The human dimension of mobile health at the 3rd mHealth BCN Conference

The iSYS Foundation, with the support of the eHealth Center of the Universitat Oberta de Catalunya (UOC) and the Catalan Society for Family and Community Medicine (CAMFiC), organized the third mHealth BCN Conference, a forum for researchers and experts in m-health interventions. This year, the debate focused on the human factor and m-health. Participating in the event was the director of the eHealth Center, Albert Barberà, and two of his colleagues from the centre, Manuel Armayones and Eulàlia Hernández.

The conference was hosted by Francisco Grajales, vice president of the mHealth BCN Conference 2021; Albert Barberà, director of the UOC eHealth Center, and Jordi Mestres, vice president of CAMFiC. Barberà highlighted the fact that one positive outcome of the pandemic was the momentum that had been given to the implementation of e-health. At the UOC eHealth Center, a series of social and ethical challenges have been detected, such as the need for a social pact to decide what to do with the data. Moreover, in addition to the use of m-health, he underlined the need to digitize the whole system, with the commitment of all the stakeholders involved.

Meanwhile, Dr Mestres, vice president of CAMFiC, called for digitization to be integrated into the system permanently. Mestres stressed the fact that this should always be carried out respecting basic principles – such as equity and justice – in order to avoid the digital divide, and he called for rational planning that included the correction of the mistakes made to date.

About m-health and people

Next, there was a discussion by experts entitled, “About m-health and people”, moderated by Manuel Armanyones, researcher at the UOC eHealth Center’s Behavior Design Lab. This was a debate aimed at exploring the human dimension and behaviour in e-health, and at analysing the changes that have taken place and the importance of the latter being retained. It was concluded that they would be maintained if the digital experiences meet people’s needs.  

Sergi Jiménez-Martín, professor of Economics at Pompeu Fabra University, gave the first talk, “Influencing behaviour: nudges to help improve the population’s health”. The professor explained what these nudges are. They involve finding out how people think and changing the context to help them make the best decisions in order to achieve what they want, in this case in the field of health. In conclusion, he highlighted the fact that some small, low-cost interventions can deliver great results in terms of well-being.

The next speaker was Dr Joan Escarrabill, director of the Patient Experience Unit at Hospital Clínic de Barcelona. The doctor based his speech on the meaning of PREMs (patient-reported experience measures), in other words tools used to capture patients’ experiences. According to Escarrabill, speaking about patients’ experiences at this time is a paradigm. During his talk, he noted that there is a series of elements that patients consider very important, but which are not always taken into account. One example of this is time management. In order to assess patients’ experiences, there are tools (surveys), methods to identify unmet needs (design thinking, focal groups) and PREMs to evaluate interventions. PREMs measure three dimensions of patients’ experiences: functional, relational and life experience. The greatest challenge is ensuring that the knowledge acquired by analysing PREMs gives rise to actions to improve patient outcomes.

Dr Hugo López, psychiatrist in the IDIBAPS Addictive Behaviour Unit at Hospital Clínic, gave the speech entitled, “Apps to provide support in addiction recovery”. Addiction is a disease that affects 3-7.5% of the population. M-health is a really useful means of finding out whether a patient is in a preventive phase or in an addiction phase of treatment. In some cases, e-health acts as a substitute when access to treatment is limited. In others, it serves as an additional tool when the system cannot offer the patient intensified, personalized treatment. Studies have revealed that e-health improves patients’ quality of life and helps lower costs. There are more and more applications aimed at treating patients with addictions and psychiatric comorbidities (depression or cognitive problems). Some applications are very powerful, but many others are not. The challenge is knowing how to separate the wheat from the chaff. For this reason, the doctor stated that there should be regulatory bodies that allow applications to be prescribed just like any other type of medication.

Research in progress

Once the first roundtable debate had finished, Imma Grau, president of the iSYS Foundation and member of the UOC PSiNET research group, introduced Iris Alarcón, secretary of CAMFiC and moderator of the second debate, “Research in progress”.

To kick off this second part, Dr Jordi Vidal, a GP with over ten years' experience in telemedicine, gave his speech, "Telemedicine in times of COVID-19”, from a primary healthcare perspective. Vidal described his analysis of how the visiting patterns had changed with the arrival of the pandemic. Many centres closed and the number of face-to-face consultations dropped as an initial response to the pandemic, and the number of telephone visits, remote consultations and video consultations increased. Remote consultations, very rarely used before the pandemic, were a solution that allowed direct communication with patients.

In order to discuss “Literacy for digital health”, Eulàlia Hernández, coordinator of the UOC PSiNET research group, spoke about the Spanish Network for Health Literacy [Red Española para la Alfabetización de la Salud], a group of professionals whose common goal is to promote digital health through its essential building block: literacy.

Finally, Dr Mercè Bonjorn presented her thesis, “Design thinking and innovation in digital health”. The doctor carried out her research through the CATCH (Cancer: Activating Technology for Connected Health) project, in order to find out how technology can add value for cancer patients. The three drivers that the bibliography refers to are: technology, the stakeholders and the system. As for the facilitators, they would be the context and the tools, including design thinking, which Bonjorn analysed. Her research concluded that this is an innovative approach for the development of innovation services, since it adds value, involves the stakeholders and focuses on problem-solving.

Top 5 health applications

The conference ended with the presentation of the fourth iSYScore rankings. Imma Grau presented the results of a retrospective study, which she led and that was published in JMIR mHealth and uHealth. The study includes an analysis of 1,358 apps captured using Google’s advanced search tool over a five-year period between 2014 and 2019. The study concluded that 46% of the medical apps for patients that were available in 2014 had disappeared five years later. Finally, she announced the ranking of the best health apps for patients and professionals. The results can be found by clicking on the following link.