A patient as a self-manager of their personal data on health and disease with new technology--challenges for nursing education.

Background: Digital technologies have transformed nearly every aspect of our lives. However, for many of us, they have not yet improved the way we receive or participate in our health services and disease care. Hostetter et al. (2014) explore in a new multimedia essay the changes occurring with the arrival of new digital tools, from mobile apps and data-driven software solutions to wearable sensors that transmit information to a patient's team of health care providers. Digitisation will revolutionise health technology to a new extent, as the self-measurement, cloud services, teleconsultation and robotics technologies are being used to get health expenditure under control. In the future, robots will dispense drugs, and treatment routines will utilise cloud services (Biesdorf and Niedermann, 2014; Grain and Sharper, 2013). According to the rationale of the Horizon 2020 (European Commission, 2013b) work programme, personalising health and care has been stated to empower citizens and patients to manage their own health and disease, which can result in more cost-effective healthcare systems by enabling the management of chronic diseases outside institutions, improving health outcomes, and by encouraging healthy citizens to remain so. Solutions should be developed and tested with the use of open innovation platforms, such as large-scale demonstrators for health and service innovation. It is a fact that ICT/new health technology and personal health applications are transforming patients' self-management in many ways. A huge amount of personal health application solutions are being offered in the marketplace, which engage in activities that promote health, monitoring the symptoms and signs of illness, and managing the impact of illness (European Commission eHealth Action Plan 2012-2020, 2012). The WHO (2011) has conducted a comprehensive study and published a report on Member States' use of mHealth (mobile Health) as well as the readiness and barriers to its use. The percentage of countries reporting that they had formally evaluated mHealth initiatives was 12%. Seven per cent of developing countries reported conducting a mHealth evaluation. Mobile technologies have already changed, and they will continue to change the lives of millions around the world. In the WHO's report, it was estimated that mHealth can revolutionise health and well-being outcomes if implemented strategically and systematically, thereby providing virtually anyone with a mobile phone with health and well-being expertise and knowledge in real-time. In the research reports (European Commission eHealth Action Plan 2012-2020, 2012; Blake, 2013), it was reported that mobile phones as a tool are cost-effective and wide reaching, while they easily target large samples and hard-to-reach groups. Studies show that eHealth as a way to self-monitor and self-manage as well as supportive interventions for clients offers a good possibility to bridge the gap between inpatient and outpatient care. The mobile phone is especially effective in enhancing the therapist-patient bond so that this does not collapse when the client leaves the therapist's consulting room. Furthermore, eHealth applications can assist the client to cope with everyday situations in an autonomous way while improving the transfer of the abilities acquired by the client in the health care setting to everyday life. The findings of various projects (European Commission eHealth Action Plan 2012-2020, 2012; European Commission, 2012; European Commission, 2013b; Hämäläinen, 2013) provide an opportunity for an open discussion regarding the digital health revolution, which will change health care processes and citizens' applications for health promotion and self-care.