By Martin Seneviratne, MD
Over 5.7 million American adults suffer from heart failure, and the total economic burden on the health system is predicted to exceed $70 billion by 2030. In recent years, heart failure has been a breeding ground for digital health innovation, in part because of value-based care incentives and readmission penalties. Many questions remain. How do we embed digital health tools into clinical workflows in a meaningful way? How can technology help patients to better manage heart failure at home?
As one of five international finalists in the Nokia-Medicine X Digital Health Challenge, a team of researchers from Johns Hopkins University, sought to integrate smart health devices (watches, scales, and blood pressure monitors) into the routine care of heart failure patients.
Using Everyone Included principles, with patients and caregivers deeply involved in the study design, the team set up 33 chronic heart failure patients with a suite of connected health devices during a 30-day study period.
The key finding was that at the end of the study period, patients reported increased confidence in identifying health problems and knowing when to seek help.
Dr. Michael Yu, one of the study leads, was impressed at the level of engagement he saw from the patients. Patients wanted to access their own health data, and do it in real-time so that they could see the effect of certain behaviors on their weight and blood pressure. Many of the patients continued to use their devices after the trial had ended.
However, the implementation was not without challenges. It takes a lot of effort to support patients as they adopt a new digital health tool into their lifestyle. It helped to have a responsive care team for troubleshooting, centered around an existing clinic that the patients were familiar with.
Dr. Rosanne Rouf, another lead investigator, emphasizes the importance of generating evidence for digital health interventions. It is key to find the right population and the right environment for these tools to be useful. “Heart failure is a chronic and complex illness requiring frequent and regular visits to the same team of providers. We predict that using this technology will help reduce the number of those visits and may reduce admissions to the hospital for heart failure, thus improving the overall quality of life.”
Other researchers involved in this study include co-lead investigator, Seth Martin, MD; Oluwaseun Fashanu, MBBS, MPH; Lochan Shah, BA; Vasanth Sathiyakumar, MD; Sierra Decker; Ali Sobhi Afshar, Ph.D; Ritesh Shrestha, MD; Francoise Marvel, MD; Ryan Demo, BS, MS; Matthias Lee, Ph.D; Bao Chau Ly; Debra Decker; Sami Badra; Robert Buchmeier; and Thomas Fise.
Study leads Rosanne Rouf, MD & Michael Yu, MD