Although many report successful behaviour change in those who continue to use such interventions, attrition is usually very high, and we can assume that those who drop out of using the online intervention have also dropped out of changing their behaviour. It may be that smartphone technology, by its mobility and location awareness, may be able to achieve lower attrition rates, but given the demographics of current users it is likely to be for behaviour change amongst a relatively young and healthy population.
Sarasohn-Kahn [ 41 ] had argued that medication adherence is a problem amongst patients with chronic conditions and suggested that technology can play an important role. However, there is no strong evidence yet on the effectiveness of dispensing devices, and like behaviour change, this is likely only to benefit those willing to use such reminders and who are already smartphone users, unless apps running in specialised devices can be developed. There are now hundreds of smartphone apps focusing on wellness, fitness, and nutrition. Mobile and home monitoring can be carried out with body-worn and ambient sensors communicating with smartphones as found, for example, in eCAALYX , including accelerometers measuring motion and gait, infrared detectors measuring body temperature and heart rate, and glucometers measuring blood glucose some sensors may also be built-into future smartphones.
However, Sarasohn-Kahn [ 41 ] describes how MedApps started as a mobile phone app, but given the low user base amongst chronically ill and older people they re-engineered it as a wireless handheld device, the HealthPal. Users use their 'usual' devices such glucometers, spirometers, pulse oximeters, and scales, and the Bluetooth enabled Healthpal communicates results.
Another rather obvious consideration in smartphone use for people who are chronically ill, is that most such people are at home, and unlikely to be 'out and about' using their mobile phone. However, smartphones, especially newer ones with larger touch screens, are starting to replace conventional desktop and Wi-Fi access and some smartphones are both Wi-Fi and 3G mobile Internet enabled.
At the moment, Sarasohn-Kahn [ 41 ] cites Eising of Mayo clinic mentioning their research that people use mobiles for 'action-oriented' information, and how they are not going to do in-depth research by mobile. So smartphones will be used by people who are not acutely ill but who maybe want to find some location based information - such as the location and hours of a pharmacist - while on the move. Whereas more detailed information, or communication with others may take place in the home.
But as more people get smartphones and use them as their sole means of communication, this may change. What other barriers to smartphone use in health does Sarasohn-Kahn [ 41 ] see? She is concerned that too much app development is carried out by technologists without the involvement of patients. She notes the problems of apps recommending particular products and also notes that in the USA if an app includes a sensor then the FDA US Food and Drug Administration may monitor it as a medical device. She thinks that the challenges to continued rapid smartphone growth include finding the right business model and privacy issues.
Notwithstanding all of the benefits we should be aware that the use of the mobile phone in healthcare and clinical practice is not without its problems and limitations. In comparison to laptop computers, the small internal storage capacity, processing power and screen size of the mobile phone often requires apps that are running to be in reduced format [ 25 ]. However, the use of cloud computing resources which are external to the mobile device may obviate restrictive processing speeds and memory requirements in the future [ 25 ].
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Never the less, mobile phones are smaller, more portable and less obtrusive than laptops, so it could be argued that this is a reasonable trade off. Although much mobile phone communication is now conducted using text, voice communication still necessitates the securing of space within which vocal communication can be made in private [ 46 ].
All of the major models of smart phone on cell phone listening software jones market today include a capability to perform this task to include iPhone, Android, . Gladis Matthies. Hey, you guys are doing great job in mobile monitoring! My kid lost a spanking-new iPhone the day before yesterday, damn, cost a pretty penny .
The consideration of such a constraint may be vital to maintain the confidentiality of patient information if used in public spaces. Other factors such as loss or theft of devices may impact upon the security of confidential digital health records or data held on mobile phones. The security of patient data held on mobile phones has been a concern for some time [ 47 ], while some studies warn of the security risks of using mobile instant messaging in healthcare [ 48 ]. When used as a method for monitoring the health status of remote patients, mobile phones should be applied only after due consideration to patient perceptions and feelings.
One study in Italy revealed that patients with implantable cardioverter-defibrillators for cardiac resynchronisation therapy welcomed the use of mobile technologies for remote monitoring, but did not want them to replace their personal contact with health workers [ 49 ]. Other studies using mobile technology for remote monitoring of health conditions found similar results [ 50 , 51 ].
The Canadian study by Seto et al. Those for example who suffer from poor manual dexterity, failing vision or a predisposition to high levels of anxiety may not be able to operate the remote mobile monitoring tools. These results are supported by similar findings from a study of older patients with disabilities in the USA [ 52 ]. It should also be acknowledged that prosaic issues such as remembering to recharge a device and the simple maintenance of equipment within a patient's home may be problematic.
Kurniawan [ 53 ], Lorenz and Oppermann [ 54 ], and Gao and Koronios [ 55 ] provide detailed discussions of mobile app needs of older people, covering aspects such as ergonomics and user interface issues e. However, senior citizens of tomorrow will include the young and middle aged of today, who are more familiar with, and reliant on computers, smartphones and the Internet than previous generations, and are increasingly well-versed in using these technologies on a daily basis for study, work and leisure.
This might partially contribute in the long run to solving some of the smartphone app usability and learnability issues, which current generations of older people are facing.
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According to a recent MobiHealthNews report published in November [ 56 ], from February to September of the same year, Google's Android smartphone saw a The number of health-related apps in BlackBerry's App World increased by However, Apple is still leading in terms of the absolute total number of health-related apps available on any platform. As of September , Apple's App Store offered the highest number of health-related apps at 7,, followed by Google Android at 1, and BlackBerry at Desk-based health researchers who rely on the telephone to gather their data are faced with a growing problem.
Increasingly, respondents are replacing their landlines with mobile telephones, and in so doing, they create a problem for the researcher. Legislation in some countries requires researchers to manually dial mobile phone numbers, thereby incurring significantly more cost in both time spent on calling and in call costs.
Further, calling a mobile phone on some tariffs may use up respondents' air time, and there may therefore be an ethical onus on the researcher to reimburse the costs incurred [ 58 ]. It is clear from their rapid proliferation and deep penetration into society, that there are significant opportunities to exploit the potential of smartphones in healthcare [ 27 ].
Mobile health m-health applications are on the rise, with many clinicians and allied health workers already adopting smartphones successfully in a diverse range of practices. Patients too are accessing health information, actively participating in their own care participatory healthcare , and maintaining contact with their healthcare providers through smartphones [ 25 , 27 ]. Chronic conditions such as diabetes mellitus and cardiovascular disease have in particular always been perceived as a special 'niche market' for smartphone apps [ 59 - 63 ].
Some commentators [ 27 , 41 ] suggest that the natural progression for healthcare is to go mobile, because it is information intensive and smartphones can offer a convenient solution. Smartphones are useful to keep clinicians up to date with the latest medical techniques, and it is easy and cost effective to communicate updates, advice and guidelines to a distributed community of practice in this way. As has also been demonstrated, mobile phones are useful for monitoring and diagnosing health conditions when clinicians are a distance from their patients.
Further, with the Internet playing an increasing role in medical education [ 64 ], it is likely that for itinerant health workers the most important access portal to this information will be handheld devices such as smartphones. Indeed, Georgetown Medical School in the USA, for example, is now requiring every medical student to have an iPhone [ 65 ], and surgeons are finding the device and its apps very useful in improving their diagnostic skills and education [ 66 ].
Smartphones are therefore useful to the medical and health related professions because they are agile, handheld, easy to use and can be used on the move [ 41 ]. Later adopters of new technologies may not use them in the same way as early adopters. Developers of new smartphone health apps need to look 'at the margin', i. Although there are hundreds of smartphone apps at the moment, the successful ones are, currently, likely to be for younger and healthier populations.
The adoption of smartphones by older people and people with chronic disease will come with time, but also as the relative cost comes down, as apps become easier to use, as there is a greater awareness of what smartphones can do, with the establishment of more 'community knowledge' to deal with the complexity of the new technology [ 67 ], and perhaps with apps moved to dedicated devices tailored for the specific needs of particular user groups and applications. These changes will almost certainly happen, but probably not as quickly as producers may predict.
Producers may need patience and to put more effort into making the technology easier and cheaper to use for all. All authors read and approved the final version of the paper. National Center for Biotechnology Information , U. Journal List Biomed Eng Online v. Biomed Eng Online. Published online Apr 5. Author information Article notes Copyright and License information Disclaimer. Corresponding author. Maged N Kamel Boulos: ku.
S ; Carlos Tavares: tp. Received Feb 22; Accepted Apr 5. This article has been cited by other articles in PMC. Abstract The latest generation of smartphones are increasingly viewed as handheld computers rather than as phones, due to their powerful on-board computing capability, capacious memories, large screens and open operating systems that encourage application development.
Open in a separate window. Figure 1. On smartphones Although the mobile phone has been widely used for several decades, smartphones are a more recent advance. Mobile phone applications in healthcare It is clear that the potential for mobile communication to transform healthcare and clinical intervention in the community is tremendous. Major challenges There are many challenges to the development of the mobile platform. Usability Usability is a critical issue for the target group of eCAALYX as, usually, users in this target group do not have any familiarity with technology and this is also often compounded by a range of physical e.
Figure 2. Prototype The technological platform in the current prototype is the Google Nexus, running the Android 2.
Figure 3. A closer look at ownership of smartphones Smartphone ownership in the developed world is rapidly increasing.
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Figure 4. What impact will this have on healthcare? Do people with chronic disease go online and can Internet-enabled smartphones make a difference? Some limitations of mobile phone applications Notwithstanding all of the benefits we should be aware that the use of the mobile phone in healthcare and clinical practice is not without its problems and limitations. Patient attitudes and perceptions When used as a method for monitoring the health status of remote patients, mobile phones should be applied only after due consideration to patient perceptions and feelings. Which platform to support? A developer's dilemma According to a recent MobiHealthNews report published in November [ 56 ], from February to September of the same year, Google's Android smartphone saw a Other constraints Desk-based health researchers who rely on the telephone to gather their data are faced with a growing problem.
Conclusions It is clear from their rapid proliferation and deep penetration into society, that there are significant opportunities to exploit the potential of smartphones in healthcare [ 27 ]. Competing interests The authors declare that they have no competing interests.
Mobile Year in Review Get apps from Marketplace - Windows Phone 7. In: Connected minds, emerging cultures: Cybercultures in online learning. Wheeler S, editor. Charlotte, NC: Information Age; Mobile Subcultures; pp. In: Perpetual contact: Mobile communication, private talk, public performance. Katz JE, Aakhus M, editor. Cambridge: Cambridge University Press; Finland: a mobile culture; pp.
Perpetual contact: Mobile communication, private talk, public performance. Distraction: Being human in a digital age.
Cell phone listening software jones
London: Futuretext; Convergence culture: Where old and new media collide. London: New York University Press; Smart Mobs: The next social revolution. Cambridge, MA: Basic Books; Constant touch: A global history of the mobile phone. Cambridge: Icon Books; E-health technologies show promise in developing countries. Health Affairs. Journal of Medical Internet Research. Can the ubiquitous power of mobile phones be used to improve health outcomes in developing countries? Global Health.
Analytical Chemistry. An information system and medical record to support HIV treatment in rural Haiti. Are electronic diaries useful for symptoms research? A systematic review. Journal of Psychosomatic Research. Behavior change interventions delivered by mobile telephone short-message service. American Journal of Preventive Medicine. Mobile phone technologies improve adherence to antiretroviral treatment in a resource-limited setting: a randomized controlled trial of text message reminders.
A review of randomized controlled trials comparing the effectiveness of hand held computers with paper methods for data collection. Assist technol Res Ser. Geo-enabled technologies for independent living: examples from four European projects. He said he receives between 50 and submissions per day, with a really interesting encounter with an authority figure coming in about every day and a half. To me, something like OpenWatch could help solve a major problem for investigative reporting in an age when newsrooms are shrinking. We've still got plenty of people who can bulldog an issue once it's been flagged, but there are fewer and fewer reporters with deep sourcing in a community, fewer and fewer reporters who have the time to look into a bunch of different things knowing that only one out of a hundred might turn into a big investigation.
Perhaps providing better conduits for citizens to flag their own problems can drive down the cost of hard-hitting journalism and be part of the solution for keeping governments honest. At first, the app did not have grand aspirations. Jones built it for some friends who'd gotten into some trouble with the law and who could have been aided by a recording of their interaction with law enforcement. But Jones' worldview began to seep into the project.
Informed by Julian Assange's conception of "scientific journalism," Jones wanted to start collecting datapoints at the interface of citizens and authority figures. When people think citizen media, right now they think amateur journalism I don't think that's revolutionary," Jones told me. I think the real value of citizen media will be collecting data. Already, CopRecorder is in the hands of 50, users, who've just happened to stumble on the app one way or another.
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Jones hopes that they'll upload their encounters with authority figures so that he can start to build a database of what citizens' encounters are like in different places. Then, he figures, patterns will emerge and he'll be able to point out to the world exactly where the powerful are abusing their authority. After they got into their Camry, Vu saw he was headed into a DUI checkpoint at the intersection of Harbor and Chapman, one of dozens that southern California police set up each weekend night. As they waited in the line of cars, Vu pulled out his cell phone and began recording.
From that recording, we know that a police officer approached the car and asked Vu to roll down his window. Vu sounds guilty, right? Why else wouldn't he want to roll down the window or talk to the police, we find ourselves asking. But we know that Vu hadn't had a drop of alcohol that night -- and a subsequent breathalyzer test found his blood alcohol content was 0. Rather, Vu is a criminal lawyer in southern California who has dealt with dozens of DUI cases and when he saw the opportunity to go through the checkpoint, he figured he could learn why all of his clients "consented" to various tests.
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