Mobile Health Application in COVID-19 pandemics
Hamed Mehdizadeh Ph.D in Medical Informatics Assistant Professor In Health Information Management Department Of Health Information Technology, School Of Allied Medical Sciences, Mazandaran University Of Medical Sciences International Webinar Series on Covid19: Diagnosis, Treatment, and Hospital care International Webinar Series on Covid19: Diagnosis, Treatment, and Hospital care
Concept of eHealth, Telehealth ,Telemedicine and mHealth. International Webinar Series on Covid19: Diagnosis, Treatment, and Hospital care
eHealth
WHO defined eHealth as:
“The use of information and communication technologies (ICT) for health”. International Webinar Series on Covid19: Diagnosis, Treatment, and Hospital care
Telemedicine
WHO defined Telemedicine as: “The delivery of health care services, where distance is a critical factor, by using ICT (information and communication technologies) for the exchange of information for diagnosis, treatment and prevention of disease, injuries, research and evaluation, and for the continuing education of health care providers ...”. International Webinar Series on Covid19: Diagnosis, Treatment, and Hospital care Telehealth
Telehealth:
Delivery and facilitation of health and health-related services including; Medical care Patient and provider education, Health information services Self-care and self-management via ICT International Webinar Series on Covid19: Diagnosis, Treatment, and Hospital care Telemedicine Vs Telehealth
Telemedicine and Telehealth are often used interchangeably although there exists a slight difference.
Telemedicine refers specifically to the practice of medicine via remote means, Telehealth is a blanket term that covers all components and activities of healthcare and the healthcare system that are conducted through ICT. International Webinar Series on Covid19: Diagnosis, Treatment, and Hospital care mHealth
WHO defined mHealth as:
“…use of mobile wireless technologies for public health,”
- “… medical and public health practice supported by mobile devices, such as mobile phones, patient monitoring devices, personal digital assistants (PDAs), and other wireless devices” International Webinar Series on Covid19: Diagnosis, Treatment, and Hospital care eHealth
eHealth as a clearing concept for all ICT-based healthcare services, products and systems.
-All the tele- and mobile, and other health technologies and their variants are components of eHealth. eHealth
Telehealth
Telemedicine mHealth
International Webinar Series on Covid19: Diagnosis, Treatment, and Hospital care International Webinar Series on Covid19: Diagnosis, Treatment, and Hospital care mHealth
Main features of smartphones for health interventions: 1) Information exchangeability 2) Easy access to health information 3) Entertainment 4) Social impacts 5) Communication with Health care provider International Webinar Series on Covid19: Diagnosis, Treatment, and Hospital care
mHealth and public health emergency situations
In late 2019, a new virus named Covid-19, led to the start of a pandemic around the world.
In January 2020, in response to widespread this disease, the World Health Organization declared it as public health emergency of international concern and called for collaborative efforts of all countries to prevent the rapid spread of COVID-19. International Webinar Series on Covid19: Diagnosis, Treatment, and Hospital care
mHealth and public health emergency situations
In response to the COVID-19 pandemic, a global health movement developed with countrywide campaigns providing health education.
- This information was widespread to educate the public on the newly discovered virus COVID-19 and how to best protect themselves. International Webinar Series on Covid19: Diagnosis, Treatment, and Hospital care
mHealth and public health emergency situations
- These campaigns were filled with a series of prevention protocols such as social distancing, quarantine, self-isolating in homes or hotels after coming into contact with someone who has tested positive, and restricting travel. International Webinar Series on Covid19: Diagnosis, Treatment, and Hospital care
mHealth and public health emergency situations
During the COVID-19 pandemic, mhealth app have been widely used for supporting these campaigns’ missions, to assist in raising awareness on how the population may protect itself, and for encouraging adherence to those various precaution protocols. International Webinar Series on Covid19: Diagnosis, Treatment, and Hospital care
mHealth and public health emergency situations
- Digital solutions like mHealth, can improve communities' and health care systems' response to outbreaks of infectious diseases.
- mHealth has the potential to offer different solutions to respond to the COVID-19 by providing educational context, contact tracing and tracking, tele-consultation, reducing patient referral, and prevent further spreading of the outbreak.
- International Webinar Series on Covid19: Diagnosis, Treatment, and Hospital care
mHealth and public health emergency situations
- Like previous outbreaks of (SARS, H1N1, and Ebola), mHealth technologies have the potential to promote public health and support health care systems.
- During the Ebola outbreak (2014–2016), several mHealth interventions successfully used for public awareness and surveillance. International Webinar Series on Covid19: Diagnosis, Treatment, and Hospital care
mHealth and public health emergency situations
- During the first wave of COVID-19, various mHealth apps were rapidly developed in response to tackle the virus.
- The primary focus of telehealth during the early days of the coronavirus public health crisis has been on screening COVID-
19 patients and treating those who can manage their symptoms at home.
-So, in this webinar, I want to speak about mHealth apps that help with COVID-19 management. International Webinar Series on Covid19: Diagnosis, Treatment, and Hospital care
Almalki and Giannicchi – (2021) examined 298 COVID-19 mhealth apps.
Results:
-US (25%),
- India, Italy, KSA(Kingdom of Saudi Arabia), Mexico (5%)
- Australia, Canada, France (4%) International Webinar Series on Covid19: Diagnosis, Treatment, and Hospital care
mHealth Apps for COVID-19
Results:
-Apps developed by governments or national authorities (67%)
-Apps developed by companies such as BioneXt Lab, Paxera Health, … (%21)
-Apps developed by Nonprofit organization or agency like WHO,… (4%) International Webinar Series on Covid19: Diagnosis, Treatment, and Hospital care
mHealth Apps for COVID-19
App Purpose:
-Promoting users to track their personal health
- Raising awareness on how to combat COVID-19
-Monitoring health conditions
- Managing exposure to Covid-19 International Webinar Series on Most Common Features of Covid19: Diagnosis, Treatment, and COVID-19 Apps HospitalRaising care Awareness
Promoting Health Providing Health Personal Tracking COVID-19 apps Monitoring
managing exposure to Covid- 19 International Webinar Series on Covid19: Diagnosis, Treatment, and Hospital care
Basic health Live information Statistics
Sharing data or Chatbots story
information about Lists of health services and products care lines International Webinar Series on Covid19: Diagnosis, Treatment, and Hospital care
Common Features of COVID-19 Apps
Includes: • basic health information about COVID-19 • Best health practices • medical advice • FAQs regarding COVID-19.
Information format: • Educational documents • videos • animation International Webinar Series on Covid19: Diagnosis, Treatment, and Hospital care
Common Features of COVID-19 Apps
live statistics and rolling updates:
-Provide live statistics and rolling updates in two forms:
1. Really Simple Syndication (RSS) feeds
2. Push notifications. International Webinar Series on Covid19: Diagnosis, Treatment, and Hospital care
Common Features of COVID-19 Apps
Map :
• Provide interactively the occurrence of COVID-19 cases (active, confirmed, and recovered cases)
• The density of these cases in different areas (neighborhoods, cities, and countries).
• Indicate nearby health care centers and route directions to reach these centers.
-Help health officials observe trends in the community and in turn take meaningful measures to handle the spread of the virus. International Webinar Series on Covid19: Diagnosis, Treatment, and Hospital care
Common Features of COVID-19 Apps
Information about health services and care lines
- Allowed the users to search nearby hospitals, emergency services, pharmacies, and certified COVID-19 test labs. International Webinar Series on Covid19: Diagnosis, Treatment, and Hospital care
Common Features of COVID-19 Apps
Sharing data or story with others
-Diaries describing the users’ symptom and allow to share their COVID-19 stories by posting text-based messages, recording voice-based messages, or uploading videos.
-User can share this diaries on social networks like Facebook.
- Share with medical personnel to receive a faster diagnosis. International Webinar Series on Covid19: Diagnosis, Treatment, and Hospital care
Common Features of COVID-19 Apps
Helplines and chatbot
Helplines connect users to consultants providing useful information related to COVID-19 and facilitate the introduction of patients to health workers over a toll-free number.
Chatbot, are artificial intelligence (AI) and provide personalized health advice via one-on-one conversations with users and help them find answers to their various questions in real time International Webinar Series on Covid19: Diagnosis, Treatment, and Hospital care
Common Features of COVID-19 Apps
lists of products
- Provide lists of products required for combating COVID-19 (gowns, surgical masks, respirators, face shields, …).
- Calculating the number of these products in stock to find the average consumption rate.
- Useful for informing the users about these important products and helping to optimize the use of these resources. International Webinar Series on Covid19: Diagnosis, Treatment, and Hospital care
Alert Contacts Contact tracing
Location Monitoring
Movemen t permits Health or travel Declaration Sharing Lab test result International Webinar Series on Covid19: Diagnosis, Treatment, and Hospital care
Common Features of COVID-19 Apps
Contact tracing.
- Notify users if they had crossed paths with another person infected with the coronavirus
- Allowed users to detect other devices with the same installed app and exchange an encrypted Secure Tracing Identifier
(STI).
- The STI is stored locally on the user’s device and consists of anonymized data, a time stamp, and the GPS location of the phone.
. International Webinar Series on Covid19: Diagnosis, Treatment, and Hospital care
Common Features of COVID-19 Apps
Contact tracing:
- If anyone infected, authorities with authorized access to the data can request the infected users to upload the list of STIs to their national data centers for further analysis to enable officials to respond quickly and reach out to individuals who were in close contact and who may be requested to quarantine, thus potentially minimizing the spread of the virus International Webinar Series on Covid19: Diagnosis, Treatment, and Hospital care
Common Features of COVID-19 Apps
Alert contacts:
-Enabled users diagnosed with COVID-19 to voluntarily share their tests results with people they had come into contact with over the previous 14 days.
- These alerts were received through notifications, text messages, and automatic calls.
- In contrast, some apps were configured to allow health officials to automatically and anonymously inform the user’s contacts of any encounters; the users’ consents obtained during the initial download of the app. International Webinar Series on Covid19: Diagnosis, Treatment, and Hospital care
Common Features of COVID-19 Apps
Location monitoring
- Provide real-time dashboards for identifying the next potential COVID-19 hot spots and advocating for resources
needed in those spots.
- The collected data were analyzed based on the geolocation of cases and then used to provide support in coordination with local, departmental, and national authorities, which in turn assisted in planning optimal treatment delivery. International Webinar Series on Covid19: Diagnosis, Treatment, and Hospital care
Common Features of COVID-19 Apps
Health or travel declaration
- Mandated by the country’s government or health officials. Upon arrival, travelers were requested to report themselves and their families through these apps and record their daily health status for 14 days.
-Also used to notify users of potential exposure risk in the area where the users lived. International Webinar Series on Covid19: Diagnosis, Treatment, and Hospital care
Wearable Symptoms Devices tracker
Self- assessment
Mood tracker
Medical Medication Check-up Reminder tracker International Webinar Series on Covid19: Diagnosis, Treatment, and Hospital care
Common Features of COVID-19 Apps
Self-assessment:
Provide self-assessment tools to examine whether the user may have COVID-19.
-Questionnaires designed according to CDC guidelines, WHO recommendations, and the country’s health officials. International Webinar Series on Covid19: Diagnosis, Treatment, and Hospital care
Common Features of COVID-19 Apps
Based on self-assessment result users divided into three categories:
1. Negative for the virus and are asymptomatic;
2. Negative for the virus but had symptoms (fever, cough, shortness of breath)
3. users who had tested positive for COVID-19.
The collected information locally or remotely processed and then made available to the country’s health care professionals for further analysis International Webinar Series on Covid19: Diagnosis, Treatment, and Hospital care
Common Features of COVID-19 Apps
Symptoms tracker:
Log symptoms such as fever and cough at specific frequencies by:
1. Sending text messages or emails
2. Push notifications to obtain the required data. International Webinar Series on Covid19: Diagnosis, Treatment, and Hospital care
Common Features of COVID-19 Apps
Symptoms tracker:
Based on collected data user categorized by severity and health risks into “low-risk” to “high-risk” groups.
In low-risk groups, users were provided with knowledge and resources to deal with the disease at home.
In higher-risk groups, patients were monitored in anticipation of developing symptoms. International Webinar Series on Covid19: Diagnosis, Treatment, and Hospital care
Virtual Remote Medical consultation Monitoring
Medical Making Report Medical Generator Management International Webinar Series on Covid19: Diagnosis, Treatment, and Hospital care
Common Features of COVID-19 Apps
Remote monitoring : Remote monitoring allowed health care professionals to monitor patients’ health data such as heart rate and level of blood oxygen in real time. This data inform health care teams on how their patients lived on a daily basis and allow them to be immediately alerted if any patient needed critical medical attention. International Webinar Series on Covid19: Diagnosis, Treatment, and Hospital care
Common Features of COVID-19 Apps
Virtual medical consultation :
- Enabled virtual medical consultation, live video consultations, or bidirectional text-audio communications to provide personalized support for user. International Webinar Series on Covid19: Diagnosis, Treatment, and Hospital care
mHealth app Risks
-During the initial stages of the pandemic, some developers creating fake apps, as well as ransomware apps that mandated users to transfer money and threatened deletion of the phone’s storage if money was not transferred.
-There were also large amounts of misinformation on the internet. In response, the WHO worked with Google as well as popular social media sites like Facebook, Twitter, and TikTok to combat this misinformation. International Webinar Series on Covid19: Diagnosis, Treatment, and Hospital care
mHealth app Risks
Social media apps like Facebook, YouTube, Twitter, Instagram, and Snapchat to limit the rapid spread of misinformation to their massive audience reach.
- Apple and Google made efforts to regulate COVID-19–related apps released in their app stores, only allowing apps developed by credible organizations.
- WhatsApp, a popular communication app, also limited the number of times users could forward messages related to COVID-19 to reduce the spread of misinformation about the coronavirus. International Webinar Series on Covid19: Diagnosis, Treatment, and Hospital care
Conclusion While the primary focus of telehealth during the early days of the coronavirus public health crisis has been on screening COVID-19 patients and treating those who can manage their symptoms at home.
There are four ways this form of care can help hospitals and healthcare systems address the 1. 1. 1. Increase human resources Supply (physicians, nurse,...) "Load Balancing" 2. Maximize workforce potential by using quarantined physicians (telehealth) 3. Provide care for Non-Covid-19 patients by telehealth 4. Create system efficiencies through chatbot and AI tools(provide information,…) International Webinar Series on Covid19: Diagnosis, Treatment, and Hospital care
Conclusion
mHealth advantages in COVID-19 outbreak:
• Provide reliable information and education
• Keep healthy people away from high-Risk centers such as hospitals, clinics
• Provide remote access to health care services for elderly or people with a chronic condition (Diabetes, Heart disease...)
• Screening people for COVID-19 by providing Self-assessment tools. International Webinar Series on Covid19: Diagnosis, Treatment, and Hospital care
Conclusion
(67%) Apps developed by governments or national authorities Show the essential role mhealth apps as a main tools in public health crisis management.
- By involving most of the population in self-tracking their personal health and self-assessment, the role of these apps is deemed to be a key driver for a participatory approach to curtail the spread of COVID-19. International Webinar Series on Covid19: Diagnosis, Treatment, and Hospital care
Targeted population 4.08M inhabitants International Webinar Series on Covid19: Diagnosis, Treatment, and Hospital care
TOUSANTICOVID
Targeted population 67M inhabitants International Webinar Series on Covid19: Diagnosis, Treatment, and Hospital care International Webinar Series on Covid19: Diagnosis, Treatment, and Hospital care
- GERMANY International Webinar Series on Covid19: Diagnosis, Treatment, and Hospital care
PROTEGO SAFE - POLAND International Webinar Series on Covid19: Diagnosis, Treatment, and Hospital care
COVID TRACKER IRELAND International Webinar Series on Covid19: Diagnosis, Treatment, and Hospital care
VIRUSAFE - Bulgaria -Provide Information - Symptoms assessment - Tracking and tracing - Targeted population 7 M inhabitants International Webinar Series on Covid19: Diagnosis, Treatment, and Hospital care
IMMUNI - ITALY
VIRUSAFE - Bulgaria International Webinar Series on Covid19: Diagnosis, Treatment, and Hospital care
Refrences
Ref: - Song Y, Zhang M, Yin L, Wang K, Zhou Y, Zhou M et al. COVID-19 treatment: close to a cure? A rapid review of pharmacotherapies for the novel coronavirus (SARS- CoV-2). Int J Antimicrob Agents. 2020 Aug;56(2):106080. doi: 10.1016/j.ijantimicag.2020.106080. Epub 2020 Jul 4. PMID: 32634603; PMCID: PMC7334905. - Asadzadeh A, Kalankesh LR. A scope of mobile health solutions in COVID-19 pandemics. Inform Med Unlocked. 2021;23:100558. doi: 10.1016/j.imu.2021.100558. Epub 2021 Apr 3. PMID: 33842688; PMCID: PMC8019236. - John Leon Singh H, Couch D, Yap K. Mobile Health Apps That Help With COVID-19 Management: Scoping Review. JMIR Nurs. 2020 Aug 6;3(1):e20596. doi: 10.2196/20596. PMID: 32897271; PMCID: PMC7467120. - Almalki M, Giannicchi A. Health Apps for Combating COVID-19: Descriptive Review and Taxonomy. JMIR Mhealth Uhealth 2021;9(3):e24322. doi: 10.2196/24322 International Webinar Series on Covid19: Diagnosis, Treatment, and Hospital care
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