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How mHealth Devices Rely on Patient Engagement for Better Care

mHealth devices may be effective in boosting better care outcomes, but all of that is reliant on patient engagement levels.

By Sara Heath

- mHealth devices can play a significant role in improving care outcomes, but that is dependent upon the level of patient engagement, according to a study published in the Journal of the American Medical Informatics Association.

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The study, led by a team of Army researchers, examined an mHealth communications app called mCare. The app facilitated conversations between rehabilitating soldiers, some suffering from behavioral health issues, including traumatic brain injury and post-traumatic stress disorder.

The app connected the soldiers to core members of their care teams, including their platoon sergeants and case managers. Through a series of questionnaires, mCare was designed to help these patients recover from injuries when back at home.

Through an analysis of patient answers, the research team determine mCare’s effectiveness at facilitating recovery and patients’ levels of engagement with the app.

Overall, the research team found that these mHealth tools did help improve patient well-being. More interestingly, however, the team found that there were several background characteristics that influenced patients’ engagement with the tool.

For instance, older patients were more likely to respond to mCare questionnaires, as were patients who demonstrated higher levels of well-being.

“Observation of the relationship between the measures of engagement and participants’ background characteristics showed that the total number of questionnaires responded to over the study were statistically associated with higher age,” the researchers noted. “That is, as age increased, so too did the percentage of questionnaires responded to.”

The team posited two potential explanations as to why reportedly healthier patients were more likely to respond to questionnaires. First, those patients may have been generally more able to answer the questionnaires. That is to say, they were less sick so they were able to better engage with mHealth tools.

Healthier patients also may have had a greater sense of optimism with regard to their conditions, and therefore were more willing to engage with mHealth tools.

Potential behavioral health issues also may have affected patient engagement with mCare. Although presence of a behavioral health issue, TBI, or PTSD did not affect the patient’s overall engagement with mCare, it did cause their engagement to be more sporadic. There were a handful of weeks where this population’s engagement levels were markedly low, and others where it was high.

However, the researchers were not able to determine why patients with behavioral health issues, TBI, or PTSD had sporadic engagement with mCare.

What the researchers did determine was that patient engagement with the app was notably important for mCare’s success in boosting patient outcomes.

mCare created several opportunities for care team members and patients to create important and meaningful relationships that would positively affect outcomes. If the patient was not receptive to app usage, these relationships and subsequent outcomes may not have been attained.

“Because mCare solicited detailed information about patients’ daily status, it had the potential to increase the quantity of provider-patient communications, to improve the quality of information providers received, and to shorten the waiting time for providers’ responses to problems,” the researchers explained.

Because of this, the researchers said providers must determine a patient’s level of engagement before employing a strategy such as mCare. This may include looking into a patient’s background characteristics that may affect their use of the app, including level of well-being.

“When determining whether a patient is a candidate for a mobile health solution, it might behoove clinicians to evaluate the patient’s current well-being as a proxy for their ability to engage with it,” the researchers noted.

Overall, mCare was successful in boosting patient engagement amongst all patient populations, thus helping to improve care outcomes. Going forward, the researchers suggest clinicians adopt such a tool as a means to boost patient engagement.

“If engagement is the key marker in determining the success of a rehabilitation program, mCare is a successful addition to standard care,” the team concluded.

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