Be smart and use smartphones for telemedicine: narrative review.

Background and objective: With the evolution of technology, the delivery modes of healthcare have been completely transformed. Since the first use of telemedicine in the late 20th century, it has continued to evolve with advancement of technology. Today, telemedicine does not need sophisticated equipment and expensive platforms. Using a singular device to offer a wide range of services is both desired and necessary to provide higher-quality care at greater quantities. The inclusion of smartphone-telemedicine in many high-income countries proves a plausible framework to build upon for inclusion in low- and middle-income countries (LMIC). The primary goal of this review is to analyze existing literature on smartphone-based telemedicine and assess the scalability of this form of care to provide both accessible and equal care for all.

Methods: This is a narrative review that analyzed English published literature in PubMed, Medline, Cochrane Reviews, and Google Scholar over the last 50 years.

Key content and findings: Smartphone-based telemedicine can be divided mainly to mHealth and teleconsultation. Both applications are proven cost-effective at different extents and can augment health in different capacities. While mHealth is more suitable for health behavior change, smartphone teleconsultations can be employed in direct patient care. Smartphones' applicability to different settings and flexibility make them ideal for telemedicine. This form of telemedicine might be more suitable for low-resource settings and LMIC due to compatibility with current infrastructure, ease of use, lower cost and high availability. However, ease of use comes with risk of overutilization and providers' burnout. Privacy, digital divide and health literacy are other barriers of accessing smartphone-based telemedicine. Growing smartphone penetration and technology advancement carry future potentials for scaling up smartphone telemedicine in LMIC to advance equity and equality. Still, policies and regulations need to be implemented to protect privacy while using smartphones for telemedicine.

Conclusions: Smartphone-based telemedicine is an applicable form of telemedicine for low-resource settings and LMIC. Not all mHealth applications are suitable for LMIC, but investing in smartphone-based telemedicine for teleconsultation can save lives and lower the cost of care to reach everyone efficiently without a huge burden in a cost-effective manner for many LMIC.