This week in Boston, at the International Heart Rhythm Society
meetings, new research was presented on using a smartphone to diagnose, monitor, and treat atrial fibrillation, the most common heart rhythm disorder in the entire world. It affects 2.1 million Americans and accounts for billions of dollars of healthcare spending annually.
In fact, the costs of hospitalization for AF are up 24 percent over just the last year.
When people have atrial fibrillation, they experience a racing, irregular heart beat that can result in shortness of breath and chest pain, as well as lightheadedness and dizziness. It is also one of the most common causes of stroke.
Unfortunately, many patients with atrial fibrillation do not realize that they have a problem at all — which means they may not be identified and treated appropriately. Common risk factors for atrial fibrillation include obesity, obstructive sleep apnea, diabetes, high blood pressure, and a family history of the condition.
It is critical to recognize patients with atrial fibrillation and treat them with appropriate medicines in order to prevent hospitalizations and complications such as stroke. The new era of mobile phones and wearable sensors has made it possible to better identify and treat at-risk patients — ultimately improving outcomes and reducing costs.
In the latest study, researchers gave smartphone EKG sensors to nearly 900 patients and had them transmit EKG tracings to a cloud-based server for 6 months. These tracings were analyzed for abnormalities.
During the study period, nearly 60,000 EKGs were transmitted, and 11 percent of the patients were found to have atrial fibrillation. Many of those 11 percent were able to get further therapy with blood-thinning medications in order to reduce their risk of stroke.
The mobile phone EKG tracing allowed patients that may have otherwise gone unnoticed to be identified and appropriately treated.
While this data has not yet been published in a peer-reviewed journal, it proves what many of us have suspected: The mobile phone can be a powerful tool in the battle against disease.
One EKG tracker for mobile phones is already commercially available through AliveCor.com, and has been cleared by the FDA for direct-to-consumer marketing and sales. It is likely that other medical devices for mobile platforms will follow in the next year.
In fact, the number of mobile applications for health and disease state monitoring are likely to change the way medicine is practiced in the future.
And the development of mobile health applications is coming at exactly the right time. According to Pew Research Associates, nearly 65 percent of all Americans own a smartphone, and nearly 95 percent are connected to the Internet in some way by a cellphone or other mobile device.
In addition, a similar poll found that 72 percent of users accessed the Internet via a mobile device to look up health information in the last year. Medical applications are becoming more prevalent all the time, and nearly 20 percent of those surveyed have indicated that they have downloaded and app to specifically track or manage a health condition.
Nearly two-thirds of Americans track diet and exercise with a mobile device, and another third also track blood pressure, blood sugar, or other health indicators via mobile health applications. Patients are increasingly connected and ready to embrace mobile health.
EPIC Systems, one of the leading Electronic Health Record (EMR) companies in the U.S., recently announced a partnership with Apple to integrate data from the Health Kit into the permanent EMR record — thus paving the way for patient-collected data to be accessible to doctors during routine office visits.
The latest trial on mobile tracking of patients with atrial fibrillation is just one of many mobile phone applications under evaluation. With the advent of Apple’s Research Kit and other Health Kit applications, the technologies available to patients is certain to increase over the coming years.
Ultimately, the use of these technologies will facilitate patient engagement. We know from prior research on high blood pressure and diabetes that when patients are engaged in their own disease management, better outcomes result.
I expect that one day mobile applications will be prescribed by physicians, and will be an integral part of the everyday treatment of disease.
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