Next Generation Technology for Chronic Care Self Management

描述（由申请人提供）：Advanced Medical Electronics Corporation （AME）提议开发和部署一种基于智能手机的健康指导工具，我们将专门为慢性阻塞性肺疾病（COPD）患者设计。定期自发的身体活动在维持健康方面发挥着重要作用，包括对慢性阻塞性肺病患者。该工具包括患者端的智能手机、软件和两个自定义活动监视器，以及医疗保健专业人员端的远程服务器、软件和计算机。我们建议活动监测器来检测和测量高动态运动，如行走，和低动态运动，如洗牌。商用设备，如计步器和加速度计，可以测量前者，但不能测量后者。我们使用智能手机，具有类似个人电脑功能的手机，例如RIM的黑莓，苹果的iPhone等，既用于医患沟通，也用于运行测量算法和电子日记/激励软件的计算平台。远程服务器包含患者活动数据的存储库，并托管一个web应用程序，该应用程序允许医疗保健专业人员通过web浏览器管理患者并评估他们对锻炼方案的遵守情况。该工具的一个关键特点是它的电子日记，它使患者和医生能够方便和无处不在地访问活动结果，并利用它们做出决定，例如，进行健康指导或自我管理，以增加身体活动。在第一阶段，我们设计了提出的工具，并通过验证两个关键组件来确定其可行性。在第二阶段，我们将通过临床试验完成、部署和验证整个工具。

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.