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Skimming SFL – ENGLISH PREPARATORY PROGRAM

Health and Wellness on the Go

Marie Jesperson is 92 and is beginning to have significant health problems that require a variety of
medications, but occasionally she forgets to take them, or she confuses the days or dosage. Caroline
Silva is pregnant for the second time and has serious health concerns. She lost her first baby, so her
pregnancy is considered high risk, requiring weekly visits to a clinic for check-ups. Her doctor has
informed her that she will need to spend the final weeks of her pregnancy in the hospital connected
1 to a fetal1 heart monitor that can detect whether her baby is in distress. Zhang Bao has
cardiovascular disease; his heart is weak, and many of his arteries2 are blocked. This condition
requires medication, as well as frequent blood tests and electrocardiograms to monitor his
cardiovascular health. Unfortunately, there is no hospital near his home, so he has to take time off
from work to go to a hospital in another town. If the tests indicate there is a problem, Zhang must
make a second trip to consult with a doctor and adjust his medication. For all of these patients, the
current medical care is both inconvenient and expensive, and in some cases, not as safe as their
doctors would like. In the coming years, however, this situation is likely to change for the better.

This transformation is coming in the form of mobile health care, or mHealth, which is defined as all
forms of health care that take advantage of mobile devices. The development of mHealth solutions is
possible because of a combination of technological advances: smaller, more powerful sensors;
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increased, cloud-based computing power and storage; and wireless data transfer capabilities. All of
this technology has become available within a single device - the mobile phone, or, in some cases, a
device that works in conjunction with a mobile phone. These powerful devices are capable of
providing and transmitting health information on the go. In the past, this could be done only in
doctors' offices and hospitals. As of 2013, there were nearly 100,000 health-related apps for mobile
phones. Patients can download an app, and the phone transforms into a health-care device.

I. Developments in mHealth for Patients and Practitioners

Although there are many new and prospective roles for mHealth, it is currently most widely used in
the monitoring and management of health problems, particularly those associated with chronic
disease. Monitoring comes in two primary forms and operates in two directions. In one form,
patients wear sensors on their bodies, for example, on a watch or skin patch 3. These devices can
3 measure and record a wide range of physiological functions, such as body temperature, respiration 4,
and blood pressure, or, for pregnant women, fetal heart rate. This information is transmitted
continuously and wirelessly to a laboratory or health-care provider, so at the first sign of trouble,
often before patients themselves are aware that anything is wrong, the provider can take action. This
action could be anything from adjusting medication to admitting a patient to a hospital. Such
continuous monitoring minimizes the need for patients to come in for frequent tests and, more
importantly, can avert5 a major health crisis by providing an early warning. The sale of these mobile
sensors is growing dramatically.

Mobile sensors worn on the body go in one direction, transmitting vital information from patients to
4 health providers, whereas a second form of monitoring - a lower-tech mHealth solution - works in
the other direction, from doctors to patients. When doctors prescribe medication, it can be difficult
to ensure that patients comply accurately or completely with the doctor's instructions. The second

1
Fetal: connected with a young human being or animal before birth.
2
Artery: any of the tubes that carry blood from the heart to other parts of the body.
3
Patch: a small area that is different in some way from the area that surrounds it.
4
Respiration: the act of breathing.
5
Avert: to prevent something bad from happening.

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 form of monitoring is ideal for addressing this problem. Automated SMS text messages can be sent
by health-care providers to patients, reminding them of which medications to take and when to the
take them.

Patient compliance is also crucial with communicable diseases6, such as tuberculosis, which are
difficult to treat because of the complex and extended therapy they require. In order to cure
patients' tuberculosis and, e qually important, to ensure that the disease does not spread, compliance
5 is essential. However, because the therapy takes many months and involves multiple medications,
many patients begin treatment but never finish it, or they skip doses. This kind of noncompliant
behavior can promote drug-resistant strains of communicable diseases, which can then quickly
spread. mHealth programs that utilize automated reminders can increase the effectiveness of
treatment considerably. They can also lead to huge savings in health-care costs. One estimate
suggests that advances in mHealth could save almost 200 billion dollars over the next 25 years in the
United States alone.

Advances in mHealth devices are also allowing health-care workers to provide services to patients
who do not have easy access to a doctor's office or hospital. In China, there is increasing concern
about cardiovascular disease, which kills three million people a year. Many of these deaths could be
prevented with adequate monitoring, a practice that is difficult to sustain, particularly for patients
6 who live outside of urban centers. Today nurses and local health-care workers in China are
responding to this public health challenge by using a handheld device to collect patient data. It
records thirty seconds of cardiac data and transmits it to a central facility in Beijing. There, doctors
and technicians analyze the data and can then provide an immediate diagnosis and recommend a
treatment plan. The program is already having a major impact on the annual heart attack rate in
China. One analyst estimates that if the incidence of heart disease declined by just 1 percent over the
next 30 years, China could save more than $10 trillion in health-care costs.

II. Personal Wellness

The growth of mHealth is not limited to the sick and elderly; healthy people are also using a wide
range of mobile devices and apps to monitor and maintain their health. In general, the goal of these
wellness mHealth devices and apps is to promote self-awareness and self-improvement. Mobile apps
allow individuals to track a variety of physiological metrics, such as heart rate and body temperature,
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which in the past, could only be monitored by a health-care professional. People can also track their
activities: how far they walk, how many calories they burn, how many hours and how deeply they
sleep. These metrics are recorded by wearable sensors, while other apps require input from users;
for example, users can enter what they eat, and the app tells them how many calories or how much
fat they have eaten. The recorded data can be stored, analyzed, and even shared through social
media.

In general, health-care professionals have accepted these health and wellness apps. Other mHealth
apps that provide self-diagnosis, in contrast, have received a more cautious reception from doctors.
8 Melanoma, a dangerous and often deadly form of skin cancer, can start as small lesions 7 on the skin.
Dermatologists can evaluate these lesions to determine if they are cancerous. The skin cancer
diagnosis app allows people to do this themselves by taking photographs of their skin lesions. The
photographs are then compared to a library of images stored in the app. The results suggest whether
a person's lesion may be cancerous. Health-care professionals remain skeptical of such apps. They
worry that these apps may not be accurate enough to lead to early detection and are concerned that
6
Communicable Disease: it can pass on to other people.
7
Lesion: Damage to the skin or part of the body caused by injury or by illness.

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 they might become an unwise substitute 8 for consulting a doctor. Because these self-diagnosis apps
are relatively recent, this question remains open.

It is likely that the role of mobile devices in promoting individual and community health will continue
to expand throughout the twenty-first century. Annual expenditures 9 on mHealth and wellness apps
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alone are expected to exceed10 25 billion dollars in just a few years. At the same time, mHealth is
expected to save billions of dollars and improve the lives of thousands of patients, like Marie
Jesperson, Caroline Silva, and Zhang Sao.

8
Substitute: to use something or someone instead of another thing or person.
9
Expenditure: the act of spending or using money; an amount of money spent.
10
Exceed: to be greater than a number of amount, or to go past an allowed limit.

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Match the main ideas below to seven of the paragraphs in the reading. Write the number of the
paragraph on the blank line (8 mins).

_____ A Controlling the spread of disease with mHealth devices

_____ B Attitudes of health-care professionals to mHealth

_____ C mHealth for healthy people

_____ D Providing health care in locations far from hospitals

_____ E The definition of mHealth

_____ F The role of mHealth devices in managing health-care problems

_____ G Improving communication with patients with mHealth devices