Next Generation Technology for Chronic Care Self Management

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DESCRIPTION (provided by applicant): Advanced Medical Electronics Corporation (AME) proposes to develop and deploy a smartphone-based health-coaching tool, which we will specifically design for people with Chronic Obstructive Pulmonary Disease (COPD). Regular spontaneous physical activity plays a large role in maintaining health, including for patients with COPD. This tool consists of a smartphone, software, and two custom activity monitors on the patient end, and a remote server, software, and a computer on the health care professional end. We propose activity monitors to detect and measure both high-dynamic motion, such as walking, and low-dynamic motion, such as shuffling. Commercially available devices, such as pedometers and accelerometers, may measure the former, but not the latter. We use smartphones, cellular phones with PC-like functionality, e.g., RIM's Blackberry, Apple's iPhone, etc., both for patient-physician communication as well as a computing platform in which to run measurement algorithms and electronic diary/motivational software. The remote server contains a repository of patient activity data and hosts a web application that allows health care professionals to manage patients and assess their adherence to their exercise regimens via a web browser. A key feature of this tool is its electronic diaries, which permit patients and physicians easy and ubiquitous access to activity results to use them for making decisions, e.g., health coaching or self management, in order to increase physical activity. In phase I, we designed the proposed tool and established its feasibility by validating two key components. In phase II, we will finalize, deploy, and validate the entire tool via a clinical trial. PUBLIC HEALTH RELEVANCE: The proposed methodology, which we will test in a human study, may have profound significance in chronic care: 1) access to accurate information about physical activity that can be used for health coaching/self management and may influence patients to be more active, an independent predictor of mortality and well- being, and 2) the proposed methodology is feasible for widespread use due to its size, cost, and use of elements familiar to patients and increasingly available, i.e., smartphones such as RIM's Blackberry, which facilitate its use and interpretation. Since this methodology allows health care professionals to directly or remotely adjust mutually set goals and motivational reminders to patients based on their accomplishments, it provides relevant information and responses in a timely and ongoing manner that direct patients toward activity.