What will it take for patients and clinicians to use data from mobile health apps and sensors in routine care? Watch how Linq, a new product from Open mHealth, offers a new "bring your own app" approach that puts the focus back on patients and clinicians rather than on technology.
4. How can digital health data be usable in clinical
practice in a meaningful, effective way?
5. Familiar challenges using digital health data
Impossible to keep
up with all the apps
Making sense of data
(and trusting it)
No easy way to
share data
Tracking is hard with very little reward
6. 1
2
3
Purposeful, collaborative use of data
Seamless sharing of data into clinical and personal
workflows
Clinical insights for stronger doctor-patient relationships
16. ● More positive experience
onboarding new meds
● Reduced med prescription &
fewer clinic visits
● Reinforcement of healthy
changes
● Personalized feedback &
goal setting
● Healthier outcomes
● Faster med titration: 2 months
vs. 3-6 months (less time= less
cost)
● Reduced medication dosage
● Fewer clinic visits
● Data to provide personalized
recommendations
● A healthier, happier patient
17. Dr. Michael V. McConnell, MD, MSEE
Preventive Cardiology Clinic, Stanford Medicine
18. Beyond hypertension
Understanding whether asthma is worse at
school, home, or somewhere else
Tracking course of recovery after hip surgery
Helping chronic pain patients find the most
effective pain medication at the lowest dose
Tracking sleep to see if lack of sleep is a
trigger for migraines
20. Open mHealth Platform
1 Open source data schemas: give 3rd party data clinical
meaning
2
3
Open source API wrappers: (e.g. Fitbit, Jawbone, Withings,
etc)
Open source data storage, processing and dataviz modules
1-stop toolkit! Coming soon!
openmhealth.org/developers
Imagine Sean: he’s 44, works long hours at a desk job, on the road a lot and doesn’t eat that well. He likes hanging out with his family, and doing things like grilling and go-karting. Exercising just isn’t part of his routine.
I’m Sean’s doc, and I saw him earlier this spring. His blood pressure was in the low 150s/90s, which is higher than the threshold of 140/90. A BP over 140/90 buys a formal diagnosis of hypertension, which means Sean has a higher risk for heart attack and stroke. This really worries Sean because his dad passed away from a heart attack in his early 50s.
Usually, we start meds at pressures over 140/90 but like many of us, Sean really wasn’t keen on starting meds. So we discussed other things he could do to reduce his pressure, including more exercise and losing weight. We agreed to see how much we could get his BP down by being more active -- going to a gym, and eating better.
So now it’s June, and he’s back to see me. After a couple of months of trying, like many of my patients, Sean wasn’t too successful. He joined a gym but went only a few times. He didn’t change his diet terribly much either.
His blood pressure is still over 140/90, so we start him on a daily dose of Benazepril at 10 mg, a pretty low dose. Our joint goal now is to get his BP under control through both meds and lifestyle changes, using the lowest possible dose of benaz. It would be so useful to us to track Sean’s BP as he starts his new medication, and this is where Linq comes in.
Linq allows me and Sean to create a tracking plan together, focused around his blood pressure and physical activity.
When I saved the tracking plan, Sean was sent an email inviting him to download the Linq app. He downloads it, logs in and accepts the invitation
and he is able to “bring his own app” to fulfill the tracking plan. Linq provides some advice on devices, and Sean chooses to buy a Withings blood pressure cuff, a FitBit, and he sort of went on a spending spree and got an Aria wireless scale too. He selects and connects all these up to his Linq account.
Of course, buying the gadgets is the easy part. Daily tracking is much harder! Linq sends Sean some strategies to remind him to take his blood pressure every day, including helpful reminder cards that he gets in the mail.
We know that most patients aren’t used to tracking, and not everyone is comfortable with technology, so from onboarding through regular use, Linq helps patients with make tracking as much a part of life as possible, with minimal burden. We are working with our designer Katie McCurdy to really understand what helps patients keep up with tracking, when it’s going to be a new behavior for many people. Having patients be part of the decision on what to track for how long is a big part of the solution too.
So as Sean starts tracking, his data is automatically pulled into his Linq app, and if I want, I can go take a look at it too in my clinician view, but I probably won’t.
After 3 weeks, I get a message in my medical record’s “In Box” that Sean’s average blood pressure is still over our goal of 140/90. This In Box is where I do all my clinical work, so this digital health data is coming to me just like any other test I order, which is what I need if I’m to use this type of data routinely.
Overall, Linq provided me and Sean a much more personalized experience with better health outcomes: Sean was able to experience the positive reinforcement of making healthy changes, and overall came out much better healthwise. For my part, I was able to titrate Sean’s meds weeks or months faster than usual, with less hassle, and with proper diagnosis of non-adherence. The shorter time span and fewer clinic visits means lower costs overall. More importantly, we developed a stronger doctor-patient bond and that is likely to pay dividends in the future.
We’re excited to be piloting Linq this fall with Dr. Mike McConnell at the preventive cardiology clinic here at Stanford. Let’s hear from Mike:
Thank you, Mike!
Now the Stanford pilot focuses on cardiology, but the Linq approach is useful whenever patient-generated data is needed between clinic visits. Some examples include:
- tracking asthma symptoms and inhaler use for kids: do they wheeze more at school? at grandmas?
- tracking pain and mobility after hip surgery to make sure they’re on the right trajectory
- tracking pain response to different kinds of pain medications to find the lowest effective dose
- seeing if the amount of sleep is related to migraines
These use cases require some of the same data we need for a case like Sean’s but also other kinds of data.
Here are some of the apps and devices that Linq connects to so far. We’ll be adding many other types of data, including other data sources like HealthKit. This will give patients greater flexibility over Bring Your Own App, the apps and devices they want to use. For example, we’re excited about connecting to a new med adherence tracking system called nVolve which for a patient like Sean, would have given me direct data on exactly when he was and wasn’t being adherent.