Mobile health (mHealth) is the use of mobile devices, sensor devices, and wireless technologies in healthcare. There are many advantages and opportunities of using mHealth across all areas of healthcare. There are several use cases where mHealth can provide significant benefits for example – urgent care, wellness, medication tracking, appointments and access to electronic health records. Enabling and using these apps effectively could result in improved health outcomes, patient empowerment, early detection of health issues, reduction in health spend and decreased admissions to hospital or visits to GPs and healthcare providers.
We have seen an increase in the availability of health apps, however majority of these apps do not integrate with any health information systems. For example, a wellness app that tracks steps or helps record gym workouts is usually independent to the external integrated clinical systems. These apps are standalone and provide exclusive benefits as per their scope. These applications might be excellent at what they offer, however for clinical apps a lot of consideration is required with respect to reusing data that already exists, therefore an integrated approach is paramount.
Using mHealth to support or assist in automating essential business processes can result in significant financial savings and enhance the care provided. Therefore a suitable and sustainable technical architectural strategy is required in developing and implementing health apps – especially if these apps are an extension to support business processes that are linked with the existing systems.
At a high-level, deciding on the right approach to mobile development is usually based on the three options – Native, Cross-platform and Hybrid, however there are pros and cons associated with each framework.
- Native development involves using the operating system’s own tech stacks (Java for Android and Objective-C/Swift for iOS app development). This is the default choice providing best performance, user experience and greater app store visibility.
- Cross-platform provides compatibility with multiple operating systems and can therefore run on any mobile operating systems. For cross-platform development there are frameworks including Xamarin and React Native. The frameworks provide a unified API running on top of a native Software Development Kit and use the same codebase for both Android and iOS apps.
- Hybrid mobile apps are cross-platform apps but render the user interface using an embedded web browser, leveraging HTML, CSS and Javascript. Popular frameworks include Cordova and Ionic.
All of these provide benefits and challenges for organisations and it can be tricky choosing which technology/ framework to use for current requirements as well as future sustainability. For instance, using React for code reuse by using a single technology and slightly adjusting the source code to suit either operating system, or on the other hand, using Xamarin if a company has a .NET team. An organisation might choose to use native apps for superior performance or Ionic for a low cost option or when a performance compromise is acceptable.
The development decisions in such a fast and ever-changing domain of mHealth is complex and might create path dependence in the future. Mobile app development frameworks provide benefits and challenges for organisations and it can be tricky choosing which technology/ framework to use for the current requirements as well as future sustainability and life-cycle of the whole solution/app.
For the VitalsAssist application we are utilising a React Native cross-platform framework. We tested React to make sure it will provide the functionality we need, such as testing it to work with integrated medical devices (via Bluetooth), and it was able to cope with the requirements of the VitalsAssist app.
The VitalsAssist application would be available on all latest tablets and phones (iOS and Android), with integrated medical devices for real-time vital signs monitoring and rich clinical decision support capabilities for clinicians to make informed decisions at the point-of-care.