scholarly journals Self-monitoring diabetes with multiple mobile health devices

2020 ◽  
Vol 27 (5) ◽  
pp. 667-676 ◽  
Author(s):  
Ryan J Shaw ◽  
Q Yang ◽  
A Barnes ◽  
D Hatch ◽  
M J Crowley ◽  
...  
Keyword(s):  
Mobile Health ◽  
Care Delivery ◽  
Text Message ◽  
Patient Characteristics ◽  
Models Of Care ◽  
Feasibility Trial ◽  
Self Monitoring ◽  
Health Technologies ◽  
Related Data ◽  
Patients With Diabetes

Abstract Objective The purpose of this study was to examine the use of multiple mobile health technologies to generate and transmit data from diverse patients with type 2 diabetes mellitus (T2DM) in between clinic visits. We examined the data to identify patterns that describe characteristics of patients for clinical insights. Methods We enrolled 60 adults with T2DM from a US healthcare system to participate in a 6-month longitudinal feasibility trial. Patient weight, physical activity, and blood glucose were self-monitored via devices provided at baseline. Patients also responded to biweekly medication adherence text message surveys. Data were aggregated in near real-time. Measures of feasibility assessing total engagement in device submissions and survey completion over the 6 months of observation were calculated. Results It was feasible for participants from different socioeconomic, educational, and racial backgrounds to use and track relevant diabetes-related data from multiple mobile health devices for at least 6 months. Both the transmission and engagement of the data revealed notable patterns and varied by patient characteristics. Discussion Using multiple mobile health tools allowed us to derive clinical insights from diverse patients with diabetes. The ubiquitous adoption of smartphones across racial, educational, and socioeconomic populations and the integration of data from mobile health devices into electronic health records present an opportunity to develop new models of care delivery for patients with T2DM that may promote equity as well.

scholarly journals The Digital Health Revolution and People with Disabilities: Perspective from the United States

2020 ◽  
Vol 17 (2) ◽  
pp. 381 ◽  
Author(s):  
Mike Jones ◽  
Frank DeRuyter ◽  
John Morris
Keyword(s):  
United States ◽  
Mobile Health ◽  
Chronic Conditions ◽  
Digital Health ◽  
Wearable Sensors ◽  
Healthcare Delivery ◽  
People With Disabilities ◽  
The United States ◽  
Models Of Care ◽  
Health Technologies

This article serves as the introduction to this special issue on Mobile Health and Mobile Rehabilitation for People with Disabilities. Social, technological and policy trends are reviewed. Needs, opportunities and challenges for the emerging fields of mobile health (mHealth, aka eHealth) and mobile rehabilitation (mRehab) are discussed. Healthcare in the United States (U.S.) is at a critical juncture characterized by: (1) a growing need for healthcare and rehabilitation services; (2) maturing technological capabilities to support more effective and efficient health services; (3) evolving public policies designed, by turns, to contain cost and support new models of care; and (4) a growing need to ensure acceptance and usability of new health technologies by people with disabilities and chronic conditions, clinicians and health delivery systems. Discussion of demographic and population health data, healthcare service delivery and a public policy primarily focuses on the U.S. However, trends identified (aging populations, growing prevalence of chronic conditions and disability, labor shortages in healthcare) apply to most countries with advanced economies and others. Furthermore, technologies that enable mRehab (wearable sensors, in-home environmental monitors, cloud computing, artificial intelligence) transcend national boundaries. Remote and mobile healthcare delivery is needed and inevitable. Proactive engagement is critical to ensure acceptance and effectiveness for all stakeholders.

Remote Monitoring of Patient- and Family-Generated Health Data in Pediatrics

PEDIATRICS ◽  
2022 ◽  
Author(s):  
Carolyn Foster ◽  
Dana Schinasi ◽  
Kristin Kan ◽  
Michelle Macy ◽  
Derek Wheeler ◽  
...  
Keyword(s):  
Health Care ◽  
Digital Literacy ◽  
Care Delivery ◽  
Digital Health ◽  
Health Care Team ◽  
Models Of Care ◽  
Health Data ◽  
Care Needs ◽  
Case Examples ◽  
Health Technologies

Remote patient monitoring (RPM) is a form of telemedicine that involves the collection and transmission of health data from a patient to their health care team by using digital health technologies. RPM can be leveraged to aggregate and visualize longitudinal patient-generated health data for proactive clinical management and engagement of the patient and family in a child’s health care. Collection of remote data has been considered standard of care for years in some chronic pediatric conditions. However, software limitations, gaps in access to the Internet and technology devices, digital literacy, insufficient reimbursement, and other challenges have prevented expansion of RPM in pediatric medicine on a wide scale. Recent technological advances in remote devices and software, coupled with a shift toward virtual models of care, have created a need to better understand how RPM can be leveraged in pediatrics to improve the health of more children, especially for children with special health care needs who are reliant on high-quality chronic disease management. In this article, we define RPM for the general pediatric health care provider audience, provide case examples of existing RPM models, discuss advantages of and limitations to RPM (including how data are collected, evaluated, and managed), and provide a list of current RPM resources for clinical practitioners. Finally, we propose considerations for expansion of this health care delivery approach for children, including clinical infrastructure, equitable access to digital health care, and necessary reimbursement. The overarching goal is to advance health for children by adapting RPM technologies as appropriate and beneficial for patients, families, and providers alike.

scholarly journals Smartphone Ownership and Interest in Mobile Health Technologies for Self-care Among Patients With Chronic Heart Failure: Cross-sectional Survey Study (Preprint)

2021 ◽  
Author(s):  
Jonathan W Leigh ◽  
Ben S Gerber ◽  
Christopher P Gans ◽  
Mayank M Kansal ◽  
Spyros Kitsiou
Keyword(s):  
Heart Failure ◽  
African American ◽  
Mobile Health ◽  
Self Care ◽  
Minority Population ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Self Monitoring ◽  
Health Technologies ◽  
Mhealth Apps

BACKGROUND Heart failure (HF) is a highly prevalent chronic condition that places a substantial burden on patients, families, and health care systems worldwide. Recent advances in mobile health (mHealth) technologies offer great opportunities for supporting many aspects of HF self-care. There is a need to better understand patients’ adoption of and interest in using mHealth for self-monitoring and management of HF symptoms. OBJECTIVE The purpose of this study is to assess smartphone ownership and patient attitudes toward using mHealth technologies for HF self-care in a predominantly minority population in an urban clinical setting. METHODS We conducted a cross-sectional survey of adult outpatients (aged ≥18 years) at an academic outpatient HF clinic in the Midwest. The survey comprised 34 questions assessing patient demographics, ownership of smartphones and other mHealth devices, frequently used smartphone features, use of mHealth apps, and interest in using mHealth technologies for vital sign and HF symptom self-monitoring and management. RESULTS A total of 144 patients were approached, of which 100 (69.4%) participated in the study (63/100, 63% women). The participants had a mean age of 61.3 (SD 12.25) years and were predominantly Black or African American (61/100, 61%) and Hispanic or Latino (18/100, 18%). Almost all participants (93/100, 93%) owned a cell phone. The share of patients who owned a smartphone was 68% (68/100). Racial and ethnic minorities that identified as Black or African American or Hispanic or Latino reported higher smartphone ownership rates compared with White patients with HF (45/61, 74% Black or African American and 11/18, 61% Hispanic or Latino vs 9/17, 53% White). There was a moderate and statistically significant association between smartphone ownership and age (Cramér <i>V</i> [Φ<sub>C</sub>]=0.35; <i>P</i>&lt;.001), education (Φ<sub>C</sub>=0.29; <i>P</i>=.001), and employment status (Φ<sub>C</sub>=0.3; <i>P</i>=.01). The most common smartphone features used by the participants were SMS text messaging (51/68, 75%), internet browsing (43/68, 63%), and mobile apps (41/68, 60%). The use of mHealth apps and wearable activity trackers (eg, Fitbits) for self-monitoring of HF-related parameters was low (15/68, 22% and 15/100, 15%, respectively). The most popular HF-related self-care measures participants would like to monitor using mHealth technologies were physical activity (46/68, 68%), blood pressure (44/68, 65%), and medication use (40/68, 59%). CONCLUSIONS Most patients with HF have smartphones and are interested in using commercial mHealth apps and connected health devices to self-monitor their condition. Thus, there is a great opportunity to capitalize on the high smartphone ownership among racial and ethnic minority patients to increase reach and enhance HF self-management through mHealth interventions.

scholarly journals Using Mobile Health to Improve Social Support for Low-Income Latino Patients with Diabetes: A Mixed-Methods Analysis of the Feasibility Trial of TExT-MED + FANS

2018 ◽  
Vol 20 (1) ◽  
pp. 39-48 ◽  
Author(s):  
Elizabeth Burner ◽  
Chun Nok Lam ◽  
Rebecca DeRoss ◽  
Marjorie Kagawa-Singer ◽  
Michael Menchine ◽  
...  
Keyword(s):  
Social Support ◽  
Mixed Methods ◽  
Mobile Health ◽  
Low Income ◽  
Feasibility Trial ◽  
Patients With Diabetes

scholarly journals Adolescent and Caregiver Attitudes Towards Telemedicine Use in Pediatric Nephrology

2020 ◽  
Author(s):  
Yi Qiu ◽  
Sherry Coulson ◽  
Christopher William McIntyre ◽  
Brooke Wile ◽  
Guido Filler
Keyword(s):  
Care Delivery ◽  
Pediatric Nephrology ◽  
Cost Savings ◽  
Patient Characteristics ◽  
Physical Symptoms ◽  
Models Of Care ◽  
Complex Needs ◽  
Tertiary Center ◽  
Specific Factors ◽  
Mapping Models

Abstract Background: Telemedicine is increasingly utilized as an alternative to in person consultation. Current pandemic conditions are providing additional impetus to virtual care delivery. We aimed at comparing both pediatric patient and caregiver attitudes towards telemedicine (here as tertiary center to remote health care location) as a crucial determinant of longer-term effectiveness. Methods: This mixed methods cohort study combined patient characteristics and analysis of transcribed structured telephone interviews with both pediatric nephrology patients (11-18 years) and their caregivers. Results: For 11 child-parent dyads, the median distances to tertiary center were 191 km (range 110-1378 km) and 1 km (1-54 km) to remote telemedicine location. Overall a ratio of 2:1 for telemedicine to in-person visits was favored; with caregivers more in favor of remote care than patients. Qualitative analysis found that experiences with telemedicine were distinguished by consultation-specific factors and contextual factors. Contextual factors (travel/cost savings) were valued for telemedicine by patients and caregivers. Consultation-specific factors, such as the ability to show the doctor physical symptoms, were more valued during in-person consultations, especially by patients. The overall visit type preference was related to the nature of the consultation. For regular check-ups, and for patients with less complex needs, participants felt that telemedicine offered a comparable experience to in-person visits. Conclusions: Indiscriminate transfer to chronic care predicated on mainly telemedicine approach is not compatible with user expressed attitudes (especially patients). Accurately mapping models of care to these attitudes is an essential determinant of effective management and longer-term engagement with potentially life-long health challenges.

scholarly journals Effects of Mobile Health Technologies on Uptake of Routine Growth Monitoring among Caregivers of Children Aged 9 to 18 Months in Kenya

2021 ◽  
Vol 12 ◽  
pp. 215013272110109
Author(s):  
Edna Nyang’echi ◽  
Justus Osero
Keyword(s):  
Experimental Study ◽  
Mobile Health ◽  
Text Message ◽  
Growth Monitoring ◽  
Voice Call ◽  
Policy Makers ◽  
Short Text ◽  
Health Technologies ◽  
Quasi Experimental

This study aimed at finding out the effects of mobile health ( mhealth) technologies on uptake of Routine Growth Monitoring (RGM) among caregivers of children aged above 9 months in Kenya. This was a quasi-experimental study. The experiment groups received Short Text Message (STM) and Voice Call (VC). The analysis demonstrates that in month 1, caregivers who received STM were 6.875 times more likely to take their children for RGM compared to control (OR = 6.875; 95 CI: 3.591-13.164); caregivers who received VC were 6.750 times more likely to take their children for RGM compared to those in control arm (OR = 6.750; 95 CI: 3.522-12.938). Policy makers and implementers in the health will find these study findings useful in deciding whether or not to adopt STM or VC in improving uptake of RGM for children above 9 months.

scholarly journals Examining the Use of Glucose and Physical Activity Self-Monitoring Technologies in Individuals at Moderate to High Risk of Developing Type 2 Diabetes: Randomized Trial

10.2196/14195 ◽  
2019 ◽  
Vol 7 (10) ◽  
pp. e14195 ◽  
Author(s):  
Maxine E Whelan ◽  
Mark W Orme ◽  
Andrew P Kingsnorth ◽  
Lauren B Sherar ◽  
Francesca L Denton ◽  
...  
Keyword(s):  
Physical Activity ◽  
Type 2 Diabetes ◽  
At Risk ◽  
High Risk ◽  
Feasibility Trial ◽  
Self Monitoring ◽  
Health Technologies ◽  
Freestyle Libre ◽  
Monitoring Technologies

Background Self-monitoring of behavior (namely, diet and physical activity) and physiology (namely, glucose) has been shown to be effective in type 2 diabetes (T2D) and prediabetes prevention. By combining self-monitoring technologies, the acute physiological consequences of behaviors could be shown, prompting greater consideration to physical activity levels today, which impact the risk of developing diabetes years or decades later. However, until recently, commercially available technologies have not been able to show individuals the health benefits of being physically active. Objective The objective of this study was to examine the usage, feasibility, and acceptability of behavioral and physiological self-monitoring technologies in individuals at risk of developing T2D. Methods A total of 45 adults aged ≥40 years and at moderate to high risk of T2D were recruited to take part in a 3-arm feasibility trial. Each participant was provided with a behavioral (Fitbit Charge 2) and physiological (FreeStyle Libre flash glucose monitor) monitor for 6 weeks, masked according to group allocation. Participants were allocated to glucose feedback (4 weeks) followed by glucose and physical activity (biobehavioral) feedback (2 weeks; group 1), physical activity feedback (4 weeks) followed by biobehavioral feedback (2 weeks; group 2), or biobehavioral feedback (6 weeks; group 3). Participant usage (including time spent on the apps and number of glucose scans) was the primary outcome. Secondary outcomes were the feasibility (including recruitment and number of sensor displacements) and acceptability (including monitor wear time) of the intervention. Semistructured qualitative interviews were conducted at the 6-week follow-up appointment. Results For usage, time spent on the Fitbit and FreeStyle Libre apps declined over the 6 weeks for all groups. Of the FreeStyle Libre sensor scans conducted by participants, 17% (1798/10,582) recorded rising or falling trends in glucose, and 24% (13/45) of participants changed ≥1 of the physical activity goals. For feasibility, 49% (22/45) of participants completed the study using the minimum number of FreeStyle Libre sensors, and a total of 41 sensors were declared faulty or displaced. For acceptability, participants wore the Fitbit for 40.1 (SD 3.2) days, and 20% (9/45) of participants and 53% (24/45) of participants were prompted by email to charge or sync the Fitbit, respectively. Interviews unearthed participant perceptions on the study design by suggesting refinements to the eligibility criteria and highlighting important issues about the usability, wearability, and features of the technologies. Conclusions Individuals at risk of developing T2D engaged with wearable digital health technologies providing behavioral and physiological feedback. Modifications are required to both the study and to commercially available technologies to maximize the chances of sustained usage and behavior change. The study and intervention were feasible to conduct and acceptable to most participants. Trial Registration International Standard Randomized Controlled Trial Number (ISRCTN) 17545949; isrctn.com/ISRCTN17545949

scholarly journals Smartphone Ownership and Interest in Mobile Health Technologies for Self-Monitoring and Management of Heart Failure Symptoms (Preprint)

JMIR Cardio ◽  
10.2196/31982 ◽  
2021 ◽  
Author(s):  
Jonathan Leigh ◽  
Ben S Gerber ◽  
Christopher P Gans ◽  
Mayank M Kansal ◽  
Spyros Kitsiou
Keyword(s):  
Heart Failure ◽  
Mobile Health ◽  
Self Monitoring ◽  
Health Technologies
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