Mobile Medicine: Digital Dynamo or Virtual Vaporware

摘要

A scant 20 years ago or so, the Internet was still mostly the purview of government researchers and academics. Smartphones and their applications (or apps) were still fledgling to nonexistent. The iPhone was still more than a decade away, and social media was the tabloid press rather than the myriad posting and sharing platforms available today. Oh, how times have changed. In far less than a generation, digital devices and social media now dominate many people's lives. Whether we admit it or not, many of us are device dedicated and device driven; hence, the advent of the moniker “crackberry” to describe some people's addiction to 1 particular type of smartphone. These devices give us geographic directions, almost instant access to startling amounts of information, and the ability to stay in close touch with family, friends, and our workplace. Our smartphones organize, inform, and often run our day-to-day professional and personal lives. Indeed, given the very rapid manner in which this technology has come to dominate contemporary life, it is amazing that digital health care and mobile medicine, or mHealth, has not enjoyed more success or a more ubiquitous uptake. mHealth could actually improve population health and health care through better communication between patients and their health care professionals, better communication between health care professionals themselves, improved adherence to longevity-enhancing health behaviours, and greater awareness of and adherence to evidence-informed clinical practice guidelines. Regrettably, to date, mobile medicine has been more virtual vaporware than digital dynamo. There is almost universal acknowledgment that mHealth could substantially improve patient outcomes. Lamentably, the opposite seems to be true. Rather than improving the health and wellness of our patients and our daily professional lives, the digital information explosion and the exponential perpetuation of online access means that almost every health care professional must now deal with dubious, and often bogus, second opinions from Dr Google on a daily basis. Thus, perhaps predictably, smartphones and instant access to digitally stored information seem to have introduced only obfuscation and confusion into the patient care arena instead of the commonly desired goal of clarity and consistency. The problem of myth communication in the digital world of health care delivery is rapidly expanding and becoming ever pervasive, and this distressing problem does not even encapsulate the future expansion of handheld and mobile devices, software programs, and applications. Today, digital technology and social media platforms are accelerating at a pace that is truly daunting. It has been estimated that within the next 10-15 years, the smartphone will contain more connections than the human brain and may have shrunk to the size of blood cells.1Matyszczyk C. Google exec: With robots in our brains, we'll be godlike. Available at: https://www.cnet.com/news/futurist-ray-kurzweil-on-smartphones-ai-and-the-human-brain. Accessed November 15, 2016.Google Scholar Facebook has more than 1.5 billion users. For all its power and connectivity, however, has digital technology made the delivery of health care better or has it just made it more chaotic? Social media sites that could potentially improve the successful delivery of health care services can become uncensored, unfettered, and unregulated platforms that allow some individuals or organizations to engage in professional or vocational cyberbullying aimed at their competitors or others providing similar services within the same health and disease care communities. In these difficult circumstances, rather than a digital tide that should float all boats, this from of cyberbashing and cyberbullying diminishes entire sectors of the health care system leaving them virtually high and dry. However, these detractors and drawbacks aside, mobile medicine could and should significantly improve patient