Recently, with the development of technologies, the healthcare sector has shown remarkable development in several areas. One of the most important of these technologies is smart mobile, devices, which have become widespread; they are increasingly owned around the world. Smart applications of mobile devices enable patients to contact medical care providers directly and help patients manage diseases by reading vital data such as blood glucose level, cholesterol in the blood, blood pressure rate, heart rate, and oxygen level. This type of technology helps monitor patients in their homes, especially for people who have chronic diseases and those recovering from surgeries. This research is intended to review smart applications in five broad fields of health care and cover their uses and implementation. These fields are diagnostics and treatment, electronic medical records for patients, education for medical students, patient monitoring, and assisting drug research.

M-health; Mobile Applications; Health Care Applications

Background

The current era of information and communication technology has fostered the tremendous growth of smart devices and applications. These devices and applications are used in human life daily. Smart mobile devices have become widespread and owned by more people around the world. These devices are considered computers-they contain features such as large screens, storage capacity, high-speed data flow, handling of multimedia, powerful processors, high-resolution cameras, NFC, Wi-Fi, Bluetooth, and portability. In addition, people use these devices more often than computers, and these features have become so ubiquitous that developers compete to provide various types of applications. Technology’s presence has helped to improve the quality of the health care sector, as it contributes to managing crises and chronic diseases, raising the efficiency of prevention and protection from the spread of disease, and reducing costs and time involved in providing health care. In taking advantage of technologies such as sensors, Bluetooth, the wireless application protocol, 3G or 4G, Wi-Fi, or global positioning systems, the health care field has benefited greatly. Using mobile applications in health care fields is called mobile health (M-health). M-health involves providing health services through mobile platforms and applications connected to the internet using a cellular or wireless network. Its development has helped provide urgent solutions and great opportunities for the health sector. Mobile devices are characterized by their rapid and effective ability to collect and exchange health information between a patient and their health care provider and the ability to monitor the patient and communicate with doctors efficiently. Designing an application that serves the health care field requires assessing accessibility, high quality, and value. Access means that the user can access data at any time and place. High quality is represented in providing an integrated application with high-level medical services, and value means that the service provided is characterized by effectiveness. In this paper, we review smart applications in various areas of health care: diagnostics and treatment, electronic medical records for patients, education applications for medical students, patient monitoring, and assisting drug research.

There are many technologies used in smart health care systems, such as IoT, big data, 5G, portable internet, artificial intelligence, cloud computing, sensors, smart mobile, and microelectronics. They can be used in treatment, decision-making, health management, disease monitoring and controlling, diagnosis, and research of medical and drugs. Patients, hospitals, doctors, and medical research can all benefit from technology use. Below, we review how each category can benefit.

• Patients can use wearable gadgets to keep track of their health at all times, request medical care through virtual assistants, and implement remote services from their homes’
• Doctors utilize a range of sophisticated clinical decision support technologies to aid and improve diagnosis. Doctors can address medical data using an integrated information system. Surgical robots and mixed-reality technology can help with precise surgery.
• In hospitals, radio-frequency identification technology can be used to manage people, materials, and supply chains, with integrated management platforms collecting data and assisting decision-making. Patients’ experiences can be improved through the usage of mobile medical applications.
• From the standpoint of scientific research institutes, techniques such as machine learning can be used instead of manual drug screening, and big data can be used to discover suitable participants [1].

In this work, we will focus on smart mobile applications in health care. The framework for mobile applications in health care is shown in Figure 1. Individuals use mobile devices or tablets that support internet connection and Bluetooth to connect to the internet and get services from providers. 

Smartphones have become indispensable. They are used in accomplishing all daily activities, such as studying, following up on work, social communication, and managing health. Smartphone applications have improved health care services, making them more effective, as well as providing rapid communication with doctors and health care providers. They also help increase the efficiency of health services and improve productivity. Their benefits are evident in countries with large populations that are socially and economically diverse. These applications also help those of low socioeconomic status who cannot afford medical insurance or treatment by making it easy to communicate and consult with doctors. In addition, they help relieve congestion and overcrowding in clinics [2].

Smart applications for mobile phones are used in several health care areas, the most common of which are presented below [2-5].

• Monitor patients-Smart applications help monitor patients, especially the elderly, patients with chronic diseases, and children.
• Manage medical records-Medical staff can review and understand patients’ conditions in or outside the hospital.
• Diagnoses of diseases-Applications help diagnose diseases accurately by evaluating patients health conditions and symptoms.
• Monitoring chronic infectious diseases-The most popular application in this field is HESN. The Ministry of Health in Saudi Arabia launched it on Oct 1, 2012, and it is considered a version of the Public Health Solutions for Diseases Surveillances and Management that was launched in Canada to monitor the SARS virus. HESN is an electronic system intended to monitor infectious diseases, help reduce outbreaks of epidemic diseases, determine the percentage of vaccinated population, evaluate the level of vaccine stock, help organize and manage work, and create reports. After COVID-19, it was developed by adding records for all COVID-19 patients [6].
• Personal health monitoring-Applications can help individuals to monitor their weight, activity, and vital signs.
• Help in the medicine field-Some applications are designed to help patients remember to take medicine, record the correct doses, and help them to adhere to the dose at the specified time. An example of this is the MOH Formulary application, which provides information on pharmaceuticals. Users can learn about approved medications and their features, side effects, and regulations.
• Telemedicine and telephone consultations for patients-Patient can contact and consult doctors and via audio, video, or text chat. The SEHA application is an example. The Ministry of Health in Saudi Arabia launched it on March 12, 2017 to provide online medical consultations. It was later developed to include information about COVID-19 to raise awareness [6].
• Reserving appointments in health facilities or obtaining health services-The Mawid application is an example. The Ministry of Health in Saudi Arabia launched it on Dec 29, 2017. It allows users to make, cancel, or reschedule medical appointments, as well as handle referrals [6].
  

Figure 1: The Framework of Mobile Applications in Health Care

The use of smartphones and the internet in Saudi Arabia is close to 100% [7]. One of the most important motivators for this research is to activate technology and utilize its features to increase our health quality. In particular, smart applications on smart devices can help manage human health and provide a greater quality of life through disease management. In Saudi Arabia, many populations suffer from chronic diseases, according to Members (n.d.); 18.3% of adults suffer from diabetes, 15.2% have high blood pressure, 28.7% are obese, and 18.5% have high cholesterol. Due to these widespread chronic diseases among the Saudi people, smart applications should be used to help patients’ self-management of diseases and provide effective health care. This work is intended to raise awareness of this technology and highlight some applications that assist patients in self-managing their health.

We searched Google Scholar and some digital databases in the Saudi Digital Library, such as IEEE, EBSCO, Science Direct, Springer Journals, and medical journals for smart applications in the field of health care using keywords such as mobile applications, health care applications, and fields of mobile applications. We read the relevant studies and categorized them based on popular fields of mobile applications’ use in health care, as shown in the next section.

M-Health

The World Health Organization defines M-health as “medical and public health practice supported by mobile devices, such as mobile phones, patient monitoring devices, personal digital assistants (PDAs), and other wireless devices” (date, p. #). In addition, it is considered one of the components of e-health.

Advantages of M-health include the following:

• It helps health care staff enter patients’ information, treatment plan, and medical history periodically, thus helping to reduce medical errors [8].
• Staff can access patient data anytime and anywhere [8,9].
• It helps staff monitor chronic diseases outside the hospital and makes telemedicine available) [9].
• It improves patients’ health care and reduces the length of hospital stays [9].
• It raises the efficiency of health services and increases productivity [8,9].
• It facilitates communication between patients and health care providers [9].
• It limits the spread of infectious diseases [8,9].
• The most important challenges related to M-health are the following:
• In some cases, the level of security and confidentiality of patient information is insufficient, and patients’ information can be obtained and used without their knowledge [10].
• Diagnosis reliability is not always high; misinformation between a patient and doctor can lead to misdiagnosis [10].
• Some doctors may not be satisfied with the way payments are processed [10].
• In some countries, there are no clear policies or laws regarding the adoption of smart applications [11].
• All parties might lack experience using mobile devices and services, including medical care employees, doctors, and patients [11].

Mobile devices contain many types of technology, such as networks, mobile middleware, mobile commerce stations, location services and content creation. Other examples include short message service, the wireless application protocol, global systems for mobile communication, universal mobile telecommunications systems, Bluetooth, 3G or 4G, Wi-Fi, and global positioning systems.

In this work, we focus on smart applications on mobile devices, especially in the field of health care.

The spread of the internet of things (IoT), sensors, cameras, Bluetooth, cloud computing, big data, facial and fingerprint recognition ,light detection will contribute to the development of health services, diagnosis, communication with doctors, and health tracking, especially in remote areas [12]. Smart applications using these technologies will give telemedicine a promising future and provide an effective means of using. In addition, the presence of these technologies and the emergence of new technologies, such as sensors in smartphones, will helpdevelop the health sector. It has become possible for patients contact medical care providers directly, and these technologies help patients managing diseases through applications’ ability to read vital data such as blood sugar level, cholesterol, rate of blood pressure, heart rate, and oxygen level. These technologies can also help monitor patients in their homes, especially for people who have chronic diseases or those recovering from surgeries [13]. Smart applications are used to understand the context of a patient’s environment, vital functions, and other data through sensors. The information is saved and processed or sent to a larger control unit. These applications can also be used for diagnosing or for displaying or controlling data [14]. The two most popular smartphone operating systems are Android and iOS, which have more than 165,000 applications used in health care, patient monitoring, diagnosis, and detection of many diseases [15].

According to health care needs, mobile applications are divided into many areas. We discuss the most common areas [16,1] or fields below

With the spread of modern technologies such as machine learning, artificial intelligence, sensors, robots, and expert systems, diagnosis by machine has become more accurate than human diagnosis. It has become used in diagnosing difficult-to-treat diseases such as types of cancers, tumors, infections such as hepatitis, and diabetes. Modern technology helped reduce misdiagnosis and enabled the management of diseases and the provision of appropriate treatment in a timely manner [17]. In addition, these technologies are used in clinical decision-making. The emergence of robots and virtual reality systems has helped provide treatment to patients and perform surgical operations effectively. Smart applications on smart devices have provided easy, convenient ways to diagnose disease, provide consultations, give patients direct contact with doctors, and monitor patients’ vital signs. Thus, smart mobile applications have helped in the development of health care services [18], including Seha, Blood Donation Smart, Test Your Vision, Test Vision, Audiogram, re: Mind, and Pregnant + app Festersen & Corradini, 2014; [19-23]. Smart applications are also used to limit the spread of diseases. For example, the Saudi Ministry of Health launched five applications to reduce COVID-19 effects and prevent its spread: Tabaud, Tawakalna, Tetamman, Seha, and Mawid [24].

Medical records have gone through many stages; they started with paper and leather manuscripts in which doctors recorded notes and medical prescriptions. Arab scholars wrote medical references and notes about patients and the medicines used in their treatment. By the mid-nineteenth century, most physicians were writing down their patients’ data and notes in the form of annual volumes containing patients’ files arranged alphabetically. At the beginning of the twentieth century, the idea of establishing a special section for medical files appeared in hospitals, in which employees would arrange and preserve files and provide doctors what they needed during their work. Medical records have been handwritten on paper for a long time, in files containing major medical data, tests, diagnoses, treatment, followup reports, and important medical decisions. Subsequently, with the development of technology, these records were automated. Electronic health records preserve all patient information electronically and allow files to be exchanged between medical institutions [25]. Many mobile applications are used to manage electronic medical records, making interaction between health care providers and patients easier and helping patients monitor their health continuously. Examples of these applications are AidIT [26] and mPHR [27].

Education through mobile devices and their applications is known as mobile learning. This form of education is different from distance education, in which educational content is accessed through mobile devices only. One of its advantages is that it is collaborative and interactive, and it enables students to learn anytime and anywhere. Its use in the medical field is a new trend. Studies have proven the efficiency and effectiveness of this type of education in the medical field, as students benefit from virtual reality and augmented reality techniques, multimedia programs, and the use of images and video to increase understanding. Additionally, students can join educational lessons from anywhere in the world [28]. Examples of these applications are AEMR [29] and EZ-HCM [30].

Some patients require long-term care that includes monitoring their health conditions, raising their spirits, and educating them about their health. These patients include people with chronic diseases, the elderly, or people with high-risk pregnancies. This long-term care costs health facilities a lot of resources and effort, and it reduces the number of beds available in hospitals. It may also cause some problems for patients, such as acquiring infections [31]. With the development of technologies such as mobile devices, Bluetooth, sensors, and IoT, health care providers can provide medical services such as remote monitoring of patients’ vital signs and treatment plans. This will help reduce costs and provide the best, most efficient health services [32].

Mobile application use supports long-term health care for patients with chronic diseases, especially the elderly, and helps them understand their health status [33].

Mobile applications are used to monitor patients after surgical operations [34]. There are also many applications for monitoring blood glucose, such as Dieta Para, Diabéticos, SocialDiabetes, RT Diabetes, Diario de la Diabetes, Glucosio, Mi Glycemia, gluQUO, Fundación para la Diabetes, Con la Diabetes, and Conoce tu Diabetes [35].

As mobile technology has been used increasingly in the medical field, scientists have realized its importance. Its use in the field of medicine has become an urgent matter as scientists have come to understand its ability to administer medications to patients. A machine can program, but a human needs to organize time, create a plan, and remember the correct time to give medication. More than 14,893 applications are used in medicine management [36] for patients with chronic diseases such as asthma [37]. Mobile applications have also been used to reduce errors in dispensing medication and determining doses. In addition, they can verify patients’ identity before dispensing drugs [38]. Mobile applications have also been used to confirm epilepsy patients’adherence to treatment among those with a low level of education about medication. As they suffered from many seizures and loss of consciousness, it was difficult for doctors to ensure that patients adhered to their medication schedule [39].

Table 1 shows details about the applications mentioned in the five fields discussed in this section. 

Examples of Applications in the Five Fields

Table 1: Shows details about the applications mentioned in the five fields discussed in this section.

As mentioned previously, smart mobile applications help doctors and patients monitor diseases and limit their spread. In this section, we compare the most important applications of telephone counseling in some of the Gulf States. These applications are considered the most prominent smart solutions to combat COVID-19, which appeared in December 2019 in Wuhan, China, and created significant hurdles for global governments, research, and communities of medical and global health. It is an extension of the SARS virus [40], which has spread and mutated continuously. Therefore, applications to help prevent this disease, which represents a recent threat to human health, have been more significant.

More than 476 smart applications have been created around the world to mitigate this pandemic. These applications have been launched for various purposes related to this disease, such as remote medical consultations, monitoring infected patients, monitoring the current state of the disease, controlling it, booking vaccinations, and examination appointments [41]. In this section, we focus on the most prominent applications in remote medical consultations in four of the Gulf States: Saudi Arabia, the Emirates, Kuwait, and Bahrain (Table 2). In these areas, social distancing and reduced hospital visits are important to reduce transmission [42].

The significant challenge considered the main limitation of this work is time. In this paper, we discuss only popular fields of mobile applications of health care. In addition, we do not cover all applications of these fields, only provide examples. We do not cover areas such as personal health management, monitoring chronic infectious diseases, telemedicine and telephone consultations, and other miscellaneous aspects.

Smartphones have become indispensable. They are used in accomplishing all daily activities, such as studying, following up on work, social communication, and managing health. We reviewed smart applications in the field of health care, considering only smart applications in the most common fields. We focused on diagnostics and treatment, electronic medical records for patients, education applications for medical students, patient monitoring, and assisting drug research.

In future work, we intend to cover more fields of health care, mention the largest possible number of applications, and present their advantages and disadvantages.

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