Researchers from the University of California, San Francisco and the University of California, Los Angeles described a new initiative called Open mHealth in an article recently published in the Journal of Medical Internet Research.
Open mHealth is a new not for-profit organization for the creation of an “open software architecture for mHealth” to catalyze an “open community of developers, clinicians, researchers, and entrepreneurs to build and reuse Open mHealth modules across a broad range of mHealth applications, disease conditions, and user populations.” Be sure to also check out our recent conversation with Ida Sim, one of the principal investigators.
Problem?
The researchers identify a number of problems with the mHealth research currently. They state that the evidence base for mHealth interventions is “sparse and methodologically weak.” While this may be true, the researchers ironically provide little evidence to support this claim in their article. The article they cite to support their claim focuses on mobile preventive health interventions in developing countries – a small subset of mHealth research. So, with such a broad claim more evidence is needed.
The researchers also state that the “mHealth ecosystem lacks modular tools and techniques for drawing meaning and scientifically valid inferences from the masses of collected data.” They further state that there is a need for more heterogeneous, sophisticated and defective tools for visualizing and analyzing data. They view these displays as offering better ways for patients and providers to understanding the enormous amount of data that is aggregated during mHealth research.
Currently, they argue, the use of the mHealth research data is limited by the lack of these tools. Given this view, they argue that an open mHealth community and architecture will catalyze increased mHealth efficiency, effectiveness, and innovation.
The Open mHealth Solution
The researchers list five features of the solution to the stated problems.
The features include:
“1) Community: must be multidisciplinary, safe, and collaborative; 2) Iteration: delivers efficient reuse through collaborative cycles of development; 3) Flexible architecture: recognizes both the limits and the utility of existing closed systems and is designed to maximize participation from all players; 4) Shared learning: uses the strongest appropriate methods, matched to the evidence needs and the rapid pace of technological advances in mHealth; 5) Scalable solutions: offers mass customization of applications and evidence, from personal to population.”
The researchers further state that common standards along with open access computer programming can meet the needs of an open mHealth community. As shown in the figure for this article, this approach would created an hourglass architecture for mHealth development which allows for more efficient innovation than the stovepipe approach which does not encourage the sharing of strategies and resources.
This open access approach, according to the researchers, will provide better mHealth interventions more likely to impact health outcomes. They cite examples of prior efforts from the Internet world that followed this model including Mozilla, the creator of the popular Firefox web browser.
In an effort to catalyze this open access approach to mHealth, the researchers have developed products that create the framework for this new community. The first product is InfoVis, an “architectural scaffolding for data analysis and visualization building blocks that the Open mHealth community is creating, combining, evaluating, and adapting.” They have also developed a personal evidence architecture that provides “(1) standardized, validated clinical measures, 2) ways of collecting and interpreting these measures over time (such as statistical and graphical methods for time series analysis), and (3) use of an n-of-1 trial structure to reduce bias.”
Future Challenges
The next step for the researchers is to continue using the open access platforms for their work and marketing it to others. As with an open access venture, participation by as many people as possible makes the effort useful. Wikipedia and other websites have shown this over and over again. If the researchers are successful, they may spur new ways of conducting medical/public health research generally and not just in the mHealth context.
