Mobile tools help to cut readmits for COPD patients
Research focused on a mobile device-based rehabilitation program for patients suffering from severe pulmonary disease reveals that smartphone and real-time communications between home-based patients and providers can boost treatment and help reduce hospital readmissions.
Hospital readmission is typically very high for patients suffering from chronic obstructive pulmonary disease (COPD), with about 20 percent of patients readmitted to a hospital facility within 30 days due to complications relating to the disease, according to Surya Bhatt, M.D. (pictured), assistant professor in the division of pulmonary, allergy and critical care at the University of Alabama at Birmingham.
For the study, Bhatt connected COPD patients to medical professionals on the UAB campus using videoconferencing technology via smartphones. The system provided patients and doctors two-way interaction, as well as real-time patient support. During the study, none of the 14 patients needed to be readmitted to a hospital in the first 30 days, and each revealed significant improvement in everyday functions.
"We were pleasantly surprised at how quickly patients adapted to the new technology," Bhatt told FierceMobileHealthcare via email. "We recognize this may not always be the case and have simplified the technology to about the level of simply being able to use a smartphone."
Bhatt said there can be challenges with familiarization and willingness to use technology. He also pointed to bandwidth as a potential hurdle as the program grows.
"As we start incorporating more measurements and collect more data, bandwidth and energy can be a problem, especially in remote rural areas," he said. "We are collaborating with engineers at UAB to improve data efficiency and energy efficiency to enable transmission of large amounts of data in packets without overburdening the system."
The UAB efforts comes on the heels of similar research focused on home-based mHealth tools and how they can boost medication adherence. That study, regarding a mobile health medication inquiry system, revealed a 5 percent error rate for patients suffering from chronic kidney disease.
Such benefits are prompting providers to launch mHealth tools to help patients better manage ailments and disease in a non-clinical setting. In Florida, a hospital physician group is launching an mHealth platform to enhance chronic care and treatment for Medicare patients.
For the UAB study, Bhatt's team crafted an exercise program based on patients' abilities and resources. A smartphone and several apps allowed caregivers to observe patients as they exercised and monitor vital signs such as heart rate, blood pressure and oxygen levels. The physicians were able to serve both in a medical role and a supportive monitor role. Patients were motivated to complete exercise programs as physicians were able to view activity via video.
Bhatt believes that despite patient adaptation to technology increasing rapidly, it's important to keep intervention as simple as possible.
"Recent studies suggest 10 percent of Americans have not been online in the past year," Bhatt said. "This is certainly surmountable. Most healthcare providers are aware of the benefits of smart technology. Barriers to greater adoption include lack of awareness of all the benefits, concerns about information overload, potential malfunctioning of technology and reimbursement issues. Showing that this works is perhaps the best way to encourage embracement by the health system and especially insurance providers."
Going forward Bhatt said he hopes to expand the study, and calls telehealth the future of medicine, especially for chronic diseases that need monitoring and adjustments of medication or behavior.
"For example, asthma and COPD patients can register when they use their inhalers and can be sent a reminder via text message if they do not," he said. "Blood sugar values can be seamlessly transmitted to doctors' offices, especially when they are above or below a certain level. Blood pressure values can also be similarly monitored. Pedometers connected to a central location can send text reminders when patients fall below their exercise expectations. The possibilities are numerous."
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