Review and analysis of mhealth applications. Development and evaluation of a heart diseases self-management app

Resumo

In the last years, Internet has been reaching almost every zone in the world and new technologies have been discovered and created, especially in mobile telecommunications. These technologies have propitiated the development and fast expansion of mobile devices such as smartphones and tablets, and, with these devices, a new software industry: the mobile apps industry. Currently, there are apps for every aspect of life, videogames, educational, productivity apps, and, of course, apps focused on health care. These apps related to health care are part of what is called mobile health or mHealth, defined by the World Health Organization as ¿medical and public health practice supported by mobile devices, such as mobile phones, patient monitoring devices, personal digital assistants (PDAs), and other wireless devices¿. Hence, the objective of mHealth applications and systems is to fight against conditions and diseases that undermine the health of the patients trying to diagnose, treat or relieve them. This work has two main objectives. The first is to perform a review of the existing mobile applications focused on non-communicable diseases or conditions, especially in the field of cardiology. This review was focused on the most prevalent conditions, the diseases that are leading causes of death and heart diseases. This was complemented with a review of Mobile Decision Support Systems (MDSS). The second objective is the design, creation and development of an innovative mobile application in the field of cardiology in order to fill a gap found in the previous review. In order to achieve that goal, several researches were performed to solve the problems encountered. The experience learned is shared with researchers and developers in order to help them in the process of developing mHealth apps. The review was performed in different stages and it was done in both academic and commercial systems and databases, with a number of requisites. Several results were obtained, such as the distribution of work done in the different diseases, the evolution of this work along the years and some classifications of the different apps found. With one of these classifications obtained for heart related apps, a very interesting type with limited research was found. It was an app for the self-management of heart diseases and conditions. It was catalogued with high potential by the authors, who decided to create an app with this objective named Heartkeeper. Several aspects should be considered when creating a mHealth app, apart from the technical issues. It is important to consider security and privacy aspects according to the users¿ data treated in the app. The app should be tested not only in the technical aspects, but also from the point of view of the Quality of Experience (QoE) from the users and the compliance with the guidelines for the operating system selected. Finally, it is recommended to perform an ex-ante analysis of the economic impact of the use of the app in a region. All these issues were faced and researched, and the experience and lessons learned are shared with the academic community and also with developers, who can obtain special advantage from this work.