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130 New Medical Technology in Patient Care: A Physician’s Guide
The impact of wearable mobile medical devices on diagnoses and
patient outcomes is profound. For example, wearable devices significantly
enhance patient engagement by providing real-time health and fitness
data, encouraging patients to participate in their care actively.6 This leads
to better adherence to treatment plans and fosters positive lifestyle
changes. For example, a heart rate monitor can help patients manage their
cardiovascular health more proactively, or a continuous EKG monitor can
identify irregular heart rhythms, enabling timely medical intervention.
In remote monitoring, healthcare professionals can keep track of
patients’ vital signs and health metrics from a distance. Monitoring vital
signs is an aid in detecting clinical deterioration, and changes in these
parameters may occur several hours before an adverse event.
7,8
This is
especially beneficial for individuals with chronic conditions9 or those
recovering from surgery, as it allows for informed decisions and timely
interventions when necessary.10 For instance, a wearable device that monitors blood glucose levels can be crucial for a diabetic patient’s ongoing
care. They can play an essential role in maintaining better glycemic control, thereby reducing the risk of complications.
Wearable technology also plays a pivotal role in enhancing research
and treatment monitoring.11 It enables tracking treatment effectiveness,
medication adherence, and patient experiences, leading to more comprehensive and accurate research outcomes. For example, data from wearable
blood pressure monitors used by participants can enhance a study on the
effectiveness of a new hypertension drug.
Additionally, wearable technology contributes to reducing healthcare
costs. Allowing individuals to monitor their vital signs and health in real
time reduces the need for expensive hospital visits and unnecessary medical treatments.
12,13
This leads to more efficient and effective medical care,
ultimately cutting healthcare expenses. For example, a 2021 study in
Nature revealed that using wearable devices for remote monitoring significantly reduced hospital readmissions by 43% among patients with type
I myocardial infarction (MI), a coronary artery disease.14 Through continuous fitness monitoring and timely health interventions, these devices
helped prevent complications and reduced hospitalization needs, saving
an average of $6,000 per patient.
Beyond the Clinic 131
Lastly, data-driven decisions are a significant advantage of wearable
technology. It provides healthcare professionals and patients with insights
based on extensive information about a person’s health and activity levels
gathered through wearable devices. This abundance of data supports
informed decision-making, enhancing the overall quality of healthcare.
For example, a fitness tracker’s data can help a physician tailor an exercise
program to a patient’s health needs.
mHealth Apps: Definition and Scope
The widespread accessibility of the smartphone in the past two decades
has changed how people monitor their health.
of U.S. adults own a cell phone,
17,18
and they carry these phones on them
15,16
Indeed, as of 2018, 95%
most of the day. They are making19 the cell phone a convenient and accessible device for health management on the go.20 In addition, more than 84
million people in the United States use apps with health and health-related
content.
The U.S. Food and Drug Administration (FDA) defines mHealth
apps, short for mobile health applications, as mobile software that diagnoses, tracks, or treats disease.21 These software programs are developed for
mobile devices such as smartphones, tablets, or watches,22 and they can
promote patient health and aid in disease prevention.23 They can also help
increase patient autonomy24 and treatment adherence25 while decreasing
medical costs.
26
These devices typically involve more active patient participation than
digital health monitors. They require the patient to manually input health
data or perform a specific action to gather health information.
The scope of these apps is broad and varied. They can range from
simple tools that provide users with medical information and advice to
more complex systems capable of tracking and monitoring vital signs
such as heart rate27 and blood pressure.28 Some mHealth apps are designed
to assist in managing specific health conditions, such as diabetes, by helping users monitor their blood sugar levels and medication schedules.29
Others might be focused on mental health, offering resources for stress
management, mindfulness, or therapy support.
30
132 New Medical Technology in Patient Care: A Physician’s Guide
Additionally, mHealth apps facilitate telemedicine, allowing patients
to consult with healthcare professionals remotely. Examples of mHealth
apps include MyFitnessPal,31 a nutrition and exercise tracker; Headspace,32
for mindfulness and meditation; and Teladoc,33 which provides access to
medical consultations via video calls.
Currently, these apps are only loosely regulated, and laws specific to
apps are rare.
Wearable Monitor Versus mHealth App
The primary difference between wearable monitors and mHealth apps lies
in the required level of patient engagement. mHealth apps require active
patient input and are generally used for specific, periodic health measurements. In contrast, wearable medical monitors are more about passive data collection, providing continuous monitoring without active
patient involvement. This difference in patient engagement can influence
the choice of a device based on the patient’s condition, lifestyle, and preference for interaction with their health monitoring tools.
Evolution and Rapid Growth of mHealth in Patient Care
The mHealth market has seen exponential growth, driven by the widespread adoption of smartphones and advancements in digital health technology. This growth transforms how patients and healthcare providers
interact and manage health and wellness.
34
The Potential of mHealth in Transforming Healthcare Delivery
mHealth apps can significantly improve healthcare delivery by
enhancing access to care, personalizing treatment, and reducing healthcare costs.
35
Beyond the Clinic 133
Categories of mHealth Apps
Care Coordination Apps
Apps that focus on facilitating communication and coordination play a
crucial role in healthcare by strengthening the continuity of care and minimizing the likelihood of errors. These applications serve as a bridge
between healthcare providers and patients, ensuring that all parties are
consistently informed and aligned in understanding the patient’s care
plan.36 By providing a platform for seamless information exchange, these
apps help maintain an ongoing, coherent treatment process, even when
multiple providers are involved.37 This continuous flow of information can
significantly reduce misunderstandings or information gaps that might
lead to errors in patient care. Examples include apps such as Cerner’s
CareAware or Epic’s MyChart, which have been instrumental in streamlining patient–provider communication and improving care coordination.
Medication Management Apps
Medication management applications are designed to assist patients in
engaging with their treatment plans and effectively managing their medication regimens.38 Increasing engagement in their treatment improves a
patient’s compliance with their treatment.39 Mobile apps can offer patients
tools to enhance their engagement in the treatment and well-being.
apps achieve this by providing features such as reminders for when to take
medications, tracking systems for dosages, and tools to monitor adherence
to prescribed treatment plans. Some apps allow the patient to monitor and
track health parameters related to the medication (e.g., blood glucose
level, HbA1c, and weight). Others can alert users about the need for a
prescription renewal. In their study, Ahmed et al. explored various strategies to improve adherence through apps, including gamification elements
and typical reminder functions.
25
These functionalities are vital in ensuring patients follow their medication schedules accurately, which is essential for optimal treatment
40,41
The
134 New Medical Technology in Patient Care: A Physician’s Guide
outcomes.42 Examples of such apps include Medisafe,43 which provides
personalized reminders and a medication tracker, and MyTherapy,44
known for its pill reminder and health journal features.
These apps have been shown to improve adherence rates and patient
outcomes by providing reminders and tracking capabilities.
45,46
Chronic Disease Management Apps
Apps designed for managing chronic conditions such as diabetes, hypertension, and asthma are increasingly becoming integral to patient care.
The goal of mHealth apps is to increase self-management of chronic diseases, which plays a central role in improving clinical outcomes.
apps typically include features for monitoring various health parameters
relevant to the specific condition. For instance, diabetes management apps
may have functionalities for tracking blood glucose levels, carbohydrate
intake, and insulin doses.49 Hypertension apps might focus on monitoring
blood pressure and heart rate, while asthma apps could include symptom
diaries and peak flow meter recordings.
These apps often incorporate medication adherence tools, such
as reminders for taking medication at prescribed times, which is crucial
for conditions requiring strict medication regimens. By providing these
reminders and enabling patients to log their medication intake, these apps
help ensure that patients follow their treatment plans more closely, reducing the likelihood of complications associated with nonadherence.
Furthermore, many of these apps engage patients more actively in
their health management by offering educational content, personalized
feedback, and interactive features. This increased engagement can lead to
better self-management of the condition, fostering a sense of control and
empowerment among patients.
50
Improved patient outcomes are a significant benefit of these apps. By
enabling better disease monitoring, enhancing medication adherence, and
increasing patient engagement, these apps can contribute to better disease
control, reduced hospitalizations, and overall improved quality of life for
patients with chronic conditions.
51,52
47,48
These
Beyond the Clinic 135
Examples of such apps include MySugr, a diabetes management app
that specializes in logging blood sugar levels, insulin use, and carbohydrate intake; OMRON Connect, a blood pressure monitoring app that
works with compatible Omron blood pressure cuffs; and AsthmaMD, an
app that allows asthma patients to track their symptoms, medication
usage, and peak flow readings.
Benefits of mHealth Apps for Patient Engagement and Shared Decision-Making
Enhanced Patient Engagement
Research indicates that higher levels of patient engagement are associated
with better health outcomes and more efficient healthcare utilization.53
mHealth apps foster active patient participation in their healthcare, leading
to increased engagement. These apps offer a variety of tools and resources
that empower patients to take a more active role in managing their health.
One crucial way these apps encourage active participation is through
personalized health tracking. Many apps allow patients to monitor vital
health metrics relevant to their conditions, such as blood glucose levels in
diabetes, blood pressure in hypertension, or symptom patterns in chronic
illnesses such as asthma. This ensures better management of their condition and educates them about their medication, fostering a deeper understanding of their treatment.
Additionally, many mHealth apps include educational content tailored
to the user’s health conditions. This information helps patients better
understand their health, informing them about their conditions and treatments. Apps such as WebMD54 offer a wealth of information on various
health topics, enabling patients to educate themselves beyond the doctor’s
office.
Interactive features such as symptom checkers, virtual consultations,
and health challenges significantly increase engagement. For instance, the
Symptomate55 app uses an AI-driven symptom checker to help users identify potential health issues and seek appropriate care.
136 New Medical Technology in Patient Care: A Physician’s Guide
Furthermore, some apps use gamification to encourage healthy behaviors. For example, MyFitnessPal31 incorporates gamified elements to
motivate users to achieve their diet and exercise goals, making the process
more engaging and enjoyable.
How mHealth Apps Support Informed and Collaborative Decision-Making
Shared decision-making is defined as “an approach where clinicians and
patients share the best available evidence when faced with the task of
making decisions, and where patients are supported to consider options,
to achieve informed preferences.”56 Shared decision-making is necessary
to support the ethical tenets of patient self-determination57and autonomy.58
mHealth apps provide patients access to their health information, enabling
informed discussions and shared decision-making with healthcare providers.59
Evidence suggests that shared decision-making leads to higher patient
satisfaction and adherence to treatment plans.
60–62
Ensuring Clinical Validity
To ensure their safety and effectiveness, mHealth apps must be based on
scientific evidence and clinical validation. Healthcare providers should
assess apps based on their development process, clinical evidence, regulatory approval, and user reviews. By thoroughly evaluating these aspects,
healthcare providers can recommend mHealth apps to their patients,
ensuring that these digital tools are effective and safe and align with their
patient’s specific needs and circumstances.
User-Friendly Design
The design of mHealth apps should prioritize ease of use, accessibility,
and engagement to ensure they are effective for a diverse range of users.63
Factors to consider include readability, navigation ease, language options,
and the inclusion of assistive technologies for users with disabilities. The
effectiveness of mHealth apps is heavily influenced by their user experience and interface design. These aspects are crucial because they directly
Beyond the Clinic 137
impact how easily and effectively users interact with the app, affecting
their willingness to use it and adhere to its recommendations or features.
Ease of use is a critical factor in mHealth app design. If an app is
complicated or unintuitive, users, especially those who may be less techsavvy or have limited experience with digital technology, might find it
challenging to use. This difficulty can lead to frustration, decreased
engagement, and, ultimately, abandonment of the app. For instance, older
adults or individuals with specific disabilities might struggle with small
text sizes or complex navigation menus. Therefore, designing apps with
simple, straightforward interfaces and providing options such as adjustable text sizes can significantly improve accessibility and usability for
these groups.
Accessibility is another critical aspect. This includes making the
app usable for people with disabilities (such as incorporating screen
reader compatibility for visually impaired users) and ensuring the app can
be used across various devices and platforms. This broad accessibility
ensures that a more comprehensive range of users can benefit from the
app, regardless of their device type or physical limitations.
Engagement is also closely tied to design. A visually appealing app
that provides personalized feedback and includes interactive elements are
more likely to keep users engaged. Gamification elements, for example,
can make tracking health metrics or adhering to treatment more engaging
and less monotonous. Apps such as MyFitnessPal use these techniques to
encourage users to log their food intake and exercise regularly.
What Type of Device Should a Patient Get?
Determining the suitability of a wearable mobile monitor versus a
mHealth app for a patient involves considering their specific health needs,
lifestyle, comfort with technology, and the extent of monitoring or interaction their condition necessitates.
Wearable mobile monitors are particularly beneficial for patients with
chronic conditions such as diabetes, heart disease, or hypertension. These
devices, such as CGMs for diabetics or heart rate monitors for cardiac
patients, provide essential real-time data for managing these conditions.
They are also ideal for conditions that require constant vigilance, such as
138 New Medical Technology in Patient Care: A Physician’s Guide
arrhythmias or sleep apnea, offering continuous, real-time monitoring.
Elderly patients, especially those at risk of falls or sudden health changes,
can benefit significantly from wearables equipped with fall detection and
emergency alert systems. Additionally, wearables are advantageous for
patients in physical rehabilitation, tracking movement patterns, progress,
and physical activity levels.
On the other hand, mHealth apps are well suited for individuals
focusing on general health and wellness, such as fitness tracking, diet
monitoring, and mental well-being. They are also appropriate for managing conditions that do not demand constant monitoring, such as mild
asthma or occasional migraines. Tech-savvy patients who are comfortable
using smartphones and prefer digital healthcare management, including
appointments and prescriptions, may find mHealth apps more userfriendly. Moreover, these apps are valuable for patients seeking educational resources about their conditions, treatments, and health maintenance
strategies.
Often, a combination of both wearable monitors and mHealth apps
can provide a comprehensive approach, particularly for patients with complex health needs. Wearables can supply the necessary continuous monitoring data, while mHealth apps can enhance this with medication
reminders, educational content, and a platform for healthcare provider
communication.
This approach to determining the most suitable digital health tool
considers patients’ diverse needs and preferences, ensuring that the chosen
technology aligns well with their specific healthcare requirements.
Conclusion
The healthcare landscape is being profoundly reshaped by the advent of
wearable medical devices and mHealth apps. These technologies bridge
the gap between traditional healthcare settings and patients’ daily lives,
offering unprecedented opportunities for continuous health monitoring,
enhanced patient engagement, and more personalized care. Wearable
devices provide vital insights into a patient’s health status, facilitating
early detection of potential issues and more effective management of
chronic conditions. Simultaneously, mHealth apps empower patients with
Beyond the Clinic 139
tools to better manage their health, from medication adherence to accessing medical information and support. Together, these innovations are
transforming how healthcare is delivered and experienced, paving the
way for a more proactive, patient-centered, and data-driven approach to
health and wellness. As we continue to embrace and integrate these technologies, their potential to improve healthcare outcomes, reduce costs,
and enhance the quality of life for patients worldwide becomes increasingly evident.
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