mHealth Technology and Clinical Integration of Patient-Generated Health Data (PGHD) for Improving Patient Engagement

Purpose: mHealth technologies are becoming an integral part of everyday life; this is particularly true among people suffering from chronic health conditions. Sixty two percent of Americans with 2 or more chronic conditions track a health indicator; of those, 45% have Diabetes Mellitus. While using sensors and technology has the potential to empower patients to better understand their disease and help them in self-management, technologic limitations exist due to the lack of integration of patient generated health data (PGHD) into the Electronic Health Record (EHR) thereby limiting it’s availability to their healthcare team. Focus group participants with live with diabetes identified that partnering with their healthcare professional by sharing PGHD could lead to a more meaningful support in establishing personalized health goals, monitoring progress, and getting targeted feedback to help shape their lifestyle choices to achieve their health goals.

Methods: The team compared and evaluated different commercially available sensors and apps which tracked physical activity and nutrition data. We also identified mHealth technology that can serve as a connector to direct the data collected by the sensors to the EHR.  Using an iterative process, the Information Technology team at our institution developed the necessary platform and dashboard for the sensor data within the EHR.  The advisory boards for this project (patient, provider and technology) were actively engaged in all phases of the technology development including: designing, implementation and testing of the technologies. 

Results: Among the different sensors evaluated, the Basis PEAK was selected for its data quality and compatibility with Apple HealthKit.  The Basis PEAK tracked and shared physical activity data and  My Fitness Pal, was determined to be best suited to collect information on the patient’s daily nutritional choices.  Apple HealthKit was chosen as the connector which directed the data to the EHR (EPIC) using the MyChart app.  MyChart App will manage patient authentication and allow for control over what data elements from the sensor is shared with the healthcare provider. Within the dashboard, the patient and provider have the ability to choose and visualize PGHD and clinical parameters such as HbA1c, LDL, triglycerides, etc., to be displayed within the same graphical view which has the potential to lead to a more meaningful clinical conversation based on goals set by the patient and the associated metrics highlighting progress toward those goals.  

Conclusion: mHealth technologies have the potential to support a person’s effort to engage in sustainable lifestyle choices which can lead to better self-management of their disease.  These technology solutions can play a critical role in improving the health of patients living with diabetes not only by empowering the patient but also by enhancing patient-centered healthcare interactions.