title: Development of mHealth system for supporting self-management and remote consultation of skincare.
abstract: BACKGROUND
  Individuals with spina bifida (SB) are vulnerable to chronic skin complications such as wounds on the buttocks and lower extremities. Most of these complications can be prevented with adherence to self-care routines. We have developed a mobile health (mHealth) system for supporting self-care and management of skin problems called SkinCare as part of an mHealth suite called iMHere (interactive Mobile Health and Rehabilitation). The objective of this research is to develop an innovative mHealth system to support self-skincare tasks, skin condition monitoring, adherence to self-care regimens, skincare consultation, and secure two-way communications between patients and clinicians.
  
  
  METHODS
  In order to support self-skincare tasks, the SkinCare app requires three main functions: (1) self-care task schedule and reminders, (2) skin condition monitoring and communications that include imaging, information about the skin problem, and consultation with clinician, and (3) secure two-way messaging between the patient and clinician (wellness coordinator). The SkinCare system we have developed consists of the SkinCare app, a clinician portal, and a two-way communication protocol connecting the two. The SkinCare system is one component of a more comprehensive system to support a wellness program for individuals with SB.
  
  
  RESULTS
  The SkinCare app has several features that include reminders to perform daily skin checks as well as the ability to report skin breakdown and injury, which uses a combination of skin images and descriptions. The SkinCare app provides reminders to visually inspect one's skin as a preventative measure, often termed a "skin check." The data is sent to the portal where clinicians can monitor patients' conditions. Using the two-way communication, clinicians can receive pictures of the skin conditions, track progress in healing over time, and provide instructions for how to best care for the wound.
  
  
  CONCLUSIONS
  The system was capable of supporting self-care and adherence to regimen, monitoring adherence, and supporting clinician engagement with patients, as well as testing its feasibility in a long-term implementation. The study shows the feasibility of a long-term implementation of skincare mHealth systems to support self-care and two-way interactions between patients and clinicians.
authors.affiliation: Department of Health Information Management, University of Pittsburgh, 6026 Forbes Tower, Pittsburgh, PA 15260, USA. parmanto@pitt.edu.
authors.forename: Bambang
authors.initials: B
authors.lastname: Parmanto
authors.affiliation: Department of Health Information Management, University of Pittsburgh, 6026 Forbes Tower, Pittsburgh, PA 15260, USA.
authors.forename: Gede
authors.initials: G
authors.lastname: Pramana
authors.affiliation: Department of Health Information Management, University of Pittsburgh, 6026 Forbes Tower, Pittsburgh, PA 15260, USA.
authors.forename: Daihua X
authors.initials: DX
authors.lastname: Yu
authors.affiliation: Department of Occupational Therapy, MGH Institute of Health Professions, Boston, MA 02129, USA.
authors.forename: Andrea D
authors.initials: AD
authors.lastname: Fairman
authors.affiliation: Department of Physical Medicine and Rehabilitation, University of Pittsburgh, Pittsburgh, PA 15260, USA.
authors.forename: Brad E
authors.initials: BE
authors.lastname: Dicianno
mesh_terms: D000328:Adult; D006801:Humans; D063731:Mobile Applications; D019114:Remote Consultation / Q000379:methods*; D012648:Self Care / Q000379:methods*; D012871:Skin Diseases / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D016135:Spinal Dysraphism / Q000150:complications; D017216:Telemedicine / Q000379:methods*