Mobile health, or mHealth for short, uses mobile technologies for health research and healthcare delivery. At last November's annual mHealth Summit, held at the Walter E. Washington Convention Center in Washington, D.C., Francis S. Collins, M.D., Ph.D., Director of the National Institutes of Health, talked with NIH MedlinePlus magazine about the impact of cell phone technologies on global health.
What does the explosion in cell phones mean to people's better health?
The marriage of mobile technologies and applications is a growing opportunity. NIH grants for mobile phone related research have been rising rapidly, thanks to the American Reinvestment and Recovery Act (ARRA). There were about 150 awards in 2010, and we expect these numbers to grow. Most of NIH's 27 institutes and centers have significant investments in this area; some more than others, but all moving quite rapidly.
Where are the largest investments in the new technologies?
The largest are in mobile phone and "tele-health." The National Library of Medicine has been a prime mover in getting adequate, well-validated health information in front of the public through their various Web sites and information resources, such as Medline and MedlinePlus. Last year, NLM launched a mobile format, called Mobile MedlinePlus, in English and Spanish. (Go to http://m.medlineplus.gov.)
What does Mobile MedlinePlus offer the public?
Users have instant access to summaries of over 800 diseases, conditions, and wellness issues; a full medical encyclopedia; lots of diagrams, images, and pictures; drug information; news stories; a medical dictionary; and a powerful search engine. It is a mobile optimized Web site, accessible from any platform, including basic flip phones, iPhones, and Androids. That's just one of the concrete ways we are trying to bring medical information to the public.
What else is in the pipeline?
One of the more interesting gadgets is a wearable chemical sensor system to assess, in real time, a person's exposure to potentially health-threatening levels of hydrocarbon and acid vapors during emergencies. The sensor's readings can be transmitted through a cell phone connection to a receiving laboratory for immediate analysis. The system is also useful in wide-scale environmental disasters. During the Gulf oil spill, for example, researchers used the sensor to successfully track and measure levels of leaking oil at varying depths over significant distances.
How about something someone can use at home?
There is a novel one in the works, a small lapel button that combines a tiny video camera, microphone, GPS connection, and accelerometer to assess the health consequences of diet and exercise. It transmits by cell phone a person's actual dietary and physical activity to a dietician for evaluation. Rather than people reporting what they wished they had done, the system objectively records what they actually did eat, how many miles they really did walk.
"Many opportunities to improve health very much depend upon cell phone technologies, since cell phones are so rapidly expanding in many parts of the world that otherwise don't have much access to communication."
— NIH Director Dr. Francis Collins
Do you believe these new technologies can help to control the global threat from new and old diseases?
Global health is one of the five themes that I've identified as particularly important for investment. Many opportunities to improve health very much depend upon cell phone technologies, since cell phones are so rapidly expanding in many parts of the world that otherwise don't have much access to communication.
Is there a specific you can point to?
Yes, a microscope not much bigger than a quarter that doesn't require a lens and can be connected to a cell phone to transmit high quality images of cells—information that would normally be very hard to acquire. It comes from UCLA and is being tested for its application to assess infectious disease—HIV in this case. It transmits images to a remote computer that can automatically interpret them. It's highly valuable in following the course of infected individuals who are far from the nearest medical center.
Another, also about HIV monitoring, is basicrly a pill holder that sends a signal every time it is opened. A lapse in opening the box undoubtedly means there's been a lapse in taking the pills. Since the data are submitted to a clinic, efforts can then be made to contact the patient, or the health worker, to make sure treatment gets back on track.
What are your immediate plans for expanding health information by cell phone?
We recognize there is great growing interest in the field. But, especially for early-stage investigators, there may not be an easy way to be mentored and trained by experts. So, this coming summer, NIH will be running an institute on mobile technology for 25 junior investigators. It will run for five days, cover all aspects of the emerging discipline, and be managed by the NIH office of Behavioral and Social Science Research, with a variety of other partners.