Cell phone-based health systems for remote access—Evolution, capabilities, applications and impact for precision medicine and beyond

The revolution in cell phone technology over the past few decades has created many opportunities to innovate health-related applications for health use of phone-based systems. With the advance of technology added to each phone “generation,” new technical capabilities are loaded within phones, which unlock opportunities for novel health monitoring. Coupled with this is an increasing array of health-related apps for health monitoring, assessment, and intervention. As sophistication in hardware and software evolved, the cell phone has morphed into a vital medical device. In parallel with technological advances, are price reductions and worldwide ubiquity of phones that extend to most people on the planet. This parallel evolution has allowed the cellphone to be adapted to issues of self-monitoring and prevention, remote care, health disparities of access, and opportunities for improved follow-up and care, that is otherwise difficult with conventional hospital and clinic visits and infrequent due to health system overload. In this chapter, we discuss the progression of the phone from a land-based wired system to a cellular and smartphone status, with on-board sensing and processing capabilities. Categories of cell phone-based health utility are outlined, addressing both consumer as well as prescriptive applications. Specific examples of phone-based use for motion and related clinical physical examination skills developed by our group are presented as well. Challenges and future directions for smartphone-based systems are also addressed, with an eye for utilization towards the advance of precision medicine as well as health for all.