Study: In resource-poor areas, connected devices reduce hospitalizations, deaths

By Dave Muoio

alivecorUpdate: This story has been updated to include additional quotes from the study's researchers.

Heart disease patients visiting mobile health clinics outfitted with pocket-sized, smartphone-connected ECGs and other point-of-care medical devices are more quickly referred for therapy, and less frequently experience hospitalization or death.

According to a recent study, published in the Journal of the American College of Cardiology, the benefits of these portable devices could be especially key in transforming healthcare delivery in regions strapped for resources.

“Such areas have the highest rates of chronic diseases, [yet] have the lowest availability of diagnostic tests,” lead author Dr. Sanjeev Bhavnani, of the Scripps Clinic and Research Foundation, told MobiHealthNews. “By way of their portability, new mobile health devices such as pocket ultrasound and the smartphone-iECG maybe uniquely poised to improve healthcare access and lead to earlier treatment decisions, especially for high risk patients.”

In the study, researchers enrolled Indian outpatients with new or established diagnoses of rheumatic and structural heart disease. The patients were randomly assigned to receive either standard care (n=114), or were referred to a clinic equipped with a suite of wireless point-of-care devices (n=139), including pocket-echocardiography (General Electric’s VScan); smartphone-connected oximetry and blood pressure monitors (iHealth); activity monitors (Ozeri); a smartphone-connected ECG (AliveCor); and fingerstick B-type natriuretic peptide tests (Alere Triage).

Over a 12-month observational period, the researchers found that patients who initially visited a mobile health clinic were significantly more likely to be referred for a valvuloplasty, valve replacement, or both procedures and, to a less significant extent, undergo the therapies. Furthermore, those assessed with the mobile health devices were also at significantly less risk of hospitalization or death, which the researchers attributed to the mobile health clinic’s improved characterization of structural heart disease and more prompt referral to care.

The researchers lamented the smaller and unequal sample sizes of the treatment groups, but noted in their study that the use of readily available technologies, hard clinical outcome measurements, and real-world implementation add validity to their results.

"To our knowledge this is the first randomized study that shows how modern cardiology clinics can be organized for triaging symptomatic patients efficiently and how decision making can be accelerated using a combination of mHealth technologies that look at different dimensions of a disease,” principal investigator Dr. Partho Sengupta, of the West Virginia University School of Medicine, told MobiHealthNews. “The outcomes suggest potential substantial cost-savings and cost-efficacy studies are needed to evaluate the impact on health-economics using such strategies."

The opportunities and need for more data regarding mobile phone-connected health devices outside of resource-rich settings was previously explored in a 2015 review, in which the authors argued that “priorities should be set for investments and guidance in evaluation disseminated by the scientific community to practitioners and policymakers.”