BOSTON, MA -- A recent pilot study conducted by Partners HealthCare Connected Health demonstrated that a secure Web-based self-management program for heart failure patients is an effective way to improve patient engagement and reduce hospital utilization. The study was designed to engage patients in self-managing their heart failure through objective data collection and feedback using the iGetBetter system, and personal connected health devices that are currently available to consumers. This study was published in the April issue of the Journal of Medical Internet Research’s mHealth and uHealth journal (JMU).
Ninety-five percent of study participants reported feeling more connected to their healthcare team and more confident in performing their care plan activities. Over half of participants had an 89% daily adherence rate with the iGetBetter system. Twenty ambulatory, clinically stable adult heart failure patients (median age, 53 years) completed the three-month study. The study was conducted at the outpatient clinic of the Massachusetts General Hospital (MGH) Heart Center's Heart Failure and Cardiac Transplant Program.
"The fact that over half of our study population had 89% adherence to their daily care plan for the duration of the study is very encouraging and unprecedented when compared with other web-based self-management programs for heart failure," said Kamal Jethwani, MD, MPH, Senior Director of Connected Health Innovation at Partners HealthCare, and the Principal Investigator on this study. "We believe the portable, user-friendly devices and wireless technology used in this study played an important role in improving engagement."
The iGetBetter system includes a web platform, interactive voice response (IVR) telephone system and wireless personal connected health devices that measure and collect key vital signs. Patients received a Bluetooth weight scale and self-inflating blood pressure cuff to measure their weight, blood pressure and heart rate each morning. Participants were also provided an iPad Mini tablet computer equipped with cellular connectivity to view their measurements via the Internet. The IVR system provided patients with an alternative way to manually record their measurement and care activities.
Of the 20 study participants, 11 (55%) consistently logged into the web portal to view their data; 64% viewed their measurements daily. Over 80% of patients reported they found the web portal to be helpful and easy to use.
Overall, hospital utilization was comparable to control groups identified from Partners EMR system. However, the mean duration of hospital stays for unplanned admissions in the EMR-matched control group was over twice as long as that for study participants. Although not statistically significant, study participants also recorded fewer 30-day readmissions than controls.
“Our study results failed to achieve statistical significance due to the small sample size, but the trends across all outcomes are encouraging, and a future well-powered study could show vast savings in readmission costs,” added Stephen Agboola, MD, MPH, a co-investigator on the study and a research scientist on the Connected Health Innovation team.
Study participants also reported improved quality of life measures. Sixteen of the 20 participants (80%) believed their heart failure was better controlled as a result of the intervention. Patients also reported feeling more empowered to carry out their self-care activities at home with the help of the iGetBetter system.
"This is an important study evaluating the use of a web- and telephone-based remote monitoring program using portable, wireless and easy-to-use personal connected health devices to engage heart failure patients in self-managing their disease outside of the hospital setting," added Joseph C. Kvedar, MD, Vice President, Connected Health, Partners HealthCare. "While additional study is required, we are quite encouraged by the results and believe that mobile-based, heart failure self-management can play an important role in improving disease management and clinical outcomes."
This pilot study was funded by iGetBetter, Inc.