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      mHealth Assessment: Conceptualization of a Global Framework

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          Abstract

          Background

          The mass availability and use of mobile health (mHealth) technologies offers the potential for these technologies to support or substitute medical advice. However, it is worrisome that most assessment initiatives are still not able to successfully evaluate all aspects of mHealth solutions. As a result, multiple strategies to assess mHealth solutions are being proposed by medical regulatory bodies and similar organizations.

          Objective

          We aim to offer a collective description of a universally applicable description of mHealth assessment initiatives, given their current and, as we see it, potential impact. In doing so, we recommend a common foundation for the development or update of assessment initiatives by addressing the multistakeholder issues that mHealth technology adds to the traditional medical environment.

          Methods

          Organized by the Mobile World Capital Barcelona Foundation, we represent a workgroup consisting of patient associations, developers, and health authority representatives, including medical practitioners, within Europe. Contributions from each group’s diverse competencies has allowed us to create an overview of the complex yet similar approaches to mHealth evaluation that are being developed today, including common gaps in concepts and perspectives. In response, we summarize commonalities of existing initiatives and exemplify additional characteristics that we believe will strengthen and unify these efforts.

          Results

          As opposed to a universal standard or protocol in evaluating mHealth solutions, assessment frameworks should respect the needs and capacity of each medical system or country. Therefore, we expect that the medical system will specify the content, resources, and workflow of assessment protocols in order to ensure a sustainable plan for mHealth solutions within their respective countries.

          Conclusions

          A common framework for all mHealth initiatives around the world will be useful in order to assess whatever mHealth solution is desirable in different areas, adapting it to the specifics of each context, to bridge the gap between health authorities, patients, and mHealth developers. We aim to foster a more trusting and collaborative environment to safeguard the well-being of patients and citizens while encouraging innovation of technology and policy.

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          Most cited references34

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          FDA regulation of mobile health technologies.

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            Economic Evaluation of Text-Messaging and Smartphone-Based Interventions to Improve Medication Adherence in Adolescents with Chronic Health Conditions: A Systematic Review

            Background The rate of chronic health conditions (CHCs) in children and adolescents has doubled in the past 20 years, with increased health care costs. Technology-based interventions have demonstrated efficacy to improving medication adherence. However, data to support the cost effectiveness of these interventions are lacking. Objective The objective of this study is to conduct an economic evaluation of text-messaging and smartphone-based interventions that focus on improving medication adherence in adolescents with CHCs. Methods Searches included PubMed MEDLINE, Embase, Cochrane Central Register of Controlled Trials, Cumulative Index to Nursing and Allied Health Literature, PsycINFO, Web of Science, and Inspec. Eligibility criteria included age (12-24 years old), original articles, outcomes for medication adherence, and economic outcomes. Results Our search identified 1118 unique articles that were independently screened. A total of 156 articles met inclusion criteria and were then examined independently with full-text review. A total of 15 articles met most criteria but lacked economic outcomes such as cost effectiveness or cost-utility data. No articles met all predefined criteria to be included for final review. Only 4 articles (text messaging [n=3], electronic directly observed therapy [n=1]) described interventions with possible future cost-saving but no formal economic evaluation. Conclusions The evidence to support the cost effectiveness of text-messaging and smartphone-based interventions in improving medication adherence in adolescents with CHCs is insufficient. This lack of research highlights the need for comprehensive economic evaluation of such interventions to better understand their role in cost-savings while improving medication adherence and health outcomes. Economic evaluation of technology-based interventions can contribute to more evidence-based assessment of the scalability, sustainability, and benefits of broader investment of such technology tools in adolescents with CHCs.
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              Developing a Framework for Evaluating the Patient Engagement, Quality, and Safety of Mobile Health Applications.

              Rising ownership of smartphones and tablets across social and demographic groups has made mobile applications, or apps, a potentially promising tool for engaging patients in their health care, particularly those with high health care needs. Through a systematic search of iOS (Apple) and Android app stores and an analysis of apps targeting individuals with chronic illnesses, we assessed the degree to which apps are likely to be useful in patient engagement efforts. Usefulness was determined based on the following criteria: description of engagement, relevance to the targeted patient population, consumer ratings and reviews, and most recent app update. Among the 1,046 health care-related, patient-facing applications identified by our search, 43 percent of iOS apps and 27 percent of Android apps appeared likely to be useful. We also developed criteria for evaluating the patient engagement, quality, and safety of mobile apps.
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                Author and article information

                Contributors
                Journal
                JMIR Mhealth Uhealth
                JMIR Mhealth Uhealth
                JMU
                JMIR mHealth and uHealth
                JMIR Publications (Toronto, Canada )
                2291-5222
                May 2017
                02 May 2017
                : 5
                : 5
                : e60
                Affiliations
                [1] 1Norwegian Centre for E-health Research University Hospital of North Norway TromsøNorway
                [2] 2UiT The Arctic University of Norway Department of Clinical Medicine TromsøNorway
                [3] 3Universitat Oberta de Catalunya (UOC) CataloniaSpain
                [4] 4TransLab Research Group Departament de Ciències Mèdiques Universitat de Girona (UdG) CataloniaSpain
                [5] 5Red de Investigación en Servicios Sanitarios en Enfermedades Crónicas (REDISSEC) BilbaoSpain
                [6] 6Mobile World Capital Barcelona BarcelonaSpain
                [7] 7Agència de Qualitat i Avaluació Sanitàries de Catalunya (AQuAS) CataloniaSpain
                [8] 8CIBER de Epidemiología y salud Pública (CIBERESP) MadridSpain
                Author notes
                Corresponding Author: Carme Carrion mcarrionr@ 123456uoc.edu
                Author information
                http://orcid.org/0000-0003-4540-225X
                http://orcid.org/0000-0003-1479-7551
                http://orcid.org/0000-0002-9006-7633
                http://orcid.org/0000-0002-3506-0260
                http://orcid.org/0000-0002-1671-0248
                http://orcid.org/0000-0002-4277-3672
                http://orcid.org/0000-0001-6098-1152
                Article
                v5i5e60
                10.2196/mhealth.7291
                5434253
                28465282
                e0993c6d-f1a0-453d-856e-0af0d2d4f196
                ©Meghan Bradway, Carme Carrion, Bárbara Vallespin, Omid Saadatfard, Elisa Puigdomènech, Mireia Espallargues, Anna Kotzeva. Originally published in JMIR Mhealth and Uhealth (http://mhealth.jmir.org), 02.05.2017.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR mhealth and uhealth, is properly cited. The complete bibliographic information, a link to the original publication on http://mhealth.jmir.org/, as well as this copyright and license information must be included.

                History
                : 10 January 2017
                : 31 January 2017
                : 14 March 2017
                : 14 March 2017
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                mhealth,evaluation,assessment,checklist,framework
                mhealth, evaluation, assessment, checklist, framework

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