The discussion on the potential role of “mobile health” in sustainable care management is continuously growing. A new generation of telemedicine, overcoming the limits of simple video calls with our general practitioners, is expected to relieve the pressure on the healthcare systems by revisiting the relationship between citizens and their well-being.
Our health and well-being are lifelong matters where the lifestyle we maintain and the environment we live in play a key role every single day. It’s urgent to make citizens aware and convert them into active players in taking care of their health from an early age. Screening and prevention are already core tools for the future of society at the large.
Almost 7 billion smartphone users worldwide in 2023 constitute a valuable ground for a new era in well-being healthcare delivery.
Is there something we can do for them just by installing an app on their phones? Looking at the scientific debate the answer should be definitely yes.
Our lifestyle and behaviour are valuable indicators of physical well-being as well as mental health and their variations over time may be significant predictors of disorders and diseases, but how we can evaluate behaviour? From a psychological perspective, behaviour describes the way we act, how we interact with things, and how we react to external events, so its description is very close to the storyline of our daily activities.
Our smartphone may help a lot in recording our behaviour because it is with us for most of the day: in a pocket, in a handbag, on our working desk or our night table, but always very close to us.
Also, the very new concept of digital phenotyping, aimed at describing our behaviour from the data that we produce interacting with our digital devices, further boasts the usefulness of this approach. There is extensive evidence that variations in our digital behaviour (e.g the way we use the phone, to call or to receive, and the type of mobile apps we use) may be symptoms of alterations in our mental health.
So, let’s start a technological journey in our smartphones to revise our approach to the monitoring and understanding of our health and well-being.
What can we measure with a smartphone?
Within a smartphone, there are a lot of “electronics” that we normally use for communicating or even just for fun which makes it a very interesting hub for personal data collection.
Also, our smartphone is always connected through the Internet and telecom subscription plans often include several gigabytes of data transfer making the availability of this data for processing and interpretation immediate.
Accelerometer and gyroscope are sensors available in almost all smartphones; the accelerometer is a sensor able to detect the motion of the phone (e.g. along the vertical or horizontal direction), while the gyroscope perceives its rotation. Normally they are used together to detect changes in the position of the phone for example to accommodate the screen orientation (portrait or landscape) or to run some action games.
In some smartphones, also barometers and magnetometers are available. The barometer senses atmospheric pressure and is normally used to compute altitude, and the magnetometer detects the magnetic field and is utilised as a compass in our smartphone.
The whole group of these sensors may be used as an ensemble to supply a detailed description of our motion, but the quality and meaningfulness of this narrative depend on where the smartphone is placed: it needs to be on our body, preferably in a predefined location. So, if we want to get an accurate description of a gesture by the smartphone, we need to be actively participating. This means starting the recording of sensors through a devoted application, performing a predefined movement, and stopping the data acquisition.
This kind of use of the smartphone sensors is called active, because it requires the performance of voluntary action on our side, in this case, to allow the recording of the way we execute an agreed task.
However, the same sensors may be used also in a passive way, that is they are transparently switched on to record the motion of the smartphone, not for recognising and describing a specific action, but only to detect if we are moving or not.
Levels of physical activities or, still better, variations in such levels are strongly correlated to our mental health. When we abruptly change our habits, there may be some issues in our health worthy of further attention.
Our mobility is still better measured by the GPS sensor. All of us exploit GPS data to navigate unknown environments or to manage our route in a new city. GPS is available on the majority of existing smartphones and may be also used, passively, to record our daily movements. Scientific literature associates the data we get from our GPS sensor with several mental health issues, ranging from anxiety to depression to specific pathologies. Just to give an example, variations in the time we spend at home, the shorter or longer duration of visits to different places, or the time we spend travelling are all meaningful indicators of changes in our lifestyle and behaviour, maybe it is only because we are taking few days off, but on the long term, they may also become markers of disease.
Moving close to specific smartphone functions, information often used to assess mental well-being is the number and duration of access to the phone itself. This is measurable using the analysis of technical events, normally recorded by our smartphone: our willingness to use the phone is assessed by the number of times we unlock the screen, while the time we spend using it may be measured by the time in which the screen of the phone is on.
Another interesting sensor widely available on our smartphones is the light sensor. Light per se is not an indicator of any disorder, but it is often investigated together with the motion of the phone (accelerometer) and its use (screen lock/unlock) to infer a potential sleeping status. Alterations in our sleep patterns are a generally recognised marker of pathological mental conditions, and to be able to estimate it just from the use of a smartphone may be a powerful tool for continuous health monitoring.
There is a lot of other information, generated by our smartphones, that is worthwhile to be used both for active and passive monitoring of our health. We will be back to them in future talks if you like.