University of Manchester | August 2019 |Smartphones could transform patient care, finds study
A smartphone app used remotely to provide information on parents with arthritis could have the potential to transform the care of patients with long-term conditions reports a study now published in the journal Rheumatology.
Remote Monitoring of Rheumatoid Arthritis (REMORA) study designed and tested a system to support clinical care and research, enabling people living with RA to report daily symptoms using a smartphone app with data integrated into the electronic health record (EHR). The study evaluated the system’s acceptability and feasibility including exploration of participants’ views and experiences of remote monitoring, with specific focus on how integration of smartphone data into the EHR in graphical format influenced consultation
A sample of 20 patients’ data from the app was uniquely integrated into their EHR at their hospital, with the data summarised as a graph visible at their outpatient visit.
The app, jointly designed by patients, clinicians and researchers, allowed patients to input what symptoms they were experiencing each day and the impact it had on their lives.
Their doctors used the data generated by the app when carrying out face to face consultations.
The system provided a “bigger picture” than doctors would otherwise get, capturing “symptoms that would otherwise have been missed”.
And the graphs generated by the app made it easier for patients to participate in consultations and treatment, enabling a shared discussion between the patient and their doctor (Source: University of Manchester).
The authors’ report that:
- Daily remote monitoring using a smartphone app was viewed positively by patients and completed regularly.
- Graphs of patients’ daily data identified changes in disease that would otherwise have been missed.
- Patients valued consultations being focused around their own data, supporting person-centred care.
Read the full news story from University of Manchester
Abstract
To establish the acceptability and feasibility of collecting daily patient-generated health data (PGHD) using smartphones and integrating PGHD into the electronic health record, using the example of RA.
The Remote Monitoring of RA smartphone app was co-designed with patients, clinicians and researchers using qualitative semi-structured interviews and focus groups, including selection of question sets for symptoms and disease impact. PGHD were integrated into the electronic health record of one hospital and available in graphical form during consultations. Acceptability and feasibility were assessed with 20 RA patients and two clinicians over 3 months. A qualitative evaluation included semi-structured interviews with patients and clinicians before and after using the app, and audio-recordings of consultations to explore impact on the consultation. PGHD completeness was summarized descriptively, and qualitative data were analysed thematically.
Patients submitted data on a median of 91% days over 3 months. Qualitative analysis generated three themes: RA as an invisible disease; providing the bigger picture of RA; and enabling person-centred consultations. The themes demonstrated that the system helped render patients’ RA more visible by providing the ‘bigger picture’, identifying real-time changes in disease activity and capturing symptoms that would otherwise have been missed. Graphical summaries during consultations enabled a more person-centred approach whereby patients felt better able to participate in consultations and treatment plans.
Remote Monitoring of RA has uniquely integrated daily PGHD from smartphones into the electronic health record. It has delivered proof-of-concept that such integrated remote monitoring systems are feasible and can transform consultations for clinician and patient benefit.
The full article can be read at Rheumatology
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