ACCEL interviews and topical summaries of cardiology ’ s most interesting research areas
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American College of Cardiology Extended Learning
ACCEL interviews and topical summaries of cardiology ’ s most interesting research areas
What ’ s News ? The Latest in mHealth
Digital health or mHealth ( as in mobile health ) is used to describe the new technologies that bring health and fitness to patients via diet and exercise applications ( or apps ) or wearable technologies , such as those that measure steps , calories burned , and stairs climbed .
How accurate are they ? Recently investigators evaluated four different products and all the activity monitors tested were accurate in their step detection over the variety of different surfaces tested ( natural lawn grass , gravel , ceramic tile , tarmacadam / asphalt , linoleum ), when wearing both running shoes and hard-soled dress shoes . 1 A recent systematic review concurred , suggesting high validity for devices used to track steps taken , but lower validity for energy expenditure and measurement of time spent sleeping . 2 In general , 2,000 steps equal about 1 mile .
Elizabeth A . Jackson , MD , an assistant professor of medicine at the University of Michigan Health Center , said tht “ there is real evidence to suggest that people can change behavior ( i . e ., regular physical activity ) and evidence that these devices can change dietary behavior when combined with peer support .”
When you are done with this issue of
Elizabeth A . Jackson , MD
CardioSource WorldNews , go to the September issue of ACCEL and listen to the interview with Bonnie J . Spring , PhD , who discusses data demonstrating how valuable this technology can be in getting patients to make positive changes in their diet and activity habits .
This is an important topic : as the $ 3 trillion health care industry moves more towards consumer choice , increasing numbers of individuals are taking an active role in their overall health and wellness . Consumers are taking on more risk for managing their own care , and the industry is responding in kind by rolling out new products and services that empower them to do so . One problem : the wave of sophisticated wearables and self-diagnosis tools may be off target . As the saying goes , all that glitters is not gold : there are tons of great-looking apps out there that don ’ t do much .
David E . Conroy , MD , noted recently that more than half of American adults own smartphones , and half of those owners use some type of fitness app . He and his team identified the 100 top-selling health and fitness apps in the Apple iTunes and Google Play marketplaces .³ They looked for any of 93 possible behavior-changing techniques in the apps , including social support , instructions , demonstration , feedback , goal settings , prompt , and self-monitoring of behavior . Overall , there was an average of about seven ( OK , it was 6.6 ) such techniques per app .
The good news : there is a base of evidence supporting some of those behavior-changing techniques Conroy and colleagues evaluated ; the bad news is that ’ s not what the most popular apps are providing . Most of them had attractive interfaces , sure , but the apps favored behaviorchanging techniques with a modest evidence base over others with more established evidence of efficacy . Overall , almost all of the apps are busy trying to find ways to help the user connect with Facebook , Twitter , and Instagram rather than promote active self-monitoring by users .
Don ’ t necessarily blame the consumer here . In late June , a survey demonstrated that people don ’ t crave the latest fitness wearable . Their overwhelming preference is for simple applications that provide and organize information .
The survey of 500 people was conducted for PwC ’ s Strategy & ( that ’ s not a random abbreviation and a typo , by the way !). With spelling and spacing issues taken care of , here is what the survey found :
• The five most preferred features were out-ofpocket cost estimators , simple access to health records ( both online and mobile ), mobile post-care instructions , online appointment scheduling with in-network providers , and a centralized payment portal to both health plan and provider .
• The second category , labeled as “ Nice to Have ,” included things that would enhance current health plans , such as telehealth and mobile consultations , personalized health and wellness predictors , and ratings tools for quality transparency .
• Even though wearables linking to health records and remote monitoring systems may be flashy ( and enticing to health care providers and necessary to gather data to evaluate their worth ), consumers rank those among the least important , along with health goal-management programs and interactive tools for self-diagnosis .
And people are not shy about sharing : 97 % of those surveyed said they are willing to share personal health data , with just a few ranking data privacy as an important feature of a health plan .
What ’ s News ? If you are interested in mHealth , check out http :// mobihealthnews . com . Here is some recent news :
June 22 , 2016
July 5 , 2016
July 7 , 2016
July 7 , 2016
Ochsner Health System in New Orleans was able to get a little over two-thirds of their out-ofrange hypertension patients within range in 90 days by having those patients measure their blood pressure once a week with a connected device .
UnitedHealthcare teamed with a health coaching startup Vida for a study of 1,000 high-body mass index patients . Over a period of 5 months , > 58 % lost weight , including 30 % who lost more than 5 % of their body weight . At baseline , 31 % of the group had a systolic blood pressure > 140 mm Hg . Using various means , coaching reduced that to 11 % at 5 months .
Investment in digital health for the first half of 2016 reached $ 3.9 billion , breaking funding records and showing a robust market that is expected to continue growing .
The National Institutes of Health ( NIH ) has launched a Participant Technologies Center to test and maintain connected sensor technologies as part of the White House ’ s Precision Medicine Initiative . Towards that end , the NIH has awarded $ 120 million to Scripps and others to enroll 350,000 participants in the program via mobile apps .
ACC . org / CSWN CardioSource WorldNews
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