**2.4 Mobile health (mHealth)**

mHealth is a medical and public health practice supported by mobile devices, such as mobile phones, smart phones, the Internet, patient monitoring devices connected to mobile phones, personal digital assistants (PDAs), and other wireless devices. mHealth support includes patients, care-takers, pharmacists, or other healthcare providers making use of any digital technology in addition to the devices mentioned above specialized applications called APPs [37]. The top six areas of using mobile phones for health, according to the WHO global survey, include: tollfree emergency, health call centers, appointment reminders, community mobilization, information delivery, mobile telehealth and emergency management systems and mHealth applications [38]. Mobile APPs are software programs that run on smart phones and other mobile communication devices. They can also be accessories that are attached to a smartphone or other mobile communication devices, or a combination of accessories and software [39].

These APPs:


A very wide range of mobile health APPs is available right now, which helps patients (and non-patients) to access healthcare services and information on their own convenience. There are infrastructural, cultural, legal and ethical challenges. In general, these APPs have been used in areas such as: sports and fitness activity tracking, diet and nutrition, weight loss coaching, pharmacy; sleep cycle analysis, stress reduction and relaxation, meditation, symptom checkers, access to personal health records, digital imaging, electronic chart review, laboratory results review, life scan for patients with diabetes, remote heart monitoring, ECG viewer, oxygen level remote check, telehealth services, prescription management, appointment reminders, International Classification of Diseases (ICD) reference guide, evaluation and management coding, specialized medical reference material, pregnancy and baby development, exercise and fitness, remote dictation, surgery scheduling and interoffice communication.

#### **2.5 Big data**

"Big data in health refers to large routinely or automatically collected datasets, which are electronically captured and stored. It is reusable in the sense of multipurpose data and comprises the fusion and connection of existing databases for the purpose of improving health and health system performance. It does not refer to data collected for a specific study" [40]. Leveraging big data to find patterns and predict diseases which helps both medical researchers and health leaders to better understand the disease distribution in a country or a community, which if properly used can contribute to building sustainable healthcare systems, collaborate to improve care and outcomes and eventually increase access to healthcare. It is to be noticed that the major bulk of medical data unstructured and is clinically relevant, that data resides in multiple places like individual electronic medical records (EMR), laboratory and imaging systems, physician notes, medical correspondence, claims, etc. [41]. Accompanied with big data concept is data analytics which is evolving into a promising field for providing insight from very large data sets and improving outcomes while reducing costs. The potential of big data to transform healthcare has been identified [42]. The study of data science and the emerging importance of data as a resource in health have influenced the way that healthcare is being studied and its cost-effectiveness, efficiency, disease prevalence and accessibility are predicted.

#### **2.6 Geographic Information Systems (GIS) for health**

Among the major challenges to accessing healthcare services is lack of knowledge of their existence, lack of knowledge of the distance between the place of residence and the healthcare centre and unaffordability to transport to the centre. Brown [43] enumerated five potential benefits of integrating GIS in healthcare IT: identifying health trends, tracking the spread of infectious disease, utilizing personal technologies, incorporating social media and improving (health) services. Brown concluded that "GIS is a powerful tool that has been successfully implemented to help address a number of significant health issues ranging from disease management to improved services". Geolocation technologies for health have made it easier to locate the nearest healthcare centre, provision of the full

*Improving Healthcare Access through Digital Health: The Use of Information… DOI: http://dx.doi.org/10.5772/intechopen.99607*

profile of the centre and the best method to reach it. Integration of geographic data elements (locations) and the thematic data in a database utilizes the best of the two worlds as it has become possible to locate the place where a specific type healthcare services exists. "GIS plays a critical role in determining where and when to intervene, improving the quality of care, increasing accessibility of service, finding more cost-effective delivery modes, and preserving patient confidentiality while satisfying the needs of the research community for data accessibility [44].

#### **2.7 Blockchain in healthcare**

Blockchain in healthcare which has been described as "a distributed system which records and stores transaction records. "… a shared, immutable record of peer-to-peer transactions built from linked transaction blocks and stored in a digital ledger" [45]. It allows to securely transfer the ownership of units of value using public key encryption and proof of work methods [46]. Security and data privacy have been among the major reasons for not trusting a system by the patients. Not trusting a system is one limiting factor to access to healthcare system. Increasing security and trust would encourage more people to come forward to use healthcare systems. For patients, in particular, block chain allows payments through cryptocurrencies, which is becoming a trend in the money market. Patient safety is being monitored through drug traceability, especially tracing of counterfeit medicine. Patient data management as personal health data is growing at a very high rate and from multiple sources, many patients became more conscious that data about them needs to be more secure and less accessible by unauthorized parties.

#### **2.8 The Internet of Things (ToT)**

The IoT is described as a network of physical devices that uses connectivity to enable the exchange of data [47–49]. The Internet of Medical Things (IoMT) has allowed patients to stay at home or anywhere and yet provide health data about themselves to specialized centers for monitoring purposes. This amalgamation of medical devices and applications that can connect to healthcare information technology systems using networking technologies meant that patients can still access healthcare services enabled by technology without them leaving their places. Wearable devices for health monitoring are technologies that can be worn on the human body. This type of devices has become a more common part of the tech world as companies have started to evolve more types of devices that are small enough to wear and that include powerful sensor technologies that can collect and deliver information about their surroundings. A wearable device is often used for tracking a wearer's vital signs or health and fitness related data, location, etc. These may include continuous glucose monitoring devices, smart bandages, smart pills and remote patient monitoring, monitoring of patient's movement, dietary system, etc. Adherence to medication helps patients to take medications on time and even inform medical professionals if the patient fails to adhere to medications. In addition to the many advantages to patients, wearables aid healthcare providers in many ways, by simply improving access to healthcare services while having real time health data collection and time saving. Home care and monitoring are provided to many of the aging patients, patients with chronic diseases and those that are for economic or logistic reasons they are advised to stay at home while access to health services is enabled by digital health tools. Hospital to Home Healthcare (H2H) has become the solution of choice and is an integral part of health service delivery system. These technologies have been used to:


Landers, et al. [50] suggested four pillars as the key characteristics of the home health agency of the future: patient and person centered, seamlessly connected and coordinated, high quality of care and technology enabled that allows patients to more easily connect with healthcare professionals and receive more intensive services in new settings.

The mobile device (smart phone or an internet connection) connected to a medical device at home and linked to health centre provides the opportunity to send signals related to vital signs of the patient. The functionality of these devices depends on the type/reason for which this device is provided. These may include measuring body temperature, blood pressure, glucose level in the blood, heart beat rate, respiration and air flow in real-time mode, for patients that need kidney dialysis machines.

Medical wearables with artificial intelligence and big data are providing an added value to healthcare with a focus on diagnosis, treatment, patient monitoring and prevention. Access to healthcare is enabled by wearables as these provide a number of advantages. Wearable devices applied to healthcare offer multiple advantages to healthcare professionals as well as the patients [51]:


*Improving Healthcare Access through Digital Health: The Use of Information… DOI: http://dx.doi.org/10.5772/intechopen.99607*

9.Saving healthcare cost. Remote healthcare via wearable devices mean saving time and mobility, as it removes the need for the patient to be continuously transferred to the medical center.

It is recognized that some patients require multiple technologies which resulted in the emerging of the technology that tends to streamline data collection, delivery and use. The Internet of Medical Things (IoMT) is an amalgamation of medical devices and applications that can connect to healthcare information technology systems using networking technologies.
