This Viewpoint uses the Nightscout Project, a patient-developed mobile technology system, to discuss safety, legal, and regulatory challenges to the broader use of mobile health technology.
The US health care system has typically embraced a top-down model of health production, in which large-scale organizations, such as pharmaceutical or medical device companies or academic health centers, produce the tools and technologies for improving health. The underlying assumption is that physicians, researchers, and industry professionals are health experts rather than the patients. However, in 2014, the Nightscout Project, an innovative do-it-yourself mobile technology system for type 1 diabetes, was created by patients for patients and was rapidly scaled to a US and global population within a relatively short period. This bottom-up, patient-driven approach to health production has important lessons for a new era of medicine powered by patient engagement, mobile technology, cloud computing, and social media. This Viewpoint describes the Nightscout Project, including the challenges it poses for the current health care system, and the opportunities yielded from this new form of health production.