Can mHealth bridge the digital divide in rheumatic and musculoskeletal conditions?

Abstract

Background The impact of rheumatic and musculoskeletal diseases is significant worldwide. Progress in disease management has put current care models under pressure. Mobile Health solutions may constitute a solution for these changes. However, vulnerable populations groups including people with a migration or ethnic background different from the host country, people with low socio-economic status and people with low (digital) literacy skills seem to be underrepresented in mHealth research and practice. Main body In this editorial, we propose tailored interventions with mobile health applications on three levels including patient-related strategies, healthcare provider-related strategies and healthcare system-related strategies to solve this unmet need for patients from vulnerable populations groups with rheumatic and musculoskeletal diseases. Patient-related mobile health strategies should focus on increasing self-efficacy and enabling peer-education. Gamification could be a solution to motivate patients to use mobile health. On the level of the healthcare provider, we propose strategies including technology-enhanced learning and adaptative communication strategies, to tailor mobile health towards vulnerable populations groups with rheumatic and musculoskeletal diseases. Regarding healthcare system-related strategies, the aim is to increase minority participation in research in a cost-effective manner by remote longitudinal data tracking, using teleconsultation or remote symptom monitoring devices to ensure quality care for all patients with rheumatic and musculoskeletal diseases, even in vulnerable populations groups that are normally hard to reach. Conclusion Vulnerable population groups in rheumatic and musculoskeletal diseases are underrepresented in mobile health research and practice. Evidence is sparce on the scale of the digital divide between patients using or not using mobile health. Interventions that directly attempt to reduce health disparities among vulnerable populations groups are needed to guarantee all patients with rheumatic and musculoskeletal diseases might be engaged in the rheumatology care of the future.

Digital Health Dashboards for Decision-Making to Enable Rapid Responses During Public Health Crises: Replicable and Scalable Methodology

“…Nevertheless, data privacy protocols need to be addressed on an ongoing basis to ensure that the dashboards comply with laws and regulations that govern jurisdictions [ 73 ]. Finally, citizen-driven digital health dashboards are limited by the uptake from citizens within jurisdictions, and the uptake is in turn influenced by internet equity [ 3 ] as well as digital divides within and across jurisdictions [ 74 ]. Although there is growing evidence of the potential of digital health dashboards to transform health care systems [ 15 ], the digital health dashboard that we developed needs to be tested in real-world settings.…”

Designing Survey-Based Mobile Interfaces for Rural Patients With Cancer Using Apple’s ResearchKit and CareKit: Usability Study (Preprint)

“…This raises the need for a more effective and efficient process related to distress screening [43]. The implementation of digitizing the NCCN DT as a mobile app poses many advantages, such as real-time identification of distress factors and triage to the proper provider, generating insightful data around common issues during the cancer experience, and providing insight into potential resource allocation [12,13,49].…”

“…Unclear how to answer distress scale (7) Unclear how to indicate no to a specific symptom ( 3) Unclear what to do when no symptoms (2) Unsure if assessment was done and submitted (3) Navigation (12) Confusion when needing to vertical scroll (4) Uncertainty on how to start assessment (1) Unclear how to skip sections (3) Unsure how to continue to next part of assessment (2) Accidental navigation to other parts of app (1) Tapping on wrong button to complete surveys (1)…”

“…Specifically, rural communities, like those of the Southeastern United States or Appalachia, commonly have higher rates of chronic disease, reduced access to providers, and lack the same medical resources as their urban counterparts [4][5][6][7][8]. The ubiquity of mobile devices makes mHealth particularly attractive for reaching disadvantaged populations [9][10][11][12]. A promising use of mHealth is remote patient monitoring, which can include objective data, such as biometrics, via sensor devices or subjective data, such as quality of life surveys, via patient-reported outcomes; resulting in a better understanding of a patient's overall health and symptom tracking between visits [13].…”