Health systems face hurdles in efforts to use mobile to cut readmissions

While a pair of physician-led mobile health projects are producing respectable returns on investment, project leaders acknowledge that there are still challenges to overcome.

One project, involving the University of Pittsburgh Medical Center (UPMC) and Partners Healthcare, is a remote monitoring pilot for congestive heart failure patients aimed at reducing hospitalizations and providing physicians with real-time data. So far. it has decreased readmission rates by nearly half of the national rate average, but it was not without hurdles, according to a Healthcare Informatics article.

Bringing about culture change for physicians was one issue, Ravi Ramani, M.D., director of the Integrated Heart Failure Program at UPMC, said in the article.

"As a physician, I'm used to seeing patients every three to six months and they come to my office, I deal with the acute problem then and there and then move on," Ramani told Healthcare Informatics. "Instead of that, I'm getting these vast realms of data, and if you think about every patient, that means I'm getting a thousand blood pressure readings every day. And most doctors are already very busy as it is."

The project team made some tweaks using stakeholder feedback and created a more patient-centric strategy that is proving more efficient. One change included streamlining alerts sent to physicians, he said.

Using mobile technology to stem readmission is an increasing focus for providers and caregivers. A Canadian hospital is deploying a mobile app to track bigger patient populations in and out of the hospital, according to mHealth Intelligence. A San Diego-based health system is using a text-messaging coaching program to keep patients from being readmitted to the hospital.

Another hospital that faced challenges with its own mobile health project was Duke Medicine. The health system wanted to integrate patient-generated data into an electronic health record system via Apple HealthKit, with a goal of reducing hospital readmissions. The biggest hurdle, however, has not been the technology, but rather the workflow, according to Ricky Bloomfield, director of mobile technology strategy at Duke.

"It's the individual workflows and the fact that every clinic might want to do it a different way, because of the staff on hand and the ratio of nurses to clinicians," Bloomfield told Healthcare Informatics.

For more information:
- read the Healthcare Informatics article