Mobile health (mHealth) strategies offer opportunities for improving access to care, engagement, health care delivery, and clinical outcomes at large scale. We know that people who interact with mobile health programs have better clinical outcomes. Patient engagement is a critical component for success and the medical content must be understandable and meaningful to the patient, which means that the health applications need to be flexible so as to offer different solutions that are relevant to a particular patient.
Our Telehealth Eye and Associated Medical Services network (TEAMSnet) study, undertaken at three sites in the Northern Territory, has developed a mobile tablet application for use by GPs, nurses, diabetes educators and Aboriginal Health Practitioners who represent a key point of interaction with the patient, delivering educational material as well as capturing valuable feedback regarding patient lifestyle, healthy behaviours and disease management. The mobile platform is expected to facilitate patient encounters outside the clinic and actively engage the patient in lifestyle support.
The application draws from the Central Australian Rural Practitioners Association (CARPA) Standard Treatment Manual (STM) around lifestyle management encounters. This includes the electronic delivery of CARPA-based Smoking, Nutrition, Alcohol, Physical activity and Emotion (SNAPE) surveys. The mobile tablet-based application is wirelessly and securely connected to the clinic Electronic Health Record system so that relevant laboratory values and other appropriate medical information can be seen on the tablet during a patient encounter.
The application also includes a module on diabetic retinopathy and eye care: retinal images previously acquired for the patient can be downloaded and viewed together with educational material on diabetic retinopathy and a live demonstration of the impact of retinopathy on vision. Prior data have shown that the act of a patient seeing their own retina is a powerful education opportunity and can have a positive impact on improving self-management behaviours.
The application incorporates a number of components that could contribute to positive health outcomes, including dynamic availability of clinical data, online education, such as streaming of health education videos, lifestyle decision support tools, and lifestyle monitoring and encounter documentation.