptom checkers for self diagnosis and triage: audit study , 2015, BMJ : British Medical Journal.

[7]  Julie Redfern,et al.  The mobile revolution—using smartphone apps to prevent cardiovascular disease , 2015, Nature Reviews Cardiology.

[8]  Brian W. Powers,et al.  The digital phenotype , 2015, Nature Biotechnology.

[9]  A. Facchinetti,et al.  Retrofitting of continuous glucose monitoring traces allows more accurate assessment of glucose control in outpatient studies. , 2015, Diabetes technology & therapeutics.

[10]  Giancarlo Mauri,et al.  Managing chronic pathologies with a stepped mHealth-based approach in clinical psychology and medicine , 2015, Front. Psychol..

[11]  S. Bhavnani,et al.  WHICH PATIENTS? WHICH DEVICES? MHEALTH MONITORING WITH WEARABLE AND IMPLANTABLE DEVICES IN HEART FAILURE: META ANALYSES OF RANDOMIZED TRIALS , 2015 .

[12]  Harry W Severance,et al.  Smartphone ECG for evaluation of STEMI: results of the ST LEUIS Pilot Study. , 2015, Journal of electrocardiology.

[13]  Walid Saliba,et al.  Using a novel wireless system for monitoring patients after the atrial fibrillation ablation procedure: the iTransmit study. , 2015, Heart rhythm.

[14]  F. Collins,et al.  A new initiative on precision medicine. , 2015, The New England journal of medicine.

[15]  J. Ioannidis Stealth research: is biomedical innovation happening outside the peer-reviewed literature? , 2015, JAMA.

[16]  D. Asch,et al.  Wearable devices as facilitators, not drivers, of health behavior change. , 2015, JAMA.

[17]  S. Steinhubl,et al.  Digital medical tools and sensors. , 2015, JAMA.

[18]  E. Årsand,et al.  A Mobile Health Intervention for Self-Management and Lifestyle Change for Persons With Type 2 Diabetes, Part 2: One-Year Results From the Norwegian Randomized Controlled Trial RENEWING HEALTH , 2014, JMIR mHealth and uHealth.

[19]  A. Seth,et al.  eICU reduces mortality in STEMI patients in resource-limited areas. , 2014, Global heart.

[20]  Chi-Hong Tseng,et al.  Effectiveness of a Smartphone Application for Weight Loss Compared With Usual Care in Overweight Primary Care Patients , 2014, Annals of Internal Medicine.

[21]  William T. Abraham,et al.  Wireless Pulmonary Artery Pressure Monitoring Guides Management to Reduce Decompensation in Heart Failure With Preserved Ejection Fraction , 2014, Circulation. Heart failure.

[22]  Benjamin C. K. Tee,et al.  Continuous wireless pressure monitoring and mapping with ultra-small passive sensors for health monitoring and critical care , 2014, Nature Communications.

[23]  Martin McKee,et al.  Cardiovascular risk and events in 17 low-, middle-, and high-income countries. , 2014, The New England journal of medicine.

[24]  Emma P Bray,et al.  Effect of self-monitoring and medication self-titration on systolic blood pressure in hypertensive patients at high risk of cardiovascular disease: the TASMIN-SR randomized clinical trial. , 2014, JAMA.

[25]  S. Steinhubl,et al.  Novel wireless devices for cardiac monitoring. , 2014, Circulation.

[26]  Aaron S Kesselheim,et al.  FDA regulation of mobile health technologies. , 2014, The New England journal of medicine.

[27]  Marlien Varnfield,et al.  Smartphone-based home care model improved use of cardiac rehabilitation in postmyocardial infarction patients: results from a randomised controlled trial , 2014, Heart.

[28]  David J Gladstone,et al.  Atrial fibrillation in patients with cryptogenic stroke. , 2014, The New England journal of medicine.

[29]  Frank Beckers,et al.  Cryptogenic stroke and underlying atrial fibrillation. , 2014, The New England journal of medicine.

[30]  H. Kamel Heart-rhythm monitoring for evaluation of cryptogenic stroke. , 2014, The New England journal of medicine.

[31]  Marc D. Breton,et al.  Safety of Outpatient Closed-Loop Control: First Randomized Crossover Trials of a Wearable Artificial Pancreas , 2014, Diabetes Care.

[32]  N. Lowres,et al.  Feasibility and cost-effectiveness of stroke prevention through community screening for atrial fibrillation using iPhone ECG in pharmacies , 2014, Thrombosis and Haemostasis.

[33]  W. Kenneth Ward,et al.  Modeling the Glucose Sensor Error , 2014, IEEE Transactions on Biomedical Engineering.

[34]  Toby Xu,et al.  Single-chip CMUT-on-CMOS front-end system for real-time volumetric IVUS and ICE imaging , 2014, IEEE Transactions on Ultrasonics, Ferroelectrics, and Frequency Control.

[35]  L. Neubeck,et al.  A randomised controlled trial of a consumer-focused e-health strategy for cardiovascular risk management in primary care: the Consumer Navigation of Electronic Cardiovascular Tools (CONNECT) study protocol , 2014, BMJ Open.

[36]  C. Toumazou,et al.  Effectiveness of mobile phone messaging in prevention of type 2 diabetes by lifestyle modification in men in India: a prospective, parallel-group, randomised controlled trial. , 2013, The lancet. Diabetes & endocrinology.

[37]  J. Dearani,et al.  Functional recovery in the elderly after major surgery: assessment of mobility recovery using wireless technology. , 2013, The Annals of thoracic surgery.

[38]  K. Uhlig,et al.  Self-Measured Blood Pressure Monitoring in the Management of Hypertension , 2013, Annals of Internal Medicine.

[39]  Audie A Atienza,et al.  Mobile health technology evaluation: the mHealth evidence workshop. , 2013, American journal of preventive medicine.

[40]  Ilkka Korhonen,et al.  Personal Health Technologies in Employee Health Promotion: Usage Activity, Usefulness, and Health-Related Outcomes in a 1-Year Randomized Controlled Trial , 2013, JMIR mHealth and uHealth.

[41]  A. M. Kyaw,et al.  Systematic review and meta-analysis of the effectiveness of continuous glucose monitoring (CGM) on glucose control in diabetes , 2013, Diabetology & Metabolic Syndrome.

[42]  B. Williams,et al.  Novel Description of the 24-Hour Circadian Rhythms of Brachial Versus Central Aortic Blood Pressure and the Impact of Blood Pressure Treatment in a Randomized Controlled Clinical Trial: The Ambulatory Central Aortic Pressure (AmCAP) Study , 2013, Hypertension.

[43]  Martin Knapp,et al.  Cost effectiveness of telehealth for patients with long term conditions (Whole Systems Demonstrator telehealth questionnaire study): nested economic evaluation in a pragmatic, cluster randomised controlled trial , 2013, BMJ.

[44]  D. Magid,et al.  A Pharmacist-Led, American Heart Association Heart360 Web-Enabled Home Blood Pressure Monitoring Program , 2013, Circulation. Cardiovascular quality and outcomes.

[45]  Manish Bansal,et al.  American Society of Echocardiography: Remote Echocardiography with Web-Based Assessments for Referrals at a Distance (ASE-REWARD) Study. , 2013, Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography.

[46]  J. Car,et al.  Mobile phone messaging for facilitating self-management of long-term illnesses. , 2012, The Cochrane database of systematic reviews.

[47]  M. Zdeblick,et al.  A Digital Health Solution for Using and Managing Medications: Wirelessly Observed Therapy , 2012, IEEE Pulse.

[48]  Martin Knapp,et al.  Exploring barriers to participation and adoption of telehealth and telecare within the Whole System Demonstrator trial: a qualitative study , 2012, BMC Health Services Research.

[49]  J. Hendy,et al.  Effect of telehealth on use of secondary care and mortality: findings from the Whole System Demonstrator cluster randomised trial , 2012, BMJ : British Medical Journal.

[50]  Rajeev Chaudhry,et al.  A randomized controlled trial of telemonitoring in older adults with multiple health issues to prevent hospitalizations and emergency department visits. , 2012, Archives of internal medicine.

[51]  Hans Persson,et al.  Weight monitoring in patients with severe heart failure (WISH). A randomized controlled trial , 2012, European journal of heart failure.

[52]  L. Saxon,et al.  IPHONE RHYTHM STRIP–THE IMPLICATIONS OF WIRELESS AND UBIQUITOUS HEART RATE MONITORING , 2012 .

[53]  A. Capucci,et al.  Subclinical atrial fibrillation and the risk of stroke. , 2012, The New England journal of medicine.

[54]  J. Cleland,et al.  Which components of heart failure programmes are effective? A systematic review and meta‐analysis of the outcomes of structured telephone support or telemonitoring as the primary component of chronic heart failure management in 8323 patients: Abridged Cochrane Review , 2011, European journal of heart failure.

[55]  R. Reves,et al.  Early clinical experience with networked system for promoting patient self-management. , 2011, The American journal of managed care.

[56]  M. Kenward,et al.  Smoking cessation support delivered via mobile phone text messaging (txt2stop): a single-blind, randomised trial , 2011, The Lancet.

[57]  Michael Böhm,et al.  Impact of Remote Telemedical Management on Mortality and Hospitalizations in Ambulatory Patients With Chronic Heart Failure: The Telemedical Interventional Monitoring in Heart Failure Study , 2011, Circulation.

[58]  N. Schork,et al.  The n-of-1 clinical trial: the ultimate strategy for individualizing medicine? , 2011, Personalized medicine.

[59]  L. Stevenson,et al.  Wireless pulmonary artery haemodynamic monitoring in chronic heart failure: a randomised controlled trial , 2011, The Lancet.

[60]  M. Zile,et al.  Chronic Ambulatory Intracardiac Pressures and Future Heart Failure Events , 2010, Circulation. Heart failure.

[61]  M. Konstam,et al.  A multicenter randomized controlled evaluation of automated home monitoring and telephonic disease management in patients recently hospitalized for congestive heart failure: the SPAN-CHF II trial. , 2010, Journal of cardiac failure.

[62]  Steven Baroletti,et al.  Medication Adherence in Cardiovascular Disease , 2010, Circulation.

[63]  Eric J. Topol,et al.  Transforming Medicine via Digital Innovation , 2010, Science Translational Medicine.

[64]  C. Quinn,et al.  WellDoc mobile diabetes management randomized controlled trial: change in clinical and behavioral outcomes and patient and physician satisfaction. , 2008, Diabetes technology & therapeutics.

[65]  I. Olkin,et al.  Using pedometers to increase physical activity and improve health: a systematic review. , 2007, JAMA.

[66]  Marie-Pierre Gagnon,et al.  m-Health adoption by healthcare professionals: a systematic review , 2016, J. Am. Medical Informatics Assoc..

[67]  M. Bujnowska-Fedak,et al.  Usage of medical internet and e-health services by the elderly. , 2015, Advances in experimental medicine and biology.

[68]  Giovanni Sparacino,et al.  Retrofitting of Continuous Glucose Monitoring Traces Allows More Accurate Assessment of Glucose Control in Outpatient Studies , 2015 .

[69]  E. Topol,et al.  Comparison of 24-hour Holter monitoring with 14-day novel adhesive patch electrocardiographic monitoring. , 2014, The American journal of medicine.

[70]  Hung-Fat Tse,et al.  Future of Implantable Devices for Cardiac Rhythm Management , 2014 .

[71]  M. Cheitlin Impact of Remote Telemedical Management on Mortality and Hospitalizations in Ambulatory Patients With Chronic Heart Failure: The Telemedical Interventional Monitoring in Heart Failure Study , 2012 .

[72]  G.E. Moore,et al.  Cramming More Components Onto Integrated Circuits , 1998, Proceedings of the IEEE.