229277 Promoting chronic condition management through mobile technology

Monday, November 8, 2010

Andrew Steele, MD, MPH, MSc , eHealth Services, Denver Health and Hospital Authority, Denver, CO
Henry Fischer, MD , Community Health Services, Denver Health and Hospital Authority, Denver, CO
Susan Moore, MSPH , Health Services Research, Denver Health and Hospital Authority, Denver, CO
David Ginosar, MD , Community Health Services, Denver Health and Hospital Authority, Denver, CO
M. Josh Durfee, MSPH , Health Services Research, Denver Health and Hospital Authority, Denver, CO
Raymond Estacio, MD, FACP , Community Health Services, Denver Health and Hospital Authority, Denver, CO
Background. Health information technology provides benefit for managing complex chronic conditions outside the traditional clinic setting. Limited information is available on the impact of health informatics applications on health outcomes among medically underserved groups, yet underserved patients are receptive toward technology-based information sharing with care providers. Cell phone access has been positively associated with knowledge of health information knowledge, in turn associated with better health outcomes. High rates of cell phone access are reported among populations that exhibit low rates of computer and internet use. Over half of all Americans have used cell phones for data-related activities.

Objective/Purpose. This pilot study proposes to demonstrate improvements in attendance rates and diabetes self-management among adult diabetic patients in an urban safety net population by providing between-visit reminders and chronic disease support through cell phone text messaging.

Methods. 75 adult diabetic patients with cell phones who receive care at federally qualified community health centers will participate. Patients will receive three text message reminders before health care appointments and will be asked to provide fasting blood sugar levels by text message three times per week. Case coordinators will review messaging data and follow up with patients by phone according to clinical guidelines.

Results. Appointment attendance and text message response rates will be examined over four months. Clinic visit versus emergency service utilization will be evaluated. A purposively-selected sample of patients will provide input through focus groups and exit interviews. Common response themes will be identified through content analysis.

Discussion/Conclusions. Diabetes has tremendous impact on patients and healthcare systems, affecting over 20 million patients with projected costs of $192 billion by 2020. Mobile technology may be effectively used to assist patients with diabetes care. Improving patient self-management and appointment attendance can lead to improved health outcomes, reduced health care costs, and better quality of care.

Learning Areas:
Chronic disease management and prevention
Communication and informatics
Provision of health care to the public

Learning Objectives:
1) Discuss how mobile communications technology can be used to promote patient-provider communication. 2) Describe ways in which health information technology can be used to assist with chronic condition management.

Keywords: Chronic Diseases, Underserved Populations

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am qualified to present on this project because of my dual role as co-investigator and research project coordinator. In addition to work conducted in the department of health services research, including having served as a qualitative analyst on an AHRQ task order assessing the impact of a dynamic chronic care registry on the quality of care for diabetes, and experience gained while pursuing my PhD in Health and Behavioral Sciences at the University of Colorado Denver, which as a program includes emphases on the social sciences and the application of qualitative research in health care, I also have eight years of information technology industry experience in project design, implementation, coordination, management and oversight.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.