Patient health data gathered via mobile apps could improve care
CHICAGO — Collecting patient-generated health data via smart watches or mobile apps has the potential to benefit clinical care by improving patient outcomes and experience, as well as applying cost savings, according to William Dixon, MD, professor of digital epidemiology at The University of Manchester.
Though there are challenges associated with implementation, these obstacles are surmountable, Dixon explained.
Patient-generated health data are data collected by the patient rather than the health care professional and can include things like patient-reported outcomes on pain, fatigue, tender or swollen joint counts, as well as images or audio. According to Dixon, the clinical benefits are many: collecting real-time data on disease severity can help reduce information gaps in the clinic; can lead to more informed decisions, as well as shared-decision making; and saves time in the clinic normally taken up by history taking.
However, he explained the obstacles are also quite significant. These include provider concerns over an influx of data, patient concerns over the value of these data, privacy, and technological concerns.
“One of the difficult things about this is you have to get over all of the obstacles at the same time. If you leave some in the way, then it fails,” Dixon said.
Overcoming these obstacles is not impossible, though. Referencing data from the Remote Monitoring in RA (REMORA) study, Dixon explained how his group created a smart phone app that aimed to help support patient self-management, support clinical care and allow researchers to analyze the relationship between data items.
The study included three phases. Phase 1 comprised the design of the smart phone app; phase 2 included beta testing of the process from end to end; and phase 3 included app testing among 20 patients with RA over the course of 3 months. The app queried patients on a daily, weekly and monthly basis to assess things like pain and morning stiffness, with questions becoming slightly more burdensome when asked at the weekly or monthly timepoints.
Dixon reported that patients provided positive feedback at the end of 3 months, saying they felt they were receiving more personalized care and that because their data were plotted on a graph, it made it easier for them to engage in a shared conversation with their clinician.
Many of the challenges Dixon cited at the start of his talk were overcome in the REMORA study. For example, because data were plotted on a graph, it was easier for clinicians to consume and took them less time to do so. Additionally, the interface was simple, and the data were successfully integrated into the EHR system.
The research is ongoing, Dixon said, expressing enthusiasm for the future possibilities of using patient-generated health data to do things like schedule visits or enable remote care.
“I strongly believe in the transformative role of patient-generated health data. It’s new to us all, but I don’t think it will continue to be new to us. I think it will be common practice in 10 years’ time; at this meeting we’ll all be doing it, but we need to learn how to get there. There are multiple challenges, but I believe all of those are surmountable,” he said. – by Stacey L. Adams
Disclosure: Dixon reports receiving consulting fees from Bayer and Google.
Dixon W. Mobile and wearable technology in clinical practice. Presented at ACR/ARHP Annual Meeting, Oct. 20-24, 2018; Chicago.