The Journal of mHealth Vol 2 issue 5 (Oct)

The Secret Recipe of Meaningful Digital Health scribed to an expectant mother at her initial pregnancy visit. It comes in the form of a mobile app that provides gestation-specific, provider-approved content as well as two Wi-Fi-connected devices (a wireless scale and blood pressure cuff) that are delivered to the patient's home. Through the app and the devices, Babyscripts has the ability to remotely capture data in real-time and algorithmically filter aberrant data points in a risk-stratified manner so that providers can intervene more precisely. They have shown through a prospective observational study at The George Washington University’s Medical Center that their product can enhance patient compliance with recommended tasks as well as data collection, while enhancing patient satisfaction and increasing ROI for a provider’s practice7. data, such as blood sugar, weight and blood pressure. What’s more, the Mayo Clinic and the Cleveland Clinic have already worked with Apple to develop the HealthKit, while Duke University and Stanford University have recently joined in the effort. Another example is Omada Health, a company based in San Francisco, CA whose Prevent program is designed to alter the health course of at-risk patients for diabetes, hypertension, high cholesterol and obesity. Prevent functions as an intense 16-week system to lose weight using connected devices such as a pedometer and digital scale to monitor progress, a personal health coach, weekly fitness and nutrition classes, and a way to track food and activities via a website and smartphone app. The program has also been evaluated in peer reviewed clinical literature8. Given this preliminary work, mobile apps, connected devices, and wearable technologies can be used to improve the quality of care as well as enhance the operational efficiencies of healthcare providers. Finally, as an indicator of the great opportunity in this space, Apple has recently devoted massive resources to developing the HealthKit, a centralized hub that collects a person’s health data from other connected devices and mobile apps so as to organize that data into a convenient interface. This interface has been developed to be interoperable with non-Apple devices that collect clinical 700 695 690 Health Score 685 680 675 670 665 660 23 Feb 24 Feb 25 Feb 26 Feb 27 Feb 28 Feb Today Date HEALTH SCORE COMPARISON You Number of Users 682 DAC DAC DAC 0 100 200 300 400 500 600 700 800 900 13:50 Me 1000 Health Score Zurich Average 590 DAC DAC DAC DAC 13:50 DAC DAC 13:50 Me Daily Coach Weekly Monthly 682 682 +1 27 Feb 2015 80 kg -1 kg 681 Feelings +9 672 83% Coach 67% Track Social -16 % 682 685 680 My achieved goals Suggested goals 675 670 Share 665 -5 660 25 Feb 2015 Me Nutrition: Salad More... 690 +9 HS Your Health Score has decreased by -5 due to your change in stress score. Great, you have eaten salad every day for a month. You have achieved a goal. 695 Health Score +109 kcal Expanded view 700 ACTIVITY 1210 kcal OK. I got it! HEALTH SCORE Your Health Score has increased by +9 due to your increased movement. 901 kcal 9 LATEST ACTIVITY +1 HS 26 Feb 2015 STRESS Programs, Goals & Achievements Body WEIGHT 81 kg Nutrition Coach Lifestyle Your Health Score has increased by +1 due to your change in weight. Points -5 HS 23 Feb 24 Feb 25 Feb 26 Feb 27 Feb 28 Feb Today Me Me Coach Track Social Points Coach Track Social Points The poster children of academic rigor and quality of care already see the great value in these products. This is the cutting edge of healthcare, and mobile digital tools represent its future. And, unlike the tools of the past that incrementally increase performance with a greater price tag, mobile digital tools seem capable of enhancing clinical effectiveness in a cost-efficient manner. Conclusion For patients, these tools enhance the clinical experience by connecting them to their providers in a more intimate fashion, while at the same time empowering patients to take charge of their health. For many providers, these tools represent a cost-effective way to efficiently influence patient behavior through lifestyle coaching, improve patient compliance with recommended tasks, and riskstratify their patient populations through the use of algorithmic analyses of remotely-generated data. And, all of this can be accomplished through the bidirectional flow of information and communication between patients and providers. It seems then that most promising use of these tools is to creatively extend the patientprovider relationship. References 1. Fox, S. Mobile Health in Context. Pew Research Center Internet Science & Tech. (Accessed May 7, 2015 at http://www.pewinternet. org/2013/10/22/mobile-health-in-context/.) 2. Dolan B. By 2016: 80M wearable wireless fitness sensors. mobiHealthNews. (Accessed July 5, 2015 at http://mobihealthnews.com/11224/by-2016-80mwearable-wireless-fitn ess-sensors/.) 3. Dolan B. How should we evaluate a health app’s efficacy? mobiHealthNews. (Accessed July 5, 2015 at http://mobihealthnews.com/14241/how-shouldwe-evaluate-a-health-apps-efficacy/.) 4. Versel N. Scientific mobile health research found severely lacking. mobiHealthNews. (Accessed July 5, 2015 at http://mobihealthnews.com/19903/scientific-mobile-health-research-found-severely-lacking/.) 5. Kuehn BM. Is There an App to Solve App Overload? JAMA. 2015;313(14):1405-1407. 6. Quinn CC, Shardell MD, Terrin ML, Barr EA, Ballew SH, Gruber-Baldinin AL. ClusterRandomized Trial of a Mobile Phone Personalized Behavioral Intervention for Blood Glucose Control. Diabetes Care, 2011; 34(9): 1934-1942. 7. Krapf JM, Gaba ND, Ganju N, Marko KI, Martinez AG. Remote Capture and Monitoring of Clinical Data During Pregnancy [54]. 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