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With companies like Apple entering the mHealth market, the growth of health and fitness apps had begun to outpace overall app growth. However, a recent survey found only 21% patients use health IT tools to access their health data and only 36% use electronic health records to monitor their health data. In the same survey, 71% of respondents aged 18-34, reported that they wanted to use a mobile app for health data and preventative care activities. Many organizations are using the chronic care model (CCM) and patient engagement to support patient’s self-management and a greater responsibility in their healthcare. The hardest thing for a patient with a chronic disease is behavioral change, and without this type of change real success is hard to obtain. But in the patient centric CCM model, patients are more included, and through communication and access to health records they gain a perspective and a measure of control in their healthcare that can have sustainable results.

I recall a decade ago when showing patients their blood glucose readings on a graph and discussing the results, the interaction would change from unidirectional to a conversation for what strategies they could use to avoid wide variances in their glucose readings. Seeing data displayed gave them a perspective and a target with motivation to achieve, almost a gamification of sorts. The Framingham risk model is another example of how we might be able to use technology and data to bring patients forward and motivate them. This model takes non-modifiable input (i.e. gender/age) and modifiable input (i.e. BP/smoking/cholesterol) and then calculates the 10 year cardiovascular disease risk (i.e. stroke/MI/death). In the patient-centric model, where we want a patient to be informed and modify their behavior, wouldn’t it be great if they had a visual way to see how current and prospective modifiable risk factors affected their risks? A patient logging into their patient portal or health care app, thank you Epic, could see today’s values and play around with “what if” scenarios. For example, a 50 year old diabetic male who smokes, has low HDL and systolic blood pressure of 125 mm/hg could see his risk lower from 26% to less than 15% just through smoking cessation (although that’s still twice the norm). Making other modifications to his health, like exercise, could lower his blood pressure and raise his HDL, further reducing the chance of some very bad outcomes. When new lab results are posted to the electronic health record he could receive a notification that he just lowered his cardiovascular age lower than his actual age: “Way to go!” If the results show that he is not doing well, then there could be pharmacist-driven patient engagement to look at shared goals and ways to achieve them through targeted strategies of the CCM.

« Framingham Risk score Calculator using Lipids

If patient engagement is going to be successful using mobile technology, then it has to emulate other app functions and design. With the pace of today’s connected world, we have apps that visualize cause and effect for changing numbers with our mortgage or changing in values to find our happy place with airline reservations to see the impact on our fare if we leave a day early or change airports. Why should your healthcare app work any different? Answer, it shouldn’t. CT

Dr. Marc Young, Pharm.D., M.S., B.C.P.S, P.M.P., F.A.S.H.P. is chief strategy officer for Nationwide Pharmaceutical, which focuses on four core areas: business consulting (pharmaceuticals and technology); data analytics and audits; litigation support; and pharmaceutical repackaging. Marc was commissioned as a naval officer and served 20 years under various assignments in critical care settings before moving into the informatics arena as a project and program manager.

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