Assessing the Impact of Patient-Facing Mobile Health Technology on Patient Outcomes: Retrospective Observational Cohort Study (Preprint)

• DOI: 10.2196/preprints.19333
• Publication Date: 2020-04-20T19:40:01Z
• Authors: Courtenay R Bruce; Patricia Harrison; Tariq Nisar; Charlie Giammattei; Neema M Tan; Caitlin Bliven; Jamie Shallcross; Aroub Khleif; Nhan Tran; Sayali Kelkar; Noreen Tobias; Ana E Chavez; Dana Rivera; Angela Leong; Angela Romano; S Nicholas Desai; Josh R Sol; Kayla Gutierrez; Christopher Rappel; Eric Haas; Feibi Zheng; Kwan J Park; Stephen Jones; Paul Barach; Roberta Schwartz
• Keywords: mHealth; Odds

<sec> <title>BACKGROUND</title> Despite the growth of and media hype about mobile health (mHealth), there is a paucity literature supporting effectiveness widespread implementation mHealth technologies. </sec> <title>OBJECTIVE</title> This study aimed to assess whether an innovative technology system with several overlapping purposes can impact (1) clinical outcomes (ie, readmission rates, revisit length stay) (2) patient-centered care patient engagement, experience, satisfaction). <title>METHODS</title> We compared all patients (2059 patients) participating orthopedic surgeons using nonparticipating (2554 patients). The analyses included Wilcoxon rank-sum tests, Kruskal-Wallis tests for continuous variables, chi-square categorical variables. Logistic regression models were performed on gamma-distributed model All adjusted demographics comorbidities. <title>RESULTS</title> inpatient rates group when higher demonstrated odds ratios (ORs) 30-day readmissions (nonparticipating 106/2636, 4.02% 54/2048, 2.64%; OR 1.48, 95% CI 1.03 2.13; &lt;i&gt;P&lt;/i&gt;=.04), 60-day 194/2636, 7.36% 85/2048, 4.15%; 1.79, 1.32 2.39; &lt;i&gt;P&lt;/i&gt;&amp;lt;.001), 90-day 261/2636, 9.90% 115/2048, 5.62%; 1.81, 1.40 2.34; &lt;i&gt;P&lt;/i&gt;&amp;lt;.001). stay cohort was longer at 1.90 days, whereas 1.50 days (mean 1.87, SD 2 vs mean 1.50, 1.37; Patients treated by received read text messages 83% time emails 84% time. responded 60% 53% email surveys. least responsive digital monitoring questions hospital asked them &lt;i&gt;do&lt;/i&gt; something, they most engaged that &lt;i&gt;did not&lt;/i&gt; require action, including informational content. A total 96% (558/580) indicated high satisfaction support their care. Only 0.40% (75/2059) &lt;i&gt;opted-out&lt;/i&gt; program after enrollment. <title>CONCLUSIONS</title> novel, multicomponent, pathway-driven, patient-facing positively patient-reported experiences. These technologies empower play more active meaningful role in improving outcomes. There deep need, however, better understanding interactions between patients, technology, providers. Future research needed help identify, address, improve usability effectiveness; understand provider attributes adoption, uptake, sustainability; (3) factors contribute barriers adoption how best overcome them.