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mHealth Proves Its Value as a Patient Engagement Tool

Two diabetes projects focusing on self-management show that engaged patients can boost clinical outcomes, improve population health measures and make things a lot easier for clinicians.

By Eric Wicklund

- Two projects focused on improving the mHealth experience for diabetics make it abundantly clear that patient engagement works if it’s tied to self-empowerment.

At Penn State University, the winner of the university’s recent mHealth Challenge is an app that teaches diabetic children how to care for themselves. Across the country, meanwhile, a paper presented at the American Medical Informatics Association conference in San Francisco highlighted how a mixture of mobile and social technology helped diabetes patients feel more comfortable about managing their condition – and led to improved health and reduced A1c levels.

In both cases, the mHealth platforms were designed to enable patients to care for themselves, while giving them a link to caregivers for ongoing management and interventions when necessary. It’s a concept that carries far beyond diabetes to any remote patient monitoring program.

“This new sense of self-confidence carried over into their expectations of future interactions with their doctor, as patients noted that they were now able have a more knowledgeable conversation and were more confident in knowing which questions to ask,” Dr. Kendall Ho, director of the eHealth Strategy Office at the University of British Columbia in Vancouver, Canada, wrote in a paper accompanying his AMIA presentation, according to MedCity News. “In essence, participants felt they were now more ‘activated’ patients who would be more involved in making decisions about their care with their doctors.”

The three-month project conducted by UBC combined regular text messages from caregivers with Wi-Fi-enabled weight scales and blood pressure cuffs supplied by Chicago-based Blipcare. Participants were asked to collect weight and blood pressure data and send that – along with blood-glucose readings – through a secure web portal to their doctors.

At the end of the project, participants reported an average reduction in A1c levels from 7.41 to 6.77 and an average weight loss of 3.5 pounds. In addition, more than half said they’d pay the $100 to $200 in monthly costs to continue the project.

Writing for the team of researchers involved in the project, Ho said the participants all felt more assured of their ability to care for themselves, and developed their own routines based on the data. They even did a good job reporting their own blood-glucose readings, since the research time found it too expensive to use continuous monitors.

The benefit to providers, meanwhile, not only comes in improved clinical outcomes, but also a reduction in clinical interventions tied to non-compliance, including reduced tests, prescriptions and even potential hospitalizations.

The Penn State challenge winner, meanwhile, offers a far-ranging benefit to providers, and one tied to population health. By teaching young children diagnosed with Type 1 diabetes how to take care of themselves, they’ll be healthier down the road, requiring less medical care. That, in turn, points to the value of an ongoing care management plan that promotes patient self-management.

The mHealth Challenge winner, a mobile app called Invisulin Kids, was designed by students from the College of Nursing, the College of Human Health and Development’s Department of Biobehavioral Health and the College of Information Sciences and Technology. Designed for diabetics between the ages of 5 and 8, the app enables users to create their own avatar, which then teaches them how to monitor their blood glucose levels and administer insulin. It also uses the avatars in games, called Sugar Rush and Treasure Hunt, that teach users how to deal with their chronic disease.

“The goal is to use a visual, age-appropriate approach to give kids the confidence and skills they need to manage their care independently,” said Vanessa Witmer, a senior nursing major and part of the inning team, in a story in Penn State News.

While teaching young chronic care patients how to better deal with their condition, the apps (another app, GlutenXposed, an education app for kids diagnoses with celiac disease, was also a winner) help nurses to collaborate with patients on care coordination.

"We can use technology like never before to help educate clients and improve their healthcare outcomes," Beth Cutezo, a nursing instructor and faculty advisor who assisting the nursing students in the challenge, said. "The importance of technology in advancing nursing care is just now being realized. Creative apps can provide a useful teaching tool to improve healthcare, and nurses will be expected to be tech savvy as they practice in a variety of clinical settings."

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