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mHealth Devices Are Changing Chronic Care Management Standards

New research suggests that healthcare providers who use mHealth devices in chronic care management programs could be treating their patients better than current standards of care.

Source: ThinkStock

By Eric Wicklund

- New research suggests that mHealth is changing the way physicians treat patients with chronic conditions – an outcome that may merit an adjustment in how healthcare providers measure standards of care.

Researchers from the University of Colorado School of Medicine and Children's Hospital Colorado, working with digital therapeutics company Propeller Health, have found that providers are more likely to get an accurate accounting of a patient’s health by using remote patient monitoring tools – such as digital sensors – than in surveying the patient during regular checkups.

When treating patients living with asthma, for example, a physician who relies on a patient’s memory of inhaler use won’t get an accurate care management profile, thus affecting how that doctor maps out a care plan. A physician who combines patient perceptions with data from an mHealth sensor that measures inhaler use, however, will have a much better idea of how that patient is doing.

The study, recently published in The Journal of Allergy and Clinical Immunology: In Practice, suggests that the healthcare industry needs to alter its standards of care for chronic care management to include mHealth and telehealth measurements. This includes guidelines set by the 2009 American Thoracic Society (ATS) and European Respiratory Society (ERS) Task Force for inhaler use.

“In the past, providers asked patients about their use of rescue medications to determine whether the patient's asthma was well-controlled, partly-controlled or not well-controlled,” David Stempel, MD, the Senior Vice President of Clinical and Medical Affairs for Propeller Health and a co-author of the study, said in a press release. “Their understanding was based on recall and affected by patient bias, as few patients remember the number of times they used their rescue beyond the prior few days, at best.”

“Now, with data from digital therapeutics, we more accurately know how many puffs of rescue inhaler were used,” he added. “Incorporating digital science into the ATS/ERS recommendations will advance guideline development and hopefully improve patient outcomes.”

The research falls in line with dozens of studies and pilot projects that point to better care management and clinical outcomes when providers take into account connected health data. That information, either gleaned from mHealth devices or reported by the patient, improves the provider’s understanding of the patient’s daily activities, moods and diet, ultimately affecting how the doctor treats the patient.

It also helps the patient.

“Incorporating digital medicine data into clinical practice relieves the burden on the patient to recall every instance of medication use and relieves the burden on the provider to estimate whether the patient's reporting is accurate,” Stanley Szefler, MD, Director of the Pediatric Asthma Research Program in the Breathing Institute of the Pediatric Pulmonary Section at Children's Hospital Colorado and a co-author of the study, said in the press release. “A growing body of research suggests that digital medicines will completely change the way we monitor medication use and disease management.”

In the study, researchers followed 3,373 patients managing their asthma with Propeller Health’s connected health platform, which includes a sensor attached to their inhaler. Among other things, they found no clear pattern in how patients used their inhalers for “occasions of rescue use” – some used their inhalers multiple times, while others got by on just one puff. This meant that there was no clear definition of an “occasion,” so the recommendations developed by the ARS and ERS could not accurately capture a patient’s medication management patterns.

Telehealth and telemedicine advocates say a digital therapeutic platform for chronic care – ranging from asthma to cardiac care to diabetes – can help providers improve care management and coordination by giving them a better idea of medication management and adherence. This not only improves the care plan and clinical outcomes, but also helps patients with self-management.

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