That flow of patient data also allows the service to act as a continuous learning system, with the company’s data scientists studying ways to optimize and personalize interventions to improve behaviors, Duffy added.
Another app, developed by researchers at Johns Hopkins Bayview Medical Center in Baltimore, tackles a very different problem in cardiovascular health: assisting patients recovering from a heart attack.
Traditionally, hospitals saddle patients with a pile of discharge-instruction papers just before they are wheeled down to their cars—“when they couldn’t care less about what we’re giving them,” said Francoise Marvel, an internal medicine physician at Bayview. That failure to communicate can add to patients’ confusion about how to care for themselves during the crucial early days of recovery—one main reason that about a fifth of heart attack patients nationally are rehospitalized within a month after discharge.
The Johns Hopkins “Corrie” app aims to address that by integrating educational videos, medication information, medical appointment tracking, and other crucial aids in an easy-to-use mobile app. Marvel says that early results from a first clinical study of 50 patients have been promising: None were rehospitalized in the first month.
The Corrie app taps not only smartphones and smartwatches, but smart timing. “We can actually enroll patients who are six or seven hours out of having a stent placed in the ICU,” Marvel said. “We’re giving it to patients when they have the time to spend watching the videos, asking questions about their medications, and following their blood pressure and their vital signs—which they will likely need to be taking when they go home.
“We’re getting them to buy in and learn the skills,” she added, “while they care the most.”
Family members can also follow along with a companion Corrie app. “If the adult daughter knows that her dad’s not taking his blood pressure medicine every day,” Marvel said, “she’ll rain down on him in a way that no doctor or no nurse follow-up call could ever compete with.”
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Still, for all the enthusiasm surrounding these technologies, limited independent real-world testing makes it difficult to categorically say what works and what doesn’t—though researchers do suggest that one thing is abundantly clear: Patient acceptance of high-tech self-care and monitoring devices cannot be taken for granted.
“We have to think about how we intervene on behaviors in really different ways, ones that are much more consumer-like,” said Chang. Social networks such as Facebook, for instance, can provide much more pervasive, much more consistent touchpoints than traditional health-care practices and can shift behaviors in striking ways, he says.
In chronic disease, people lack instant gratification for, say, dropping that slice of pizza and eating their damn broccoli. Individual patients need to find personally meaningful ways to motivate themselves, like picturing themselves playing actively with their grandchildren, Chang said. A trained human health coach can help them build this motivational framework, but it remains a real challenge for a mobile app.