Despite rapid growth of mHealth, significant limitations remain

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Despite the rapid growth and proliferation of mHealth over the past decade, systematic research on the impact of new mobile technologies on health outcomes remains scarce, finds an article in the Journal of Medical Internet Research.

"Research interest in mHealth is growing, together with an increasing complexity in research designs and aim specifications, as well as a diversification of the impact areas," concludes the article. "However, new opportunities offered by new mobile technologies do not seem to have been explored thus far. Mapping the evolution of the field allows a better understanding of its strengths and weaknesses and can inform future developments."

The findings are based on a literature review in which abstracts and articles were categorized using typologies that were "partly adapted from existing literature and partly created inductively from publications included in the review." The objective was to provide a comprehensive examination of the field of mHealth research to date and to understand whether and how the new generation of smartphones introduced five years ago has triggered research. Specifically, the literature review focused on studies aiming to evaluate the impact of mobile phones on health, and attempted to identify the main areas of healthcare delivery where mobile technologies can have an impact.

Five electronic databases (CINAHL, Communication and Mass Media Complete, PubMed, PsycINFO, and Web of Science) were searched based on metadata (i.e., title, abstract, and keywords). To be eligible for inclusion in the review, records had to be written in English and discuss the role of mobile technology as a tool for promoting, managing, or monitoring health. In addition, records had to be published online or in print in a peer-reviewed publication. The final sample consisted of 117 articles published in 77 different journals between 2002 and 2012.

According to the authors, the increase in the number of mHealth articles over the past decade indicates an increasing interest in peer-reviewed scientific literature on the topic. In particular, they say the number of articles almost doubled from 2007 to 2008.

"Although these findings are encouraging and can be seen as indicators of a promising field, they highlight certain gaps that future research should address," the authors wrote. "So far, the focus of mHealth interventions has been on chronic conditions, similar to eHealth. However, it would be advisable to explore the impact of mobile health for acute conditions as well. Because of their wireless cellular communication capability, mobile phones allow users to have continuous, interactive communication from any location. In our view, this characteristic of mobile phones makes them an ideal tool to address in real-time the specific needs of patients experiencing acute conditions."

A shortcoming identified by the authors was that the majority of the studies they reviewed tested basic mobile phone features (such as text messaging), while only a few assessed the impact of smartphone apps. 

"Our last recommendation is for research to fully exploit the potential of technologies, especially of smartphones," the authors wrote. "We expected in our review to find more results detailing applications of new built-in features, which are the 'specialty' of smartphones. However we found that only a few interventions aimed at assessing the impact of native applications for smartphones had been reported so far in the literature. Moreover, in all the cases, the apps were not available to the public but had been created ad hoc for research purposes."

In related news, the Center for Communication Programs at Johns Hopkins University's Bloomberg School of Public Health is developing an online mHealth evidence database designed to serve as a global resource for the worldwide mobile healthcare community. A U.S. Agency for International Development-funded Knowledge for Health (K4Health) project, the database has an ambitious goal: to catalog, categorize and grade all of the known peer-reviewed and grey literature on mHealth in high-, middle- and low-income countries. 

To learn more:
- read the JMIR article

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