Mobile health

Excerpt – The results of its first pilot of remote monitoring for patients with chronic myeloid leukemia (CML) were released late last week. And so far, researchers say, they’ve found participants in the two-way secure texting program were 22% more likely to be optimally adherent to their medications.

CML patients must maintain 90% or better adherence to their medication regimens in the first year after diagnosis to significantly boost their chances at readmission. In the program, patients were offered education and coaching on their medication through secure messaging.

[..] Dea Belazi, CEO of PBM AscellaHealth, said that the traditional cost containment strategies deployed by insurers—prior authorization, step therapy and others—work for this new frontier of drugs, but they must be adapted to the times.

He told FierceHealthcare that it’s like comparing the upkeep of a budget sedan to souped-up Tesla.

“It’s still got four wheels, but it’s completely different,” Belazi said.

How CVS is using digital tools to boost specialty pharmacy adherence (2019.11.4)

“Most studies involved apps that engaged consumers using 1 or more functionalities such as by displaying and summarizing user-entered information (n = 54), tracking data (n = 52), providing guidance (n = 49), and educational information (n = 49). [..]

The 67 safety concerns relating to the quality of information presented by apps could be grouped into 5 categories including incorrect information, incomplete information, variation in content, and incorrect and inappropriate response to consumer needs. [..]

The 13 concerns relating to the functionality of apps could be grouped into 5 other categories including gaps in features, lack of validation for user input, delayed processing, failure to respond to a health danger, and faulty alarms. [..]

There were 52 reports about the actual or potential consequences of safety concerns. Five had potential for patient harm.

[…] there were 66 reports about gaps in processes to design and build apps, including the lack of expert involvement, evidence base, and validation.

[..] important that apps are safe, effective, and reliable. The gaps in app development, safety concerns, and consequences found in this review call for increased stakeholder engagement, vigilant regulatory frameworks, and more focused research.”

Safety concerns with consumer-facing mobile health applications and their consequences: a scoping review (2019.10.10)

“Mobile health (mHealth) interventions have demonstrated promise in improving outcomes by motivating patients to adopt and maintain healthy lifestyle changes as well as improve adherence to guideline-directed medical therapy. Early results combining behavioral economic strategies with mHealth delivery have demonstrated mixed results. In reviewing these studies, we propose that the success of a mHealth intervention links more strongly with how well it connects patients back to routine clinical care, rather than its behavior modification technique in isolation. This underscores the critical role of clinician-patient partnerships in the design and delivery of such interventions, while also raising important questions regarding long-term sustainability and scalability. Further exploration of our hypothesis may increase opportunities for multidisciplinary clinical teams to connect with and engage patients using mHealth technologies in unprecedented ways.”

The role of a clinician amid the rise of mobile health technology | Journal of the American Medical Informatics Association | Oxford Academic (2019.8.2)