Human Behavior with Mobile Health: Smartphone/ Devices, Apps and Cognition

Donald M. Hilty, Steven Chan

Associate Chief of Staff, Mental Health, N. Cal. VA Health Care System, CA 95655, USAUnited States
Clinical Informatics Fellow, UC San Francisco, Division of Hospital Medicine, CA 94117, USAUnited States

DOI: https://doi.org/10.17140/pcsoj-4-141 · Published 2018-10-22 · Licence: https://creativecommons.org/licenses/by/4.0 · © 2018 The Author(s)

Also available as PDF (figures and tables appear in the PDF).

Keywords: Apps; Behavior; Cognition; Devices; Mobile; Smartphones; Technology

Introduction

M obile health (mH) communications smartphones and other devices (SP/D) used for data transport, computing and integration are a force in business, entertainment and health communities. mH and social media are growing exponentially via the X, Millennial/Y and Z generations.1 They are delivering healthcare anytime/anywhere and surpassing geographical, cost, temporal and organizational barriers.2 This movement is consistent with not only patient-centered care, but participatory medicine, in which patients are responsible drivers of their health with physicians3 according to the Institute of Medicine.4-5 mH, telemedicine and other services are considered part of a telehealth or e-health (eH) spectrum of care, including e-be havioral health (eBH). 6-7 Traditional telehealthcare services have been provided synchronously by video conferencing 7 or asynchronously.8 mH and its corresponding mobility components are central to healthcare monitoring and alerting systems, clinical and administrative data collection, record maintenance, delivery pro grams, medical information awareness, detection and prevention systems, drug-counterfeiting and theft. 9 mH hasbeendefined as “unwired e-med ”, mobile communication and network technolo gies and now mobile or wireless communication technologies for health and healthcare.10-12 A worldwide review of the literature on eH through 2010 found four primary areas of service delivery: T able 1. The E-BH Spectrum of Technology Use in Healthcare for Patients and Clinicians Level Source/ Entry Initiator Goals/Aims Questions And Perspectives Liabilities Suggestions For Programs 1 Website information Health information: gain perspective, obtain standard and updated info Do I need more information? How should I approach the problem? What is out there?

Better if referred by clinician who has checked it out Quality of information and lack of regulation Provide training on how to evaluate sites and to identify good ones; how to screen for patients’ use On-line formal educational materials Person/patient: education Caregiver: education, supports, and advice Clinician: continuing medical education (CME) I learn easier this way?

I need “sound” info to make decisions for loved ones CME implies good quality; peers’ opinion helpful Some prefer in-person interaction (e.g., Q&A) May not fit learning style Provide advice on good options, how to evaluate the materials and help patients do likewise.

Support/chat groups or “communities Spontaneous, anonymity, gain answers/tips and greater perspective Socialization and networking What should/can I do?

What are others doing locally, regionally or globally?

Can I connect easier with others?

Peer compatibility?

Information quality?

Who is talking on the other end?

Provide curricula in general and how to use at specific clinical sites (e.g., inpatient unit, outpatient care) Self-directed assessment and decision-making options Person/patient: tips to reflect, make changes and get help Caregiver: tips to reflect, tools to assess loved ones, and next steps Clinician: give patients assignments/resources; obtain tips on clinical care What are my needs and resources? What is my next step in seeking help?

Can my love ones/patients get help/support outside the office with help (i.e., with a nurse, mid-level or care coordinator)?

Not all problems can be self-assessed Some illnesses affect insight and reflection Quality is an issue; get a

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