What mobile health technology has you excited?

I went to a seminar about Robyn Whittaker's STOMP project yesterday. They are using video messaging to help young people quit smoking. Really interesting and appears to be effective.

You can see more about her project here:

http://www.ctru.auckland.ac.nz/index.php/research-programmes/health-tech...

 how are they measuring effectiveness?

They are looking at self-reported quit rates I think. Here's a BMJ Tabacco Control article about the UK trial:

http://tobaccocontrol.bmj.com/cgi/content/abstract/18/2/88
Txt2stop: a pilot randomised controlled trial of mobile phone-based smoking cessation support
C Free1, R Whittaker2, R Knight3, T Abramsky1, A Rodgers2, I G Roberts1
1 Department of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
2 Clinical Trials Research Unit, University of Auckland, New Zealand
3 London School of Hygiene and Tropical Medicine, London, UK
Correspondence to:
Dr Caroline Free, Nutrition and Public Health Intervention Research Unit, Department of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK; caroline.free@lshtm.ac.uk
Aim: To conduct a pilot randomised controlled trial of mobile phone-based smoking cessation support intervention for the UK population.
Design: Randomised controlled trial (txt2stop).
Setting: Community.
Participants: 200 participants responding to radio, poster and leaflet-based promotions regarding the trial.
Main outcome measures: The response rate for the outcome measures planned for the main trial. Participants’ qualitative responses to open-ended questions about the intervention content. Secondary outcomes were the outcomes planned for the main trial including the point prevalence of self-reported smoking at 4 weeks and pooled effect estimate for the short-term results for the STOMP and txt2stop trials.
Results: The response rate at 4 weeks was 96% and at 6 months was 92%. The results at 4 weeks show a doubling of self-reported quitting relative risk (RR) 2.08 (95% CI 1.11 to 3.89), 26% vs 12%. The pooled effect estimate combining txt2stop and a previous New Zealand trial in the short term is RR 2.18 (95% CI 1.79 to 2.65).
Conclusions: Mobile phone-based smoking cessation is an innovative means of delivering smoking cessation support, which doubles the self-reported quit rate in the short term. It could represent an important, but as yet largely unused, medium to deliver age-appropriate public health measures. The long-term effect of this mobile phone-based smoking cessation support will be established by a large randomised controlled trial currently in recruitment.

In terms of Debra's original question  , I am looking forward to the day we just plug a networked  accessory lobe into our brain ; but in the meantime I think touch screen iphone type technology has some promise in range of areas, education, prompts etc but also in screening /form completion where can complete before get to an appt to save time.

When I read Martin's response I was reminded of Air New Zealand's mPass available for domestic travellers with iphones. The application generates a bar code that can be scanned at luggage kiosks and boarding gates, elminating the need for processing of a paper ticket. Travellers are also then contacted through the application if flights are delayed/ cancelled etc. 
Imagine what could be done with this type of technology if it was applied in health. Considering advancements in clincial decision-making support software I imagine that eventually we could get to the stage where patients are able to answer a series of questions including personal details as well as symptom descriptions, which can be processed before a patient even arrives at a clinic. Upon arrival we can scan our unique barcode and the doctors can know who we are and could possibly have some understanding of what the problem may be. Feedback connections could also let us know when clinicians are running late or are unable to see non-urgent patients.

Sounds pretty futuristic. However, these are areas that do have current equivalents, that perhaps are not as utilised as they might be.

1. The accuracy of personal details is very important. Consider when a referral is sent to the hospital, and then you change your address soon after. Because the hospital doesnt know this, your appointment will be sent to the wrong address, which you may not get, and so the hospital cancels the arrangement because you dont attend the appointment. Or you lose your mobile phone, and so you get another. Your GP wants to discuss an abnormal lab result, but is unable to contact you. I continually try to get patients to update their personal details every time they att. end, but it isnt that easy.
2. Screening patients as they attend their GP is a useful strategy for a number of clinical areas where there are paper-based instruments that have been developed as screening tools. These can be used in the waiting room or prior to the person being seen by the doctor, and generally speaking are underused.
3. Exploring symptoms is a bit more complex because patients can mislead the GP by presenting their own conclusions, rather than allowing the GP to go through his/her own diagnostic processes. This is part of the difficulty with the internet, where a patient can become convinced that they have a particular diagnosis, when in fact they have another. Many conditions can come to the surface in vague or unusual ways, and this is where clinical experience becomes invaluable. Challenging patients is a tricky business, because one runs the risk of losing the patient.
4. The telephone is used to manage the appointment queue, but perhaps could be used more. Texting people to remind them of their appointments is already available as an add-on to practice management systems http://www.moh.govt.nz/moh.nsf/indexmh/yourhealth-phcatwork-textsremindpatients

Stewart you're suggesting increased clerical resource as one way to ensure attendance - but at the same time the govt is redirecting funding to 'front line' clinical staff and the clerical support is vanishing.
The technology I'd love to see is increased use of email and the basic telephone! 
While mobile technology is great, it's these basics that I don't think get used well enough.  For those that have them - emailing contact details (we ask for them at every appt!), phone calls to reduce DNA's, brief telephone encounters to support self management - these are simple and easy to use strategies that don't depend on somewhat erratic broadband delivery.

As a mother of a young boy, I would LOVE a medicine reminder on my mobile phone that pings me when the next dose for my child is due! What would be nice (and quite futuristic), is to have my phone reminder connected to my son's electronic prescription so that a record is kept of what has been taken and how many of the last few doses were missed (those are the ones we usually forget to take because the child is well again). A medicine reminder system that's connected to our electronic health records. Mmmm.

I think whats very interesting is how people can get enormous benefits from very simple technology if there is a need - I'm amazed by what teens can do in terms of organising their lives via SMS - although there are drawbacks (http://www.youtube.com/watch?v=6Hk-ru57A-c). What you need though (IMHO) is -

• An interface you can use - mobiles are difficult but learnable
• Applications that work...
• A community to spread and encorouage learning

Becasue mobiles are very personal devices, I think this is going to be bottom up rather than top down - maybe putting  some competitive prizes into the android development space http://www.android.com/market/ with a netflix- like compettion would be good ? Oh and Martin - you can get a brian interface from emotiv- http://emotiv.com/ only around $500... ;-)

Its great to see how different everybody's focus is -  Martin wants a plug n play system as does Karen - but with different interfaces :-), Chris is looking for educational devices and the others seem to be looking at some kind of information management systems. 
Facing the enormous challenges of a limited expert workforce and even less money, I am very excited by any system that is designed with a "pull" element. That is people access the information they need as they need it - rather than having it delivered to them based upon on some research and many assumptions of the providers. The Cancer Care Research Centre in Scotland has done some great work using this philosophy. They are in the process of working on a mobile phone symptom managment system for lung cancer radiotherapy patients. The system is called ASyMS.
In developing this, they have captured patient symptoms against treament plan and then when a patient is experiencing symptoms as a consequence of their treatment, they connect to the system via their mobile. They indicate what treament they've just had and what kind of symptom they are experiencing. Using this information, the database is accessed and the future symptom development for the patient is modelled from the database. The system relays back to the patient recommendations on duration of symptoms, expected new symptoms and suggested treatments. Treatments "suggested" can vary from - "contact your specialist now" to "take 2 panadol and go to bed for the next 24 hours". You can find out more at: http://www.cancercare.stir.ac.uk/projects/ASyMSR.htm

check out this toy... wondered when EEG would be put to good use!
http://www.youtube.com/watch?v=KrfQGbwF8lI&feature=player_embedded
think 5 years ahead.... gives new meaning to the old bluetooth headset!

Ha! That's pretty good - I felt sorry for the guy who couldn't get his ball to rise...

Have you seen the RFP that we've just issued for the ASSET project?  ASSET is the largest telehealth project yet attempted in New Zealand and we (Auckland University plus several DHBs) are looking for a partner to privde the kit and associated support.  Roughly 300 -500 patients will particiapte in the trial which is aimed at creating an evidence base for this sort of technology enabled model of care.  More details on ASSET is available elsewhere on the hive.

I'm pretty excited about the Nexus One and the potential of the Android operating system. There's already some great Health applications being developed, such as Unbound Medicine's range (http://www.unboundmedicine.com/store/android) or Skyscape (http://whois.skyscape.net/intro/AndroidIntro.aspx). Apart from medical references, there is a lot of potential for integrating with EMRs or just home telehealth.
 
If you are interested in developing for the Android platform, you can get all you need to know at Google Android Developers: http://developer.android.com/index.html
 

Mobile Technology
Well, I find it all pretty exciting actually. I am currently interested in Iphone health applications. Especially ones which can help people living in countries where they can't easily navigate the health system. Maybe they can't speak the local language or don't know how to contact an appropriate hospital. This kind of app might sound a little redundant in the New Zealand context but here in Japan it would be most welcomed. There is one I have been using but it is still very limited. I think such an app should at least be linked to the google maps app and be able to send an alert to participating hospitals. In this way, the patients can more easily negotiate the first barrier - the receptionist. Actually I would like to ask if Iphone apps are even considered a part of HI.
Mark