UIC’s Ben Gerber: Mobile's role in healthcare still being defined

Doctor Computer and Gadgets
Ben Gerber

University of Illinois at Chicago researchers will kick off a five-year, $4 million federally-funded study next year on how texting and video can improve diabetes management among Hispanic and African American patients. Co-principal researchers Ben Gerber, a professor of medicine at UIC, and Lisa Sharp, an associate professor of pharmacy systems, outcomes and policy at the school, will lead the research effort, supported by the National Institute of Diabetes and Digestive and Kidney Diseases.

The effort, involving 220 participants, will tap text to help remind patients about medication intake and provide support messaging. The video tool, via tablets, will let health coaches connect with pharmacists during patient home visits.

FierceMobileHealthcare spoke to Gerber for insight on the research and to get his views on the potential value of such tools in patient care and treatment.

FierceMobileHealthcare: What prompted the grant effort?

Ben Gerber: We recognized that mobile health tools are becoming ubiquitous. However, there have been few rigorous studies to evaluate their impact on health outcomes, particularly beyond six months or a year. The technological advances outpace the slow progress of research.

In addition, we see high cellphone ownership in our patient population and interest in its use for communication. Our preliminary work demonstrated good feasibility using text messaging for communication, and in the proposed study will leverage community health workers who maintain strong, supportive relationships with patients to help them with their diabetes.

FMH: Is this the first federal grant supporting mHealth study and research at UIC?

Gerber: The mHealth study builds off of a current study working with community health workers and clinical pharmacists in diabetes management. However, that study did not include any mHealth components. Most of the mobile health research at UIC to date includes “pilot studies” that show feasibility or acceptability of interventions such as text messaging or Fitbit monitoring of physical activity. This study will be much larger (220 subjects) and of a longer duration (24 months), with a rigorous study design in place (randomized controlled trial).

FMH: The study will include text messaging and video conferencing. Why are these two specific technologies being tapped?

Gerber: The text messaging is designed for communication primarily between community health workers and their clients (including reminders, providing social support and promoting diabetes self-management). However, the video conferencing will enable patients to receive clinical pharmacist support from home. These interactions may include medication reconciliation, adherence assessment and intensification of therapy.

The complexity of management and therapy of these patients requires frequent contact, and we will determine if video conferencing will successfully support these needs without requiring patient travel.

FMH: What will be the ratio in terms of how many patients per coach? Also, will these patients be studied for five years?

Gerber: The number of patients per health coach (or community health worker) varies, and depends on patient location, frequency of contacts, patient complexity and other factors. In a previous study, health coaches worked with no more than 30 patients at one time. Patients will remain in the study for two years. Because enrollment occurs over one to two years, we anticipate at least five years are needed for data collection.

FMH: How do you view mobile technology's role in healthcare at this point?

Gerber: Mobile tech is still rapidly being defined in healthcare. In the space of diabetes care, its impact relies on other trends including insurance coverage and availability of chronic disease management programs. As with other healthcare interventions and electronic health records, implementation and diffusion of innovation are slow, and side effects or unwanted consequences remain unknown. Another issue that has been understudied is cost-effectiveness.

FMH: What are top challenges when deploying mobile tools into patient interaction?

Gerber: Long-term patient adoption remains a challenge. While there may be novelty early on in these new tools, over time, enthusiasm declines or life stressors arise. Many of our mHealth tools do not take individual patient context into consideration. Generic interventions that do not take into account patient’s needs, values, circumstances, progress, environment, etc. are less desirable.

Editor's Note: This interview has been edited for clarity and length.

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