The latest generation of smartphones are increasingly viewed as handheld computers rather than as phones, due to their powerful on-board computing capability, capacious memories, large screens and open operating systems that encourage application development. This paper provides a brief state-of-the-art overview of health and healthcare smartphone apps (applications) on the market today, including emerging trends and market uptake. Platforms available today include Android, Apple iOS, RIM BlackBerry, Symbian, and Windows (Windows Mobile 6.x and the emerging Windows Phone 7 platform). The paper covers apps targeting both laypersons/patients and healthcare professionals in various scenarios, e.g., health, fitness and lifestyle education and management apps; ambient assisted living apps; continuing professional education tools; and apps for public health surveillance. Among the surveyed apps are those assisting in chronic disease management, whether as standalone apps or part of a BAN (Body Area Network) and remote server configuration. We describe in detail the development of a smartphone app within eCAALYX (Enhanced Complete Ambient Assisted Living Experiment, 2009-2012), an EU-funded project for older people with multiple chronic conditions. The eCAALYX Android smartphone app receives input from a BAN (a patient-wearable smart garment with wireless health sensors) and the GPS (Global Positioning System) location sensor in the smartphone, and communicates over the Internet with a remote server accessible by healthcare professionals who are in charge of the remote monitoring and management of the older patient with multiple chronic conditions. Finally, we briefly discuss barriers to adoption of health and healthcare smartphone apps (e.g., cost, network bandwidth and battery power efficiency, usability, privacy issues, etc.), as well as some workarounds to mitigate those barriers.

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How smartphones are changing the face of mobile and participatory healthcare: an overview, with example from eCAALYX.

Background: Advancements in technology have always had major impacts in medicine. The smartphone is one of the most ubiquitous and dynamic trends in communication, in which one’s mobile phone can also be used for communicating via email, performing Internet searches, and using specific applications. The smartphone is one of the fastest growing sectors in the technology industry, and its impact in medicine has already been significant. Objective: To provide a comprehensive and up-to-date summary of the role of the smartphone in medicine by highlighting the ways in which it can enhance continuing medical education, patient care, and communication. We also examine the evidence base for this technology. Methods: We conducted a review of all published uses of the smartphone that could be applicable to the field of medicine and medical education with the exclusion of only surgical-related uses. Results: In the 60 studies that were identified, we found many uses for the smartphone in medicine; however, we also found that very few high-quality studies exist to help us understand how best to use this technology. Conclusions: While the smartphone’s role in medicine and education appears promising and exciting, more high-quality studies are needed to better understand the role it will have in this field. We recommend popular smartphone applications for physicians that are lacking in evidence and discuss future studies to support their use. [J Med Internet Res 2012;14(5):e128]

The Smartphone in Medicine: A Review of Current and Potential Use Among Physicians and Students

There is sufficient evidence proving the impact that negative lifestyle choices have on people’s health and wellness. Changing unhealthy behaviours requires raising people’s self-awareness and also providing healthcare experts with a thorough and continuous description of the user’s conduct. Several monitoring techniques have been proposed in the past to track users’ behaviour; however, these approaches are either subjective and prone to misreporting, such as questionnaires, or only focus on a specific component of context, such as activity counters. This work presents an innovative multimodal context mining framework to inspect and infer human behaviour in a more holistic fashion. The proposed approach extends beyond the state-of-the-art, since it not only explores a sole type of context, but also combines diverse levels of context in an integral manner. Namely, low-level contexts, including activities, emotions and locations, are identified from heterogeneous sensory data through machine learning techniques. Low-level contexts are combined using ontological mechanisms to derive a more abstract representation of the user’s context, here referred to as high-level context. An initial implementation of the proposed framework supporting real-time context identification is also presented. The developed system is evaluated for various realistic scenarios making use of a novel multimodal context open dataset and data on-the-go, demonstrating prominent context-aware capabilities at both low and high levels.

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Human Behavior Analysis by Means of Multimodal Context Mining.

Mobile health is an emerging field which is attracting much attention. Nevertheless, tools for the development of mobile health applications are lacking. This work presents mHealthDroid, an open source Android implementation of a mHealth Framework designed to facilitate the rapid and easy development of biomedical apps. The framework is devised to leverage the potential of mobile devices like smartphones or tablets, wearable sensors and portable biomedical devices. The framework provides functionalities for resource and communication abstraction, biomedical data acquisition, health knowledge extraction, persistent data storage, adaptive visualization, system management and value-added services such as intelligent alerts, recommendations and guidelines.

mHealthDroid: A Novel Framework for Agile Development of Mobile Health Applications

A survey on ECG analysis

Cardiovascular disease (CVD) is the single leading cause of global mortality and is projected to remain so. Cardiac arrhythmia is a very common type of CVD and may indicate an increased risk of stroke or sudden cardiac death. The ECG is the most widely adopted clinical tool to diagnose and assess the risk of arrhythmia. ECGs measure and display the electrical activity of the heart from the body surface. During patients' hospital visits, however, arrhythmias may not be detected on standard resting ECG machines, since the condition may not be present at that moment in time. While Holter-based portable monitoring solutions offer 24-48 h ECG recording, they lack the capability of providing any real-time feedback for the thousands of heart beats they record, which must be tediously analyzed offline. In this paper, we seek to unite the portability of Holter monitors and the real-time processing capability of state-of-the-art resting ECG machines to provide an assistive diagnosis solution using smartphones. Specifically, we developed two smartphone-based wearable CVD-detection platforms capable of performing real-time ECG acquisition and display, feature extraction, and beat classification. Furthermore, the same statistical summaries available on resting ECG machines are provided.

Jun Cheng

Papers

A Wearable Smartphone-Based Platform for Real-Time Cardiovascular Disease Detection Via Electrocardiogram Processing