Mobile Health Design
Let’s Discuss
• Schedule• Class list• Google Hangouts and Google Docs for team
work, time during class in breakouts• Assignments: 2 for May 30 + final paper
• Assignment for May 30 (individual): – What is your favorite app/device and why (ideally
health-related but any is fine) and prepare 1-2 PowerPoint slides with a screen shot and description. Email to Chinyere before class.
• Assignment for May 30 (team): – Select a health goal with your team (food, fitness, happiness, etc.)– Keep a shared Google Doc in which each team member notes at least 3 times daily
• What you are doing related to the goals and how you feel about it• What information you have• What information you would like to have that exists?• What information exists but doesn’t help you?• What information would you like to have that may not exist?• The perfect butler model – what is smart and/or personalized?
– Example: for fitness, Monday, 7am• I’m planning to go running, not really excited and have too much to do but know I’ll feel good when I’m done• I know where I am and my route choices; about how long I want to run for and how long I can run for generally• I don’t know the temperature which impacts what I wear (but I know how to get it)• A lot: distance and elevation for my route options, information about any runs I tracked in the past, who else is out running (social)• I would like to know the physical impact (short term/long term), if it really makes me more productive (!), if it is the best exercise to do
given time constraints and cost• What I really want is encouragement: Go Lisa, you’ll feel great
– Example: for fitness, Monday, 9am• I ran 24:14 and feel good that I went, good barometer of how I am feeling, but might be my only exercise today• My run was 4215 steps, 256 calories, and 913 Nike Fuel (however that is calculated)• Does it make a difference long term?• Distance and elevation for route• Does it make a difference long term?• I want the praise, great job, Lisa, look how fast you’ve gotten, etc.
– Before class on May 30, meet to discuss and prepare 10-15 minutes with slides on• What you learned• Think about the many factors that influence use of mobile devices, such as immediacy and access, affinity, multiple methods of
input/output, context, and big data and predictive analytics• What are the implications for the design of an app/device
Mobile Advantage: Context and Immediacy in Health Information Seeking
Lisa Gualtieri, PhD, ScMAssistant Professor
Dept. of Public Health and Community MedicineTufts University School of Medicine
Email: [email protected]: @lisagualtieri
Health search is everywhere• In J.K. Rowling’s The Casual
Vacancy, I read…– “She navigated away from the
Parish Council message board and dropped into her favorite medical website, where she painstakingly entered the words "brain" and "death" in the search box.The suggestions were endless. Shirley scrolled through the possibilities…”
7
Agenda
• Past• Present
– Focus on what mobile devices provide health seekers
• Future
8
Distant past: Literature, family, friends
Past: Look it up at work or at home
Present: Look it up on mobile device in waiting room, elevator, car, walking, etc.
Future?
Past, present, and future of health information seeking behavior
Democratization of medical information
“Democratization of location”
?
Before looking at mobile health search, need to ask if people use mobile devices
• 321.7M wireless subscribers in US at end of 2011– Penetration of 101%
• Smartphones outnumber feature phones in the US• 1 in 8 internet page views are on smartphone or
tablet, doubling in just a year– Comscore 9/12
• Almost impossible to focus only on laptops and desktops when considering health information seeking
Not only are mobile devices used but they may eradicate the “digital divide”
• Smartphone ownership in US– 49% of Hispanics– 47% of African Americans– 42% of whites– Pew Internet & American Life Project 9/12
Some people are only using mobile devices
• 34% of US household are wireless only– Stephen J. Blumberg, Julian V. Luke, Wireless
Substitution: Early release of estimates from the National Health Interview Survey, July-December 2011, National Center for Health Statistics, 2012, http://www.cdc.gov/nchs/data/nhsr/nhsr061.pdf
• But one device or many?
Some people are using lots of mobile devices
• 40% of US households have 3 or more mobile devices in addition to their PCs & TVs
• Differences in – Where mobile phones and tablets are used– Frequency of use
Church or place of worship
Bank
Library
School
Train/subway/bus
Other
Home office
Events
Airport/airplane
Bathroom
Hotel
Kitchen
Other room in my house
Restaurant/coffee shop
Stores
Car
Outdoors
Work
Bedroom
Living room
6%
6%
16%
15%
15%
9%
35%
14%
41%
30%
44%
51%
32%
32%
12%
29%
31%
35%
79%
88%
6%
13%
15%
17%
18%
18%
26%
28%
29%
30%
34%
36%
39%
41%
42%
45%
48%
49%
53%
56%
mobile
tablet*
Base: 2,116 US online adults who own a mobile phone; Base: 549 US online adults who own a tablet
Source: North American Technographics Telecom And Devices Online Recontact Survey, Q3 2011 (US)
Where are mobile phones and tablets used? Note that doctor’s office isn’t listed!
Tablets are used more frequently than smartphones with the exception of daily health content users
Daily 5-6x per Week
2-4x per Week
Once a week
Less than 1x per week
0%
5%
10%
15%
20%
25%
16%
5%
13%
6%8%
13%
9%
24%
11%
8%
SmartphoneTablet
Source: comScore Custom Research – Jan/Feb 2010 Total n=1191 and Jan 2012 Total n=1033How often do you use your device for health purposes?
What do mobile devices provide health seekers?
• Immediacy and access• Affinity• Multiple methods of input/output• Context
Immediacy and access
• 85% of respondents had cell phones– 53% of these, or 45% of US adults, had smartphones– Cell phone owners
• 31% look for health or medical information• 11% have health apps• 9% receive text updates or alerts from doctor or pharmacist
– Pew 9/12 via Susannah Fox• Mobile devices may be used immediately after leaving
doctor’s office, especially with a new diagnosis or prescription– Impact on health literacy especially recall and retention– Impact on patient-physician communication
• Could patients listen or ask questions differently due to reliance on search?
What do mobile devices provide health seekers?
• Immediacy and access• Affinity• Multiple methods of input/output• Context
More lovable when they’re cute and little
Affinity
• People relate to computers differently than people– What about smartphones? Tablets?
• Mobile users have an ongoing intimate and personalized relationship with their “digital appendage” or “cognitive prosthetic device”
• Do people seek information differently?– Searches on mobile devices tend to be about private/sensitive
conditions: sexually transmitted diseases, mental health• How is use changing?
– Greater online community use
Top 10 health searches 2011Web• 1. Cancer• 2. Diabetes• 3. Symptom• 4. Pain• 5. Weight• 6. Infection• 7. Virus• 8. Diet• 9. Thyroid• 10. Sleep
• Healthline Networks
Mobile • 1. Chlamydia• 2. Bipolar disorder• 3. Depression• 4. Smoking/quit
smoking• 5. Herpes• 6. Gout• 7. Scabies• 8. Multiple Sclerosis• 9. Pregnancy• 10. Vitamin A
Online research is up in every category with the greatest growth in community support
General information about a condition
Symptom/diagnosis information
Treatment options
Side effects
Specific information about a medication/drug
Preventative measures
Community support/experiences from others
Interactive tools
64%
55%
47%45%
41%
33%
14%
10%
65% 64%
54% 53% 52%
39%
32%
22%
2010 2012 Largest shift: more people were seeking online
communities!
Source: comScore Custom Research – Jan/Feb 2010 Total n=1191 and Jan 2012 Total n=1033What types of health-related information have you looked for online in the last 6 months?
What do mobile devices provide health seekers?
• Immediacy and access• Affinity• Multiple methods of input/output• Context
Methods of input/output
• Input: less typing, fewer spelling mistakes– Text: Autocomplete, word suggestions, etc.– Voice: “Siri, what is…”– QR codes
• Search: many types of mobile search: app and browser– In mobile browser– On mobile website– In app store– In an app
• Output: limitations are screen size and location/privacy– Text– Images– Video
Mar-11 Apr-11 May-11 Jun-11 Jul-11 Aug-11 Sep-11 Oct-11 Nov-11 Dec-11 Jan-12 Feb-12 Mar-12 -
2,000
4,000
6,000
8,000
10,000
12,000
14,000 More Mobile Health Access through Browser than App
Accessed health information [Application] Accessed health information [Browser ]
Thou
sand
s
52%
59%
SOURCE: COMSCORE MOBIL LENS, 3 MOS ENDING MARCH 2012
Number of search results viewed on smartphone versus computer
What do mobile devices provide health seekers?
• Immediacy and access• Affinity• Multiple methods of input/output• Context
Context• People are exposed to a wealth of contextual
information: what they see, hear, feel, remember– How do people act on it using their mobile device?
• Multiple devices monitor and record contextual information, including sensors and GPS– How do weather, location, time of day, blood
pressure, etc. impact personalization and tailoring?• Big data and predictive analytics
Sometimes asking questions leads to more questions: fighting the Hydra
Some of my questions…
• Do people conduct health searches differently– On smartphones or tablets?– In mobile browsers or mobile websites or app stores or apps?– Using text or voice?– Based on location?
• Are people more or less easily able to locate “helpful” information?
• Are there different indicators of quality or reliability?• How can mobile health search better help people to seek
information and achieve their health goals?
Near future
• Design for mobile first instead of retrofitting health websites into mobile format
• Make smarter smartphones and better integrate sensor data
• Learn from strategies used by well-funded retail– Use of big data and predictive analytics to provide
accurate and timely health information
Future• From digital appendages to… Google glasses• The ultimate in seamless mobile health search?