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iMHere: A Novel mHealth System for Supporting Self-Care in Management of Complex and Chronic Conditions.

Parmanto B, Pramana G, Yu DX, Fairman AD, Dicianno BE, McCue MP - JMIR Mhealth Uhealth (2013)

Bottom Line: They benefit most from receiving effective treatments beyond acute care, usually in the form of regular follow-up and self-care support in their living environments.The apps have been highly utilized consistently by patients, even those addressing complex issues such as medication and skincare.The system was capable of supporting self-care and adherence to regimen, monitoring adherence, supporting clinician engagement with patients, and has been highly utilized.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Health Information Management, School of Health & Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, PA, United States. parmanto@pitt.edu.

ABSTRACT

Background: Individuals with chronic conditions are vulnerable to secondary complications that can be prevented with adherence to self-care routines. They benefit most from receiving effective treatments beyond acute care, usually in the form of regular follow-up and self-care support in their living environments. One such population is individuals with spina bifida (SB), the most common permanently disabling birth defect in the United States. A Wellness Program at the University of Pittsburgh in which wellness coordinators supervise the care of individuals with chronic disease has produced remarkably improved outcomes. However, time constraints and travel costs have limited its scale. Mobile telehealth service delivery is a potential solution for improving access to care for a larger population.

Objective: The project's goal was to develop and implement a novel mHealth system to support complex self-care tasks, continuous adherence to regimens, monitoring of adherence, and secure two-way communications between patients and clinicians.

Methods: We developed and implemented a novel architecture of mHealth system called iMHere (iMobile Health and Rehabilitation) consisting of smartphone apps, a clinician portal, and a two-way communication protocol connecting the two. The process of implementing iMHere consisted of: (1) requirement analysis to identify clinically important functions that need to be supported, (2) design and development of the apps and the clinician portal, (3) development of efficient real-time bi-directional data exchange between the apps and the clinician portal, (4) usability studies on patients, and (5) implementation of the mHealth system in a clinical service delivery.

Results: There were 9 app features identified as relevant, and 5 apps were considered priority. There were 5 app features designed and developed to address the following issues: medication, skin care, bladder self-catheterization, bowel management, and mental health. The apps were designed to support a patient's self-care tasks, send adherence data to the clinician portal, and receive personalized regimens from the portal. The Web-based portal was designed for clinicians to monitor patients' conditions and to support self-care regimens. The two-way communication protocol was developed to facilitate secure and efficient data exchange between the apps and the portal. The 3 phases of usability study discovered usability issues in the areas of self-care workflow, navigation and interface, and communications between the apps and the portal. The system was used by 14 patients in the first 6 months of the clinical implementation, with 1 drop out due to having a poor wireless connection. The apps have been highly utilized consistently by patients, even those addressing complex issues such as medication and skincare. The patterns of utilization showed an increase in use in the first month, followed by a plateau.

Conclusions: The system was capable of supporting self-care and adherence to regimen, monitoring adherence, supporting clinician engagement with patients, and has been highly utilized.

No MeSH data available.


Related in: MedlinePlus

Mental health app mood survey.
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figure6: Mental health app mood survey.

Mentions: This app lets a patient or clinician schedule routine mood questionnaires or take them on demand. The questionnaire is based on the depression screening developed by Mental Health America, formerly known as the National Mental Health Association [42]. This 10 items survey asks questions to determine the patient’s mood, including whether the patient has: been sleeping too little or too much; had thoughts of death or suicide; had a hard time concentrating, remembering, or making decisions; had a loss of appetite and weight loss; or increased appetite and weight gain; et cetera. The app records the results of the questionnaire and sends them to the clinician. The Mood app gives an immediate warning to the patient, and provides quick access to a patient’s local mental health crisis line if the score on the questionnaire gives cause for immediate concern. Please refer to Figure 6.


iMHere: A Novel mHealth System for Supporting Self-Care in Management of Complex and Chronic Conditions.

Parmanto B, Pramana G, Yu DX, Fairman AD, Dicianno BE, McCue MP - JMIR Mhealth Uhealth (2013)

Mental health app mood survey.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4114477&req=5

figure6: Mental health app mood survey.
Mentions: This app lets a patient or clinician schedule routine mood questionnaires or take them on demand. The questionnaire is based on the depression screening developed by Mental Health America, formerly known as the National Mental Health Association [42]. This 10 items survey asks questions to determine the patient’s mood, including whether the patient has: been sleeping too little or too much; had thoughts of death or suicide; had a hard time concentrating, remembering, or making decisions; had a loss of appetite and weight loss; or increased appetite and weight gain; et cetera. The app records the results of the questionnaire and sends them to the clinician. The Mood app gives an immediate warning to the patient, and provides quick access to a patient’s local mental health crisis line if the score on the questionnaire gives cause for immediate concern. Please refer to Figure 6.

Bottom Line: They benefit most from receiving effective treatments beyond acute care, usually in the form of regular follow-up and self-care support in their living environments.The apps have been highly utilized consistently by patients, even those addressing complex issues such as medication and skincare.The system was capable of supporting self-care and adherence to regimen, monitoring adherence, supporting clinician engagement with patients, and has been highly utilized.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Health Information Management, School of Health & Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, PA, United States. parmanto@pitt.edu.

ABSTRACT

Background: Individuals with chronic conditions are vulnerable to secondary complications that can be prevented with adherence to self-care routines. They benefit most from receiving effective treatments beyond acute care, usually in the form of regular follow-up and self-care support in their living environments. One such population is individuals with spina bifida (SB), the most common permanently disabling birth defect in the United States. A Wellness Program at the University of Pittsburgh in which wellness coordinators supervise the care of individuals with chronic disease has produced remarkably improved outcomes. However, time constraints and travel costs have limited its scale. Mobile telehealth service delivery is a potential solution for improving access to care for a larger population.

Objective: The project's goal was to develop and implement a novel mHealth system to support complex self-care tasks, continuous adherence to regimens, monitoring of adherence, and secure two-way communications between patients and clinicians.

Methods: We developed and implemented a novel architecture of mHealth system called iMHere (iMobile Health and Rehabilitation) consisting of smartphone apps, a clinician portal, and a two-way communication protocol connecting the two. The process of implementing iMHere consisted of: (1) requirement analysis to identify clinically important functions that need to be supported, (2) design and development of the apps and the clinician portal, (3) development of efficient real-time bi-directional data exchange between the apps and the clinician portal, (4) usability studies on patients, and (5) implementation of the mHealth system in a clinical service delivery.

Results: There were 9 app features identified as relevant, and 5 apps were considered priority. There were 5 app features designed and developed to address the following issues: medication, skin care, bladder self-catheterization, bowel management, and mental health. The apps were designed to support a patient's self-care tasks, send adherence data to the clinician portal, and receive personalized regimens from the portal. The Web-based portal was designed for clinicians to monitor patients' conditions and to support self-care regimens. The two-way communication protocol was developed to facilitate secure and efficient data exchange between the apps and the portal. The 3 phases of usability study discovered usability issues in the areas of self-care workflow, navigation and interface, and communications between the apps and the portal. The system was used by 14 patients in the first 6 months of the clinical implementation, with 1 drop out due to having a poor wireless connection. The apps have been highly utilized consistently by patients, even those addressing complex issues such as medication and skincare. The patterns of utilization showed an increase in use in the first month, followed by a plateau.

Conclusions: The system was capable of supporting self-care and adherence to regimen, monitoring adherence, supporting clinician engagement with patients, and has been highly utilized.

No MeSH data available.


Related in: MedlinePlus