Abstract
With the passage of the Affordable Care Act (ACA) in 2010, significant changes are occurring within the healthcare system. It is imperative that ways to both reduce cost and improve health are found. Since emergency medicine is often considered the gateway to the healthcare system, healthcare providers need to determine the best way to provide high quality care in the emergency department while also curbing costs. Mobile health, or mHealth, utilizes technology to increase the mobility of patients and their providers and provides a medium to transfer data and information efficiently. In emergency medicine, this technology can be applied in various treatments including wound care, stroke care, and prehospital care. In this article, the authors discuss the current uses of mHealth within emergency care and potential areas for future growth.
TopEmergency Medicine And Mhealth Overview
Emergency care is generally considered to be a medical concern for which a prudent layperson would seek immediate evaluation (American College of Emergency Physicians, 2009). Most emergency care is delivered in Emergency Departments (ED). According to the Center for Disease Control and Prevention (CDC), there were over 129 million ED visits in the United States in 2010 (CDC, 2014). Some of the most common reasons patients visit the ED is for abdominal pain, chest pain, fever, headache and back pain (CDC, 2010). Providers in the ED utilize electronic medical records, rapid blood testing, and diagnostic procedures to determine if a patient needs inpatient or outpatient care. Other tools included telemetry, bedside sonography, point of care tests, and clinical decision aids. The emergency physician’s new technologies may allow more patients to receive the care at home that was once only available in hospital (Demiris et al., 2008).
Since patients presenting to the ED have multiple comorbid disease processes or chronic diseases, the evaluation of acute exacerbation of these complicated patients can be complex and expensive (Gonzalez Morganti et al., 2013). Patients face many other challenges such as specialty physician access, inequalities in care depending on whether they live in rural or urban setting, social support systems, and ED overcrowding. While technology will not solve all of these challenges, it is a tool to help providers and patients. Currently, telemedicine and mHealth are commonly utilized in the following areas: (1) neurological emergencies, (2) emergency radiology, (3) psychiatric emergencies, (4) wound care, burns, and dermatological emergencies, and (5) EMS and pre-hospital care.
Key Terms in this Chapter
Telehealth: Is the use of electronic information and telecommunications technologies to support long-distance clinical health care, patient and professional health-related education, public health and health administration.
Mobile Health (mHealth): An area of electronic health (eHealth) that provides health services and information via mobile technologies such as mobile phones and PDAs.
Wearables: Are clothing and accessories incorporating computer and advance electronic technologies.
Telemedicine: The use of medical information exchanged from one site to another via electronic communications to improve a patient’s clinical health status. Telemedicine includes a growing variety of applications and services using two-way video, email, smart phones, wireless tools and other forms of telecommunications technology.
Stroke: Is the sudden death of brain cells in a localized area due to inadequate blood flow (ischemic) or due to bleeding into the brain (hemorrhagic).
Emergency Care: Is generally considered to be a medical concern for which a prudent layperson would seek immediate evaluation.
Emergency Medical Service: Type of emergency service dedicated to providing out-of-hospital acute medical care, transport to definitive care, and other medical transport to patients with illnesses and injuries which prevent the patient from transporting themselves.
E-Health: Is the transfer of health resources and health care by electronic means. It encompasses three main areas: 1.The delivery of health information, for health professionals and health consumers, through the Internet and telecommunications. 2. Using the power of IT and e-commerce to improve public health services, e.g. through the education and training of health workers. 3. The use of e-commerce and e-business practices in health systems management.
Emergency Medicine: Is the medical specialty dedicated to the diagnosis and treatment of unforeseen illness or injury.
Attachables: Devices that can be mounted on a smartphone to serve a specific function (e.g. electrodes that can be attached to the smartphone to convert it into a heart monitor or ECG).