mHealth Study Proves Remote Monitoring Beats In-Person Visits

March 28, 2017 - An mHealth platform for post-operative care helped patients collaborate better and more often with their doctors and reduced follow-up visits to the doctor’s office.

In addition, more than half of those using the mobile health platform, designed for breast cancer patients recovering from reconstruction surgery, said remote monitoring was more convenient than in-person visits to the doctor’s office. And there was no statistical difference in clinical outcomes between the two groups.

The results of a study of 65 breast cancer patients, performed by the Women’s College Hospital of Toronto and published in a recent online edition of JAMA Surgery, “are important findings given the current demands on the healthcare system and the push toward patient-centric care,” says Kathleen A. Armstrong, MD, the study’s lead author.

They prove, she said, that a digital health service that replaces expensive and time-consuming in-person visits is more popular with patients and doesn’t negatively affect their recovery. In addition, the platform gives clinicians better data on their patients in a more timely manner, enabling them to intervene more quickly should an adverse health issue crop up. In the long run, this would lead to fewer health emergencies and hospital readmissions.

Armstrong, who conducted the study with Peter C. Coyte, PhD, MA, and Mitchell Brown, MD, said this was the first study to use an mHealth app instead of the telephone to facilitate the conversation between patient and doctor.

“A growing number of procedures, including complex operations such as autologous breast reconstruction, are offered in an ambulatory setting,” she noted. “Patients using the mobile app require approximately 2 minutes to input the quality of recovery, pain visual analog scale, and photographs of the surgical site. This ease of use allows patients to submit data frequently (i.e., daily or weekly), providing a continuous, richer inflow of information than could ever be achieved by telephone or in-person follow-up care.”

The study, focusing on the 30-day period following breast reconstruction surgery, equipped patients with a mobile app on their smartphones that enabled them to communicate on a store-and-forward platform with their doctors. Patients were monitored daily during the first two weeks and weekly during the following two weeks through a 9-question survey, a pain visual analog scale and photographs submitted by the patient. This platform replaced the typical in-person follow-up visits conducted one and four weeks after surgery.

According to the study, which compared 32 patients using the digital health platform to 33 patients following traditional post-operative treatment, the mHealth group didn’t need to meet in person with a doctor as much as the traditional group; and while both groups made the same number of phone calls to a doctor, the mHealth group sent more e-mails.

In addition, while there was no difference in the satisfaction rate between the two groups, 97 percent of those in the mHealth group said the service was convenient, while only 48 percent of the patients using traditional follow-up care said that service was convenient.

“Follow-up via a mobile app can be used to eliminate in-person follow-up visits during the first 30 days following ambulatory breast reconstruction surgery,” Armstrong said in the study. “Patients using the mobile app attended 0.40 times fewer in-person visits for follow-up care and sent more e-mails to their health care professionals during the first 30 days after surgery than did patients in the in-person follow-up group. This finding is important because a common criticism of telemedicine or virtual communication between patients and health care professionals is whether it truly replaces in-person care.”

“Improving patient convenience without compromising satisfaction is another critical finding as we look for ways to build a patient-centric health care system that supports quicker recovery and resumption of normal daily living,” she concluded.