Mobile health technology measures, monitors and reminds

New research using cell phone billing data to track people's movements through their daily routines finds that we humans are creatures of habit. More than an academic exercise exploiting technology to peer into human behavior, this research exemplifies the increasing recognition of the potential of mobile technology to solve problems of health-data collection and delivery. The ubiquity of mobile phones helps: They are now used by 3.3 billion people, or about half the world's population.

The research using mobile phone billing data found that people, at least in Europe where the study took place, are exceedingly predictable. Whether you commute to a cubicle or roam the map for your paycheck, your location on at any given time can likely be predicted with 80 to 90 percent accuracy. Similar research using the global positioning technology in mobile phones has tracked student movements around college campuses. Potential applications for health interventions or health policy include understanding how people interact with their environment (also known as spatial epidemiology), emergency planning, and positioning health messages.

Examples of data collection include the use by researchers at Dartmouth Medical School of iPhones reprogrammed to gather accurate health data about the elderly: How far they walk and at what pace, how many social interactions they have and whether they are with individuals or groups. The audio sensors and GPS within the phones allow this type of measurement far more accurately than the typical survey-based approach. In fact a new study that used accelerometers to measure physical exercise found for the first time that Mexican-Americans are the most likely of any socio-cultural or racial group to reach national physical activity goals, in part due to their propensity to be employed in manual labor. Previous survey-based approaches had underreported their activity levels.

Mobile sensing technology has been proposed for sentinel systems that forecast coming disasters, be they disease, warfare, industry or weather related. Geographic Information Systems and online technology has the potential to quickly spread evidence of such events. In some cases this is already being done: The voluntary online disease surveillance system Promedmail was the first to report on the outbreak of SARS. Why not equip select mobile phone users with the ability to report when "something strange or different" appears to be happening, whether it's a sudden influx of sick refugees, birds falling from the sky, or a lack of rainfall?

Text messaging of healthy behavioral reminders can successfully lead to behavior change, increasing sunscreen usage, for example. In New Orleans, clinicians are now using text messages to remind diabetics to check blood sugar and send readings back to the office, or take medications during Mardi Gras celebrations that otherwise spell an entire week of potentially life threatening lose of diabetic control.

Public health communication has long been a challenge, using technology that people carry with them everyday as tools for them to report their status, the status of the environment around them, or to provide them with data, only makes sense.