From smartphone to EHR: a case report on integrating patient-generated health data
From smartphone to EHR: a case report on integrating patient-generated health data
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DOI：
10.1038/s41746-018-0030-8
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发表时间：
2018-06-20
影响因子：
15.2
通讯作者：
Chan, Yu-Feng Yvonne
中科院分区：
文献类型：
--
作者：
Genes, Nicholas;Violante, Samantha;Chan, Yu-Feng Yvonne
从移动应用程序和设备收集的患者生成的健康数据（PGHD）为远程患者监测和及时干预提供了机会，以防止慢性疾病的急性恶化——如果数据被护理团队看到和共享的话。本案例报告描述了将数据从流行的智能手机平台集成到常用的电子病历供应商的技术方面，并探讨了这种方法在疾病管理中的挑战和潜力。使用哮喘健康应用程序（建立在苹果的ResearchKit平台上）的同意受试者能够与当地肺科医生共享吸入器使用和呼气峰值流速（PEFR）的数据，后者在Epic的电子病历上订购了这些数据。如果用户在iPhone上安装并激活了Epic的患者门户网站（MyChart），并通过HealthKit在应用程序之间共享健康数据，那么肺病专家就可以检查PGHD，并在必要时提出建议。4名患者同意与他们的肺科医生分享数据，尽管只有2名患者在4.5个月的试验期间提交了超过一个数据点。其中一名患者在65天内提交了101份PEFR读数；另一位提交了66天内24份PEFR和吸入器使用读数。两名患者的PEFR均在预先设定的生理参数范围内，但有一次向肺科医生发送了低阈值通知，后者通过电话讨论和新的电子处方来解决症状。本研究描述了使用常用框架共享PGHD的技术考虑和实施挑战，目的是远程监测以支持及时的护理干预。
Patient-generated health data (PGHD), collected from mobile apps and devices, represents an opportunity for remote patient monitoring and timely interventions to prevent acute exacerbations of chronic illness-if data are seen and shared by care teams. This case report describes the technical aspects of integrating data from a popular smartphone platform to a commonly used EHR vendor and explores the challenges and potential of this approach for disease management. Consented subjects using the Asthma Health app (built on Apple's ResearchKit platform) were able to share data on inhaler usage and peak expiratory flow rate (PEFR) with a local pulmonologist who ordered this data on Epic's EHR. For users who had installed and activated Epic's patient portal (MyChart) on their iPhone and enabled sharing of health data between apps via HealthKit, the pulmonologist could review PGHD and, if necessary, make recommendations. Four patients agreed to share data with their pulmonologist, though only two patients submitted more than one data point across the 4.5-month trial period. One of these patients submitted 101 PEFR readings across 65 days; another submitted 24 PEFR and inhaler usage readings across 66 days. PEFR for both patients fell within predefined physiologic parameters, except once where a low threshold notification was sent to the pulmonologist, who responded with a telephone discussion and new e-prescription to address symptoms. This research describes the technical considerations and implementation challenges of using commonly available frameworks for sharing PGHD, for the purpose of remote monitoring to support timely care interventions.