90 days of self-tracking via mobile app = 40% readmission reduction

The Mayo Clinic recently announced the results of a study that measured the impact that a smart phone had on the readmissions rates and ER utilization rates of heart attack patients recovering from stent surgery. As Mayo is an investor in Axial, we tend to keep an eye on their innovative work within the patient engagement space. This particular study was funded by the BIRD foundation and was presented at the American College of Cardiology's 63rd Annual Scientific Session in Washington D.C. 

Study Overview and Results

The study involved 44 patients: 25 patients used the app and 19 followed conventional recovery without the app. For 90 days, the app users viewed educational content and tracked:

  • weight
  • blood pressure
  • blood sugar
  • physical activity
  • diet

 

The results were compelling:

  App Users Non-App Uers
Readmitted or Visited ER 20% 60%

 

Additionally, the app users had lower body weight (9 lbs) and lower blood pressure (8mmHG). The study indicated that there was a dose-response phenomenon with the app. That is, the more patients used the app, the better their metrics looked.

 

From the Researcher's Mouth

 

R. Jay Widmer, M.D., Ph.D., a Mayo Clinic fellow and the lead researcher on the study, had some choice quotes in a recent interview:

“The takeaway is that digital health, mobile health, can be used for cardiovascular disease prevention, especially in a high risk group. But the success of an intervention does depend on the use and the amount of use. This is something that can be used to reduce disease burden across the healthcare system at times when paying for value is going to be at a premium.”

“The application is really set up as a patient-centered self-monitoring system,” Widmer said. “We ask the patients when they first log in to insert all of their own metrics so when they start cardiac rehab, they input their own blood pressure, weight, glucose, minutes of physical activity, and their diet so they can get a good idea of where they stand with cardiac disease prevention. Then the patient can log in either on a day-to-day or every other day basis and they are asked to again log some of those numbers, as well as perform a few educational tasks.”

“Patients who had a more frequent number of logins and the amount of time they logged in, as that increased, the patients’ blood pressure dropped more precipitously,” he said. “So there was a dose-response [relationship] between the use of the intervention and the secondary measures of cardiovascular disease we examined. … Patients were less stressed as they used the application more and had a better diet and more physical activity as they used the application more.”

Bottom Line

I know many leaders are still on the fence about deploying a true mobile engagement platform that goes beyond the administrivia of patient portals. The truth is that engagement is more about daily self-care than it is about logging into a web portal to pay bills and request appointments. And, studies like this one show that daily self care reduces utilization. We also know that at least 25% of all utlization is driven by patient behavior. In order to capture shared savings dollars, health leaders must offer patients the information and tools they need for daily self care.  

Inertia exerts a powerful force on a health organization to just check the patient engagement box via the EHR vendor's portal offering. I realize that EHRs are expensive and leave behind enourmous sunk costs. Be aware that those sunk costs might be blinding you from an emerging opportunity for improved outcomes and profits.