Transforming the care of atrial fibrillation with mobile health

Abstract

Atrial fibrillation (AF) is a multifaceted and highly variable disease that is often difficult to manage within the traditional health-care model. The conventional model of regular or pre-scheduled appointments with physicians or allied health professionals is poorly suited to the unpredictable and often urgent clinical needs of patients with AF. Mobile health (mHealth) has the potential to dramatically transform the delivery and quality of AF care. In this brief review, we summarize the current limitations and evidence gaps in treating patients with AF. We then describe the current mHealth landscape, changes in telehealth coverage and reimbursement, and recent technological advances of smartphones, mobile applications, and connected wearable devices. We also describe important barriers and challenges, such as clinical management of large volumes of data, application of predictive analytics/machine learning, and the need for high-quality randomized clinical trials.

Assessing the global reach and value of a provider-facing healthcare app using large-scale analytics

“… 47 The present work expands on previous app-related studies by enriching our understanding of how factors such as provider role and country income level relate to adoption and use of this type of resource. Prior work 10 16–18 20 21 set the stage for this study by demonstrating the feasibility of using backend analytics to monitor usage patterns. It was natural to add another dimension to these studies by tying in an examination of the demographics of the user base.…”

“…In addition, the existing studies in the literature have been primarily focused on mHealth apps used by patients. Such studies include behavioural interventions, 8 9 ‘wearables’ for cardiology research 10 and improvements in diabetes management. 11–15 It has become important to understand the drivers of app download by patients and subsequent app usage, and app-based analytics have been used to validate interview-based findings in this area.…”

National Heart Foundation of Australia and the Cardiac Society of Australia and New Zealand: Australian Clinical Guidelines for the Diagnosis and Management of Atrial Fibrillation 2018

“…eHealth can be used across all stages of the disease-management pathway, from screening and diagnosis, to decisionmaking around treatment selection, to ongoing therapeutic monitoring and management [380,381]. Furthermore, eHealth has enabled components of AF care to be offered in a wide range of practice settings, including community pharmacies, nurse-led clinics, and home-based services.…”

Factors Influencing Sustained Engagement with ECG Self-Monitoring: Perspectives from Patients and Health Care Providers

“…17,18 Thus, PGHD can improve patient selfmanagement of the arrhythmia, while also offering clinical benefits to providers seeking to improve detection and tailor care based on the unique characteristics of the patient. 19,20 Sustained patient engagement with self-monitoring using mHealth technology is necessary to generate adequate health data to enable precision management. 21 Yet, evidence shows that patient engagement is low over time, with many abandoning self-monitoring within 3 to 6 months of initiation.…”