Table 3.
Description of the included studies
| Reference | Overview | Study/System | Findings |
|---|---|---|---|
| Adams et al. (2003) | Model information system that integrates patient health information to support monitoring and care of children with persistent asthma Focus: asthma Location: USA |
Study: Feasibility/proof of concept. Ages: children and adults (parents) N = unreported System: telephone-linked communication (TLC-Asthma) with symptom monitoring and automated phone-based education, web-based alert and nurse case-management, EHR (Epic) communications |
Monitoring includes severity-treatment mismatch, use of peak flow meter, changes in symptom frequency or severity. Level 1 alerts: patient advised to seek care immediately, fax sent to dedicated line and phone call to clinic personnel. Level 2 alerts recorded to a log and reviewed by nurse |
| Albisser et al. (2001) | Glucose clamping algorithm for patient use (clamping defined as efforts to maintain glucose in a specified range through glucose or insulin administration). Focus: diabetes Location: unspecified |
Study: described by authors as “system beta testing” Ages: not specified, presumably adult N = 142 patients for 1 year (approx. 100,000 messages) System: Data entry via touch tone phone/voice response hardware (HumaLink). |
Clinical outcomes improved (rate of hyperglycemia, hypoglycemia, or symptoms; and Hemoglobin A1c level). |
| Andy et al. (2012) | Personal health record for diabetes care, based on American Association of Diabetes Educators guidelines. Focus: diabetes Location: Asia (Taiwan) |
Study: developmental evaluation. (Described as randomized but not reported as such) Data collected are application feedback, outcomes monitoring, usage Ages: not specified, presumably adult N= 61 (36 intervention, 25 control) System: Un-named; Web based app + unspecified interaction with care managers. Generates HL7 Continuity of Care Document (CCD). |
Decreased HbA1C in intervention group (66% of patients vs 40% in control group) |
| Barrett et al. (2018) | Study of AIR Louisville, a public health collaboration to improve asthma Focus: asthma Location: USA |
Study: Pragmatic single arm, interventional (CBPR) Ages: adults and children N=497 Electronic sensors to monitor medication usage (Propeller Health). FDA-approved system includes inhaler sensors, digital health platform. Also did environmental monitoring. |
78 percent reduction in rescue inhaler use and a 48 percent improvement in symptom-free days |
| Basch et al. (2007) | Monitoring symptoms of chemo toxicity in lung cancer patients (eRapid; study-specific system) Focus: cancer Location: USA |
Study: Prospective observational study. Ages: adults N= 124 enrolled. Interviews with 13 patients, 9 advocates, 19 staff. System was self-reported via questionnaires and based on NCI Common Terminology Criteria for Adverse Events (CTCAE), mandated reporting for NCI-funded studies |
Targeted advice based on national guidelines. Self-reporting found to be feasible. Patients could use system on their own but seldom used system between visits, unless prompted by explicit reminders or clinician feedback. |
| Bauer et al. (2018) | Testing the feasibility and acceptability of a mobile health platform (patient-facing smartphone application) supporting collaborative care for patients with depressive and anxiety disorder. Focus: depression/anxiety Location: USA |
Study: mixed method pilot study (4-week study period) Ages: adult N = 17. System: The platform supports the transmission of patient data to care manager via an online dashboard. Smartphone sensor data were also collected, mainly about patients’ movement and communication. The dashboard offered providers an overview of patient basic information and graphing of patients’ report of their mood and symptoms. |
Only 6 participants retained in the study, 15 completed weekly reports with a lower response rate on daily measures (i.e. medication use). |
| Holch et al. (2017) | Describing the development of eRAPID (electronic patient self-Reporting of Adverse-events: Patient Information and aDvice) for cancer patients to self-report and manage significant adverse events during and after cancer treatment. Focus: cancer Location: UK |
Study: Usability and functionality Ages: adult N = 13 patients, 9 advocates, 19 staff System: the eRAPID system. Algorithms imbedded in the system allows patients to receive tailored advice for low to moderate adverse events or contact hospital for severe adverse events. Integrated with electronic record at Leeds Teaching Hospital |
The eRAPID system allows patients to report adverse events and guide patients to better manage these events. |
| Hsu et al. (2016) | Examining the effects of a cloud based diabetes management system on glycemic control as compared to control group receiving standard care among patients with type 2 diabetes. Focus: diabetes Location: USA |
Study: Randomized controlled trial Ages: adult N = 40 System: Patients with type 2 diabetes starting basal insulin therapy, who were in the intervention group, received a cloud-based diabetes management program for communication, collaboration and decision making between patients and healthcare providers. Control group = usual care |
Patients in the intervention group achieved a better hemoglobin A1c control and satisfaction than those in the control group. |
| Jiang et al. (2016) | Describing factors associated with usage of advice from a mobile health application among lung transplant patients. Focus: transplant Location: USA |
Study: cross-sectional study examining app usage, extent to which recommendations are followed, as well as predictors of usage and following recommendations. Ages: adult N = 96 System: mobile health app called Pocket PATH for daily health self-monitoring; system generated suggestions. |
Patients with moderate use of Pocket PATH were less likely to follow system recommendations than high or low users. Usage of recommendations from system were associated with gender, past experience with technology, income, hospital stay, and self-monitoring frequency among lung transplant patients. |
| Johansen et al. (2004) | Parents of burns patients are involved in patient care by capturing suitable pictures without intensive training and cost. Focus: burns Location: Australia |
Study: Feasibility study Ages: pediatric burn patients, study enrolled parents N=4 System: email, cell phone camera. Study examined extent to which parents of burns patients can take clinically suitable pictures for follow-up communication with healthcare providers via email. |
Low-resolution images were satisfactory for diagnosis and email messages from parents were adequate for clinical decision making. Parents reported the easiness and convenience of taking photographs. |
| Lau et al. (2013) | Personally controlled health management systems (PCHMSs) with social and self-reflective features were designed to support self-maintaining and self-management of physical and emotional well-being. Focus: physical and emotional well-being Location: Australia |
Study: single-group pre/post study over 4 months Ages: university students and staff N= 709 System: Personally controlled health management systems (PCHMSs) with social and self-reflective features. Study examined how students used the features. |
Social features were considered most engaging. Self-reflective feature (i.e. diary) was associated with higher levels of professional health seeking behaviors. |
| Lindroth et al. (2018) | Describing how patient generated data via mobile apps were used by nurses and how these data transformed patient care. Focus: cancer Location: Europe (Sweden) |
Study: case study Ages: adult N = 10 System: mobile app developed for the study |
Patient generated data introduces changes in communication and decision-making between patients and nurses by providing more precise descriptions of health problems. |
| Lv et al. (2017) | EMPOWER-H that enables capture of home blood pressure (BP) data via a smartphone. Focus: hypertension Location: USA |
Study: pre-post study Ages: adult N = 149 EMPOWER-H is an interactive Web-based disease management system integrated with the electronic health record. Study explored how home BP data gendered by patients with uncontrolled BP influenced clinical decision making. |
EMPOWER-H significantly improved the usage of patients’ office-measured and home-monitored BP in patient care. |
| Marceau et al. (2010) | Describing the experiences of using electronic diaries with summary feedback in the care of patients with chronic pain. Focus: pain Location: USA |
Study: described as 10-month follow up study Ages: adult N = 134 Study: electronic diaries with feedback or paper diaries without feedback- to monitor and manage pain. |
About 23% of patients reported electronic diaries improved care. About 77% of participants reported satisfaction with the app. |
| Martinez et al. (2017) | Describing diabetic patients’ and clinicians’ experiences of using the CONDUIT-HID for the management of BP. Focus: diabetes, hypertension Location: unspecified |
Study: qualitative interview Ages: presumably adult N = 21 patients, 5 clinicians System: CONDUIT-HID Patients can upload BP data into HealthVault (personal health record) via internet; Patients have choices to allow HealthVault to send their data to Reliant Medical Group’s EHR via HL7; protocol driven feedback loop was used to adjust medications if BP was not controlled; nurses can schedule phone calls with patients between office visits when alerts were triggered. |
System that supports users’ workflow and minimizes users’ cognitive efforts is important for the successful adoption. |
| Miller et al. (2016) | Describing the use of digital images captured by parents of pediatric patients receiving ambulatory surgery. Focus: post surgical wound healing Location: USA |
Study: retrospective chart review Ages: pediatric patients age 0 – 17years (parents enrolled) N = 166 enrolled, 129 included System: cell phone camera, email A structured review of the electronic health record was conducted to explore how the digital images of post-operative wounds taken by parents of pediatric patients were used in the patient care. |
Of 166 participants who reported sending digital images to the clinician, 121 participants’ images were documented, and corresponding changes in patient care were noted. |
| Peleg et al. (2017a) | Evaluating whether the MobiGuide (mobile decision-support system) facilitated the compliance to system’s recommendations, satisfaction, and quality of life among patients with AF or GDM and their HCPs. Focus: atrial fibrillation (AF), Gestational diabetes (GDM) Location: Europe (Italy/Spain) |
Study: developmental / feasibility study Ages: older adults, adults N = 10 AF; 20 GDM System: MobiGuide is a chronic patient management system that has, patient-empowering innovative functionalities based on the interaction of patients’ activity and clinical guidelines. Incorporates data from mobile sensors via Bluetooth, self-report of symptoms, computer interpretable clinical guidelines, compliance-checking functions Data from electronic health records can be pulled into the PGHD system (semantic data integration) |
A high compliance to system recommendations was noted. Quality of life for patients was uncertain. |
| Peleg et al. (2017b) | Describing MobiGuide users’ experiences in terms of sustainable usage, patients’ perceptions of usage, and HCP’s views of patient data. Focus: atrial fibrillation (AF), Gestational diabetes (GDM) Location: Europe (Italy/Spain) |
Study: developmental / feasibility study Ages: older adults, adults N = 10 AF; 20 GDM MobiGuide, a personalized evidence-based decision-support system. |
Hypothesis of sustainable usage of MobiGuide, positive perceptions of MobiGuide usage, and clinician usage of patient data were supported. |
| Quinn et al. (2008) | Adult patients with type 2 diabetes can benefit from the use of WellDoc™. Focus: diabetes Location: USA |
Study: feasibility and usability, randomized to intervention and control Ages: adult ages 18–70 N = 30 The feasibility of using WellDoc™, a mobile diabetes management system in conjunction with web-based analytics to manage A1C by patients and HCPs. |
Better A1C control among patients who used WellDoc™. HCPs reported the system facilitated clinical decision making. The majority of patients and physicians were satisfied with the system. |
| Smith et al. (2012) | Reporting mHealth-based EMA and two-way interactive text messaging for providing treatment feedback for the care of veterans with mTBI and/or PTSD. Focus: mild traumatic brain injury (mTBI), post traumatic stress disorder (PTSD) Location: USA |
Study: pilot study to assess feasibility, potential utility Ages: adult N = 27 System: un-named. described as an electronic survey tool that supports data collection from personal digital assistants, commercial SMS text messaging Study examined ecological momentary assessment (EMA) and two-way interactive text messaging as communication modes in the care of veterans with mTBI and/or PTSD. |
mHealth-based support in conjunction with traditional mental treatment are feasible for the treatment of veterans with mental health concerns. Users’ prior mobile experiences and clear data presentation are important for the design of such a system. |
| Weissman et al. (2016) | Study of information management system, Accu-Chek Smart Pix system to improve the self-monitoring of blood glucose for patients with type 1 and type 2 diabetes in outpatient settings. Focus: diabetes Location: Europe (Denmark/ Germany) |
Study: observational prospective study Ages: adult N = 965 System: information management system, Accu-Chek Smart Pix system |
Significant reductions in HbA1c from baseline were noted, and reports from the information management system were used for therapy adjustment. |
Notes. CONDUIT-HID= CONtrolling Disease Using Inexpensive Technology-Hypertension in Diabetes; BP=blood pressure; AF=atrial fibrillation; GDM=gestational diabetes Mellitus; EMA=ecological momentary assessment; mTBI =mild traumatic brain injury; PTSD= post-traumatic stress disorder