California Initiative to Advance Precision Medicine Personal Mobile and Contextual Precision Health
This project developed a mobile health application to collect patient-reported data about blood pressure, mood, movement, and medication adherence. Led by Nicholas Anderson, PhD at University of California, Davis.
Background
Mobile Health Applications
Mobile phones have the ability to transform health care because they can collect and deliver patient-generated data to health care providers, as well as keep patients on-track beyond in-office appointments. For example, a mobile application could send a reminder to take medication, and allow the patient to record when they took the medication, and send that record to their doctor. Incorporating this information with an electronic health record (EHR) could enable a physician to, for example, assess a medication's effectiveness in a psychiatric patient by connecting a medication change to a mood change. Mobile health applications also allow patients to track their own progress over time using simple visualizations within the platform, which increases patients' role in monitoring their own health, although it's unknown if this behavior leads to better outcomes.
High blood pressure and depression are ideal conditions to monitor with mobile health applications. Patients who have or are at risk for high blood pressure can wear a blood pressure cuff that uses Bluetooth technology to wirelessly transmit blood pressure readings to an application on a mobile phone. For patients with or at risk for depression, a mobile app can be used to complete and submit questionnaires that measure their current mood. Taken between a patient's weekly or monthly in-person medical appointments, these mobile measurements can give the practitioner a better view of the patient's day-to-day status.
Central to the discussion about mobile health applications is consideration for patient privacy and informed consent. According to the U.S. Department of Health and Human Services, the federal Health Insurance Portability and Accountability Act (HIPAA) establishes privacy standards for medical records and personal health information, and sets limits and conditions on the uses and disclosures of the information without patient authorization. Any mobile health application that collects, stores, or transmits specified health information is subject to HIPAA.
Project
This project aimed to develop and evaluate a HIPAA-compliant mobile health application designed for sending alerts and collecting, monitoring, and reporting patient-generated data about blood pressure, mood, movement (steps), and medication compliance.
Over the course of the project, the research team 1) established policy, privacy and legal frameworks for linking data providers, and clinical and personal data, 2) developed a digital platform to record and report patient blood pressure, mood, physical steps, and medication use, and 3) evaluated application engagement and care plan adherence, with both quantitative and qualitative metrics.
Research Team and Collaborators
Research Team
- University of California, Davis
- Nick Anderson, PhD
- Madhan Dharmar, MD, PhD
- William Riedl, MS
- Michael Lehman
- Christopher Lambertus, MS
- Brad Pollock, MPH, PhD
- University of California, San Francisco
- Ida Sim, MD, PhD
- Meghana Gadgil, MD, MS
- Jason Satterfield, MD
- Mitch Feldman, MD
- Tim Satterwhite, MD
- Amy Lozano
- Sarah Chatfield
- Vijay Rayanker
- University of California, Berkeley
- David Lindeman, PhD
- Dan Gillette, MS
Collaborators
- Overlap Health, San Francisco
- David Haddad, MsC
- iHealth