Mobile health device usage leads to fewer deaths, hospitalizations

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 - Cardiology Phone
Top: Intracardiac echocardiography (ICE) Doppler image of left pulmonary veins. Bottom: Registered CT image of a left atrium with a projected electrical activation on its shell.
Source: Biosense Webster (top) / Siemens Healthcare (bottom)

Living in a technological era could mean quicker, more accurate and even smartphone-linked medical diagnoses, one study of mobile health device use in India has suggested.

Lead researcher Partho P. Sengupta and colleagues spent a year studying 253 patients with rheumatic and structural heart diseases (SHD) in an effort to better understand the efficiency and accuracy of mobile health (mHealth) devices, they wrote in a paper published in the Journal of the American College of Cardiology.

Pocket-sized medical technology has been helpful in large, resource-limited areas that are hurting for clinics and well-trained healthcare professionals to run them, Sengupta and co-authors wrote in their study. Due to a “global burden” of cardiovascular disease and a lack of sufficiently trained doctors, resource-limited regions are predicted to see more than 25 million deaths by 2030.

The possibility of more portable technology as a solution for these areas, then, is an attractive one. While Sengupta and colleagues mention several devices in their study, “the impact of technology-based care on long-term outcomes has not been rigorously evaluated,” they wrote.

All outpatients selected for the study had either a new or established diagnosis of SHD, according to the research. The group of more than 200 was randomized and split in two: 139 patients were sent for initial diagnostic assessments at an mHealth clinic equipped with wireless devices, and 114 were diagnosed with standard-care techniques. According to their paper, Sengupta’s team predicted the mHealth clinic would result in quicker diagnoses and a shorter time to treatment.

Mobile health clinics were stocked with gadgets that assessed structural and functional abnormalities at point-of-care, including pocket echocardiography, vital signs with smartphone-connected oximetry and blood pressure monitors, 6-minute walk tests with a trial-axial activity monitor, cardiac rhythm abnormalities classified by a smartphone-connected iECG and point-of-care testing with fingerstick B-type natriuretic peptide.

Of the 139 patients who received care at an mHealth clinic, Sengupta’s team noted that 47 individuals—34 percent of the group—underwent valvuloplasty and/or valve replacement, and 21 patients—15 percent—were either hospitalized for cardiovascular complications or died. In the second randomized group, which received no mHealth care, fewer patients—a 32 percent minority—underwent valvuloplasty and/or valve replacement, and more patients died or were hospitalized—28 percent of the cohort compared to 15 percent that received mobile healthcare.

Twice as many patients randomized to the mHealth group were undergoing treatment for their heart problems 90 days into the study, Sengupta wrote, while the standard care subjects had a longer average duration from enrollment in the study to primary outcome. Hospitalization and death were significantly lower in patients who received smartphone-connected care.

Sengupta and colleagues concluded mHealth products can be successful aids for doctors who are low on staff in unsupported geographical areas.

“Point-of-care mHealth devices used to assess the severity of symptoms, structural and functional abnormalities can be used at the point of care as clinical decision support tools,” the study’s authors wrote. “These data have important implications for the use of pocket echocardiography and smartphone-connected mHealth devices at the point of care as clinical decision support tools in the healthcare system of resource-limited areas.”