Accepted for/Published in: JMIR Cardio
Date Submitted: Nov 26, 2020
Date Accepted: Oct 3, 2021
Date Submitted to PubMed: Dec 20, 2021
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
The Box: Methods and Results of a Real World Experience of mHealth Implementation in Clinical Practice
ABSTRACT
Background:
Mobile health (mHealth) is an upcoming field of scientific interest around the globe. Potential benefits include increased patient engagement, improved outcomes and reduced healthcare costs. However, large scale implementation of mHealth care-tracks in daily clinical care is rare.
Objective:
To showcase the implementation and user experience with a large scale mHealth care-track in daily clinical cardiovascular healthcare.
Methods:
In 2016, an mHealth care-track including smartphone compatible devices - named ‘The Box’ - was implemented on the Cardiology department of a tertiary medical center in the Netherlands. Patients with myocardial infarction, rhythm disorders, cardiac surgery, heart failure and congenital heart disease received devices to daily measure weight, blood pressure, heart rate, temperature and oxygen saturation. Additional, professional- and patient user comments on experience with the care-track were obtained via structured interviews.
Results:
From 2016 until April 2020, a total of 1140 patients were connected to the mHealth care-track, which on average cost €350 per patient. Median patient age was 60.8 (interquartile range [IQR] 52.9-69.3) years, 73.6% were male. A median of 260 measurements (IQR 105-641) were taken on a median of 189 days (IQR 98-372). Patients praised the ease of use of the devices and felt more involved with their illness and care. Professionals reported more interactive and productive outpatient consultations as well as improved insight in health parameters such as blood pressure and weight. A feedback loop from hospital to patient to focus on measurements was commented as important improvement by both patients and professionals.
Conclusions:
An mHealth care-track with consumer grade Bluetooth devices, applied in diverse cardiovascular patients, is a feasible option for outpatient management. To create a continuum of care, however, development of feedback mechanisms and automation may not be forgotten.
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