Providing 'the bigger picture': benefits and feasibility of integrating remote monitoring from smartphones into the electronic health record.


Journal

Rheumatology (Oxford, England)
ISSN: 1462-0332
Titre abrégé: Rheumatology (Oxford)
Pays: England
ID NLM: 100883501

Informations de publication

Date de publication:
01 02 2020
Historique:
received: 22 10 2018
accepted: 29 03 2019
pubmed: 25 7 2019
medline: 23 6 2020
entrez: 24 7 2019
Statut: ppublish

Résumé

To establish the acceptability and feasibility of collecting daily patient-generated health data (PGHD) using smartphones and integrating PGHD into the electronic health record, using the example of RA. The Remote Monitoring of RA smartphone app was co-designed with patients, clinicians and researchers using qualitative semi-structured interviews and focus groups, including selection of question sets for symptoms and disease impact. PGHD were integrated into the electronic health record of one hospital and available in graphical form during consultations. Acceptability and feasibility were assessed with 20 RA patients and two clinicians over 3 months. A qualitative evaluation included semi-structured interviews with patients and clinicians before and after using the app, and audio-recordings of consultations to explore impact on the consultation. PGHD completeness was summarized descriptively, and qualitative data were analysed thematically. Patients submitted data on a median of 91% days over 3 months. Qualitative analysis generated three themes: RA as an invisible disease; providing the bigger picture of RA; and enabling person-centred consultations. The themes demonstrated that the system helped render patients' RA more visible by providing the 'bigger picture', identifying real-time changes in disease activity and capturing symptoms that would otherwise have been missed. Graphical summaries during consultations enabled a more person-centred approach whereby patients felt better able to participate in consultations and treatment plans. Remote Monitoring of RA has uniquely integrated daily PGHD from smartphones into the electronic health record. It has delivered proof-of-concept that such integrated remote monitoring systems are feasible and can transform consultations for clinician and patient benefit.

Identifiants

pubmed: 31335942
pii: 5537379
doi: 10.1093/rheumatology/kez207
pmc: PMC7223265
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

367-378

Subventions

Organisme : Medical Research Council
ID : MC_PC_13042
Pays : United Kingdom
Organisme : Medical Research Council
ID : MR/K006665/1
Pays : United Kingdom

Informations de copyright

© The Author(s) 2019. Published by Oxford University Press on behalf of the British Society for Rheumatology.

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Auteurs

Lynn Austin (L)

National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care, Greater Manchester, Salford Royal NHS Foundation Trust, Salford.
National Institute for Health Research School for Primary Care Research, The University of Manchester.

Charlotte A Sharp (CA)

National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care, Greater Manchester, Salford Royal NHS Foundation Trust, Salford.
Centre for Epidemiology Versus Arthritis, Division of Musculoskeletal and Dermatological Sciences, School of Biological Sciences, The University of Manchester.
NIHR Manchester Biomedical Research Centre, Central Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre.
Alliance Manchester Business School, The University of Manchester.

Sabine N van der Veer (SN)

Centre for Epidemiology Versus Arthritis, Division of Musculoskeletal and Dermatological Sciences, School of Biological Sciences, The University of Manchester.
Centre for Health Informatics, Division of Informatics, School of Health Sciences, Faculty of Biology, Medicine and Health, Imaging and Data Sciences, Manchester Academic Health Science Centre, The University of Manchester.

Matthew Machin (M)

Centre for Health Informatics, Division of Informatics, School of Health Sciences, Faculty of Biology, Medicine and Health, Imaging and Data Sciences, Manchester Academic Health Science Centre, The University of Manchester.

John Humphreys (J)

National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care, Greater Manchester, Salford Royal NHS Foundation Trust, Salford.

Peter Mellor (P)

National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care, Greater Manchester, Salford Royal NHS Foundation Trust, Salford.

Jill McCarthy (J)

Alliance Manchester Business School, The University of Manchester.

John Ainsworth (J)

Centre for Health Informatics, Division of Informatics, School of Health Sciences, Faculty of Biology, Medicine and Health, Imaging and Data Sciences, Manchester Academic Health Science Centre, The University of Manchester.

Caroline Sanders (C)

National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care, Greater Manchester, Salford Royal NHS Foundation Trust, Salford.
National Institute for Health Research School for Primary Care Research, The University of Manchester.
National Institute for Health Research Greater Manchester Patient Safety Translational Research Centre, The University of Manchester, Manchester.

William G Dixon (WG)

National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care, Greater Manchester, Salford Royal NHS Foundation Trust, Salford.
Centre for Epidemiology Versus Arthritis, Division of Musculoskeletal and Dermatological Sciences, School of Biological Sciences, The University of Manchester.
NIHR Manchester Biomedical Research Centre, Central Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre.
Rheumatology Department, Salford Royal NHS Foundation Trust, Salford, UK.

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