Beth Israel Deaconess Medical Center will soon become the latest hospital to incorporate health monitoring via connected devices and Apple’s HealthKit infrastructure. BIDMC @ Home, an initiative the hospital has been working on for the past six months or so, is currently being tested on doctors and IT personnel in the hospital and will roll out to its first cohort of patients in the spring.
“Doctors or care providers have historically had a very limited window into what’s happening in the home,” Dr. Larry Markson, vice president for clinical information systems at BIDMC, told MobiHealthNews. “And I think what’s exciting to us is this provides a window that could be very valuable in certain types of patients that we haven’t had up until now.”
The initial cohort will most likely be 25 to 50 patients and half a dozen doctors, Markson said. The focus will be on congestive heart failure and hypertension and the devices used will be connected weight scales, as a proxy for fluid balance, and blood pressure monitors. They're currently testing with Withings devices for both scales and blood pressure monitors, as well as Qardio blood pressure monitors.
“We have a long history of engaging patients in their own care at BIDC thanks to our patient portal which has been in existence for about 15 years,” Markson said. “[This program] is tied into our portal program, so while we’ll give our providers and care managers access to the data we collect from BIDMC @ Home, we’ll also let patients view it through our patient portal. I think one of the benefits of all these types of programs is it engages patients in their own care. We want them to see their results as well.”
The data collected by the devices actually passes through three different apps — the device manufacturer’s app, Apple’s Health app, and a special app developed in-house at BIDMC, which sends it securely to the patients electronic medical record and patient portal. The goal is for the monitoring to be seamless for patients, although it does require a bit of setup.
“You’ve got to bring your scale home, connect it with your phone and pair it with your phone, give your phone the correct permissions, and install our app into your patient portal credentials to be able to upload,” Markson said. “But once that initial setup is done, really all you’re doing is operating the device. You stand on the scale, you take your weight, your weight is transmitted and stored in the health database. Our app is running in the background and uploads it and you really don’t have to do that much once you’ve done the initial setup.”
If the congestive heart failure cohort goes well, the hospital plans to expand the program to help as many patients with chronic conditions as possible. There is still one snag that will keep the program from being available to all patients, though.
“It does require that patients bring their own iPhones,” Markson said. “We’re sort of leveraging the systemwide health database that Apple provides and all the security that is baked into iOS. So at this point it’s an iPhone-only application.”