mHealth: Challenges and Opportunities for Health Systems
Information and Communication Technologies (ICT) and especially smartphones are part of our daily lives. Therefore, health and health system are embedded within this trend. Citizens, patients, healthcare organizations, health professionals and managers and policymakers approach the usage of mobile technologies (mHealth) as an opportunity to improve patients’ quality of life, quality of care and health, while maintaining the sustainability, equity and accessibility to health systems. However, the available scientific evidence is not yet sufficient to achieve a widespread use of mHealth in our health system.
In this context, the Open Evidence research group of the Universitat Oberta de Catalunya is promoting a new research project titled “mHealth: Challenges and Opportunities for Health Systems” that receives funding from RecerCaixa. The aim of this project is to analyse the access, adoption, usage, impact and sustainability of mHealth in the Spanish health system.
This study combines quantitative and qualitative methodologies, including (1) a systematic review of the literature; (2) an online survey of a representative sample of the Spanish population of 800 Internet users; (3) workshops / focus groups with policy makers healthcare professionals, managers of health centers and mobile application developers and (4) a multi-center trial randomized controlled trial with a sample of at least 250 patients with a diagnosis of TCA from different hospitals in Spain. The triangulation of the results obtained with these methods will facilitate the generation of recommendations and guidelines for all stakeholders in the ecosystem of mHealth in Spain. In addition, to carry out this research, we will have the collaboration of all the actors of the system, including Internet users, patients, health professionals, health organizations and application developers.
We are currently conducting the trial in several mental health institutions around Spain, through a Randomized Clinical Trial (RCT). The clinical trial titled “Evaluation of a Program for Eating Disorders That Combines Cognitive-behavioral Therapy With Online Psychological Treatment” has been recently published on ClinicalTrials.gov portal.
The purpose of this study is to conduct a multicenter RCT with 250 patients diagnosed with an eating disorder. In this experiment, the patients from the experimental group will test an mHealth application (TCApp developed by HealthApp) and then, a clinical efficacy analysis and an economic evaluation will be performed. We expect that the implementation of the intensive intervention program with the TCApp would allow a greater improvement of the symptoms related to the eating disorder among patients and also would lead to a greater improvement of several secondary outcomes, such as anxiety, depression and quality of life of both patients and their caregivers. In addition, the implementation of the intensive treatment with the TCApp by the experimental group would be more cost-effective compared to the control group.
Finally, the study counts with the support of different hospitals where the clinical trial will be conducted, including public institutions (Parc Taulí Hospital, Sant Rafael Hospital, Servei de Salut de les Illes Balears, Sant Joan de Déu Hospital, Niño Jesús University Children’s Hospital and San Carlos Clinic Hospital) and private associations specialized in the treatment of eating disorders (Dexeus University Hospital of the Quirónsalud group and Eating Disorders Institute ITA). The trial has already started the recruitment phase on September 2017 and the estimated completion date of the trial is by October 2018.