Integration of Mobile Health Applications in Health Information Technology Initiatives: Expanding Opportunities for Nurse Participation in Population Health.

KEY POINTS The expansion of infrastructure to support wireless access has spurred both the adoption of mobile devices and opportunities to use such devices in addressing healthcare needs. Multiple opportunities for the use of technologies that vary in ease of design and user interface, including interactive voice response calls, short message services, and smartphones, exist across regions and markets. The combination of clinical insight and technological skills possessed by nurse informaticists enables this highly trained group to make significant contributions in the design and delivery of mHealth applications. T he potential for access to wireless technology continues to expand globally. According to estimates from the International Telecommunication Union, mobile broadband subscriptions have grown at an annual rate of 20% in the past 5 years, totaling 4.3 billion subscriptions internationally in late 2017. In developing countries, expanded fiber deployment is increasing fixed broadband speeds, as international bandwidth speeds also increase. Prices for mobile broadband subscriptions have dropped as much as 32% in some countries, and 95% of the world's population now lives in a geographical area with access to, at a minimum, a basic second-generation, or 2G, mobile wireless network. Proximity to wireless signal networks has increased the use of devices capable of connecting users to the Internet. Even in countries where there are large, sparsely populated geographic regions, such as exist in the continent of Africa (Ghana, Kenya, Nigeria, Senegal, South Africa, Tanzania, and Uganda), and where landline penetration may be close to zero in areas, the use of cell phones is growing rapidly. In this group of countries, only 17% of residents do not own a cellular phone; 35% of cellular devices owned by these residents are smartphones. Mobile technological devices with basic features, such as interactive voice response and short message service (SMS) or text messaging, along with more sophisticated devices like smartphones, are increasingly used to support and expand health information technology (HIT) initiatives designed to improve healthcare outcomes across the globe. In the United States, cellular phone devices are ubiquitous. According to a 2018 survey, 95% of adults in the United States own a cell phone, and 77% of these devices are smartphones. A third of Americans live in a home with three ormore cell phone devices, and 42%of adults 65 years or older own smartphones. While many smartphone users