Mobile health safety in the age of advancement

Credit: Shutterstock/greenbutterfly

The mobile health, or mHealth, sector is rapidly expanding, with forecasts predicting it will grow beyond $300 billion (€275 bn) by 2025. Around 300,000 mobile health apps are available on the market and this number continues to rise, with approximately 40% of smartphone owners using mHealth apps.  

Most health-related apps are free to download, strengthening the appetite for the convenience of mobile monitoring and real-time communication, and widening consumer access to mHealth. However, amid security and privacy concerns, the mHealth sector faces criticism and calls for better design, development and protection of its applications to safeguard data.  

Over the past decade, the adoption and success of large-scale mobile health research has failed to live up to its promoted opportunity, researchers in a 2023 study state. Public trust and methods for providing research participants with better control over their data are key areas the sector needs to address, the scientists say.

In May 2023, the European Commission introduced the European Health Data Space Regulation (EHDS), which is designed to empower patients to control and use their health data, and create a single market for digital health. France has also implemented security and interoperability requirements to its healthcare information systems.

In response to the barriers facing clinicians and biomedical researchers in developing mHealth apps, analysts have produced a 2023 guide to support concepts from idea to launch. “Compliance needs to be addressed at the beginning of a project when architecture is being designed and before the app is released publicly to ensure it meets all the required standards for privacy and security,” the researchers state.

Health is falling behind cybersecurity requirements compared to its counterpart technologies, The State of Mobile App Security 2022 whitepaper found. After analysing 30 apps, the study reported how every app was vulnerable to security risks.  

The whitepaper found that mobile app demand tripled between 2020-2022 due to the pandemic and reliance on virtual forms of engagement. Yet, security is not keeping up with demand, the report suggests, as 43% of participants in healthcare state their company has prioritised new features over ensuring security. 

In March 2023, the Health Sector Cybersecurity Coordination Centre launched a mobile device security checklist specifically for mobile usage in healthcare environments. Described as a basic checklist to maintain security, the list provides guidance on various areas of mHealth, including data backup and cloud storage, physical security, endpoint security software, remote wiping, and content and conversations. 

While NPs have been developed for TB over the past decade, the therapeutic systems have become prominent using diagnostic and therapeutic methods (theranostic). Theranostic approaches to TB management were designed to conduct nuclear imaging, optical imaging, ultrasound, imaging with magnetic resonance, and computed tomography. 

Problems with resistance to conventional TB drugs mean therapeutic methods require high doses of numerous medications over a longer time. Issues with the practical capabilities of traditional drugs for TB also exist. Solubility, stability, and penetration impact the drugs’ effectiveness. Traditional drugs may also create resistance over time, a relapse, and extend to other body parts, leading to secondary TB.  

Connected devices, which communicate information through a mobile app, raise ethical issues about the large amounts of data obtained and shared with third parties.

In a 2023 US survey, tech company Secure Data Recovery Services stated that of the survey’s top ten least trusted apps, women’s health apps, including period and pregnancy trackers, took up five of these positions. The respondents were most worried about the apps tracking their data.

Privacy concerns are a significant inhibitor to download and use these apps, the survey indicates. While 45% of respondents said that worrying about data collection and privacy is exhausting and they have given up, 61% confirmed they had deleted an app specifically because of data collection and/or privacy concerns. However, two-thirds (66%) of respondents said they would be more open to data collection if companies paid them for it.

Device users are highly concerned about privacy issues and consider informed consent “very important” when sharing information with third parties, researchers have found. Users called for the involvement of regulatory authorities and favoured legal consequences for violating or misusing health information communicated to devices.

A 2022 research study found that various factors, including geographic region, user type, mHealth type, user age, and publication year, significantly influenced users’ trust. The researchers recommended mHealth developers create personalised, continuous-use promotion strategies based on user characteristics.

Developers seek technologies and operating systems that overcome ethical, logistical and technological concerns and challenges. The high-performance integrated virtual environment (HIVE), funded by the Food and Drug Administration (FDA), is one solution researchers are exploring. HIVE adopts a collaborative approach, connecting with blockchain technology, to develop a more secure and protected data ecosystem.

In March 2023, researchers announced that the HIVE mobile app had been tested on 20 patients with stress urinary incontinence after the Women’s Health Technology Coordinated Registry Network sought a tool to help with data collection. The patients and surgeons scored their experience with the app as  9 and 8.6 out of 10, respectively. 

A 2023 research study saw scientists examine the acceptability and usability of a mobile app for health professionals delivering hospitalisation at home. As over 90% of participants could complete the tasks with some difficulty, the researchers determined the app’s significant usability and acceptability relating to its effectiveness, efficiency and satisfaction. 

As the pandemic saw a considerable rise in medical app downloads, mHealth is set to see further growth in the wake of Covid-19 and heightened consciousness of preventative health and management.  

Gamification may present opportunities in mHealth. In 2022, researcher Dr Darren Edwards developed a mobile-based game to support users’ mental health after learning approximately 50% of Europeans engage in video gaming on a games console, VR, or mobile application. 

Highlighted as a main therapy field for mHealth app creators, diabetes prevention and care will be a core area of focus as the US sees a growing prevalence of the condition. Continuous glucose monitoring (CGM) and flash glucose monitors (FGMs) are recent developments in the diabetic mHealth field.  

Medical device technology company, Abbott, introduced its FGM, the FreeStyle Libre 2 system, to eliminate the need for daily finger-pricks to get glucose readings. Using a small sensor to continuously track a person’s glucose levels for up to 14 days, it can send the glucose information wirelessly to a user's smartphone through a mobile app.  

“New diabetes treatment options are available today as a result of advancements in technology and new innovative approaches,” a spokesperson for Abbott told Medical Device Network in an earlier interview on easing the burden of diabetes. Despite the brightening spotlight on diabetes in mHealth, Abbott’s FreeStyle Libre 2 system remains the only flash glucose monitor to buy in the UK. Cost is a potential barrier to uptake, with the FreeStyle Libre 2 sensor costing approximately £50 every two weeks.