UK Research and Innovation | Survey

1st Submission Bronze Trophy

Improving self care among patients with chronic conditions utilizing mHealth, machine learning algorithms and wearable sensors.

Self care is defined as a naturalistic decision-making process addressing both the prevention and management of chronic illness, with core elements of self-care maintenance, self-care monitoring, and self-care management.

Recently American Heart Association  has published scientific statement on prevention and management of cardiovascular disease (Journal of American Heart Association 2017). It is important to improve self care at all 3 levels. Individual level. family level and community level.

 This would impact on many ways. Its proved to improve quality of life, improves self efficacy, reduce all cause mortality, reduce unscheduled hospitalizations etc

How could digital technologies provide a solution to this challenge?

mHealth apps, machine learning algorithms and wearable devices can be used to improve self care.

edited on 21st December 2018, 06:12 by BHUVANA K.B

BHUVANA K.B 1 month ago

Please vote and comment, if you feel interesting. Thank you

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BHUVANA K.B 1 month ago

This attachment gives the details on this topic.

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Cyril France 1 month ago

Dear Bhuvana, thank you for sharing this great idea. The attachment is equally useful and informative. mHealth apps, machine learning algorithms and wearable devices can be used to improve self care in the three major areas of early detection and diagnosis, treatment, as well as outcome prediction and prognosis evaluation. On the backdrop of context specificity, are there any empirical studies on this subject in India or at the health facility where you work?

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BHUVANA K.B 1 month ago

Hi Cyril,

Thanks for your interest and question.

I am happy to share with you about the project in this area.

We have Wellcome DBT funded project on improving quality of care among patients with heart failure in India. We have completed formative study. Initial phase, we conducted and analyzed semi structured interviews with patients and caregivers (n=40). We noted barriers and facilitators for self care among patients and caregivers, and through grounded theory approach we have emerging behavioral theory around this.

We designed mHealth application (user centered approach) in collaboration with tech people, to bridge the gaps in self care. mHealth app will be used to educate patients and improve their skills on self care and cardiovascular health behaviors. We would capture BP values, weight and adherence to medications, intervene with calls and follow up care will be carried out. We are yet to conduct usability and feasibility of this mHealth app. With the iterative development of the app, we will conduct full fledged RCT.

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BHUVANA K.B 1 month ago

But I am interested in extending this idea among patients with multimorbidity (two or more chronic conditions). Educating patients on importance of self care and consequences of ignoring self care, giving educational materials with appealing pictorial formats. Later with workshops, we could pool patients to improve skills on self care. Example: measuring blood glucose, injecting insulin, measuring blood pressure, planning diet and excercise, setting their realistic goals, sharing experiences etc. We can achieve this both in hospital and community settings through trained social workers and non physician health care workers, to guide patients and caregivers.

We could form caregivers and patient support groups, with people who express interest in workshops, through whtsapp. So that social support could be improved, in turn enhances positive psychological wellbieng and other outcomes.

Also machine learning can understand the behavior of patients and give appropriate recommendations, with decision support system and algorithms. With wearable devices, through telehealth, we could improve patient quality of life and other clinical outcomes.

To take forward, we need a team of interdisciplinary researchers. Biomedical scientist, tech scientist, behavioral scientists, NGOs, Activists etc.

Same can be applied to Africans as well.

Below is an interesting article on positive psychological wellbeing published in J of american college association, 2018.

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BHUVANA K.B 1 month ago

Please find the article metasynthesis of qualitative studies: Barriers and facilitators of self care.

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Peju Adeniran 1 month ago

My question is a bit simplistic Im afraid, and it is about how, if at all, the model of self-care bypasses health care providers or healthcare delivery.
Because the idea to me, seems to take the access to health care as a given, and then to move further down the slope, to tackle the patient/self behavioral patterns as the factor.
So, my question is a how replicable or what level of external validity will be applied in populations that have different access to health levels play out?

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BHUVANA K.B 1 month ago

Hi Peju, Sorry for delayed response. I missed your question.

It wont be bypassed from health care providers or health care delivery.

once patients are registered in hospital with these chronic conditions, they would be trained from nurses in the hospital settings- at primary/secondary/ tertiary care level.

In the community settings, patients would be remotely monitored from social workers/ community health workers. These workers ensure the continuity of care/ bridge the gap between health care provider and patients in follow up care.

Telehealth has prooved its effectiveness in implementation research else where.

Hopefully I answered your question. Please let me know if I didn't understand your question.

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BHUVANA K.B 2 weeks ago

Hi Peju,

Hope I answered your question.

At different levels of health care, patient can be given an option to choose whom/which health care provider to give ownership to.

Like we have the concept of family physician/doctor, whom patients go primarily. They will actually refer to superspeciality if necessary.

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DOUGLAS ORAMIS 1 month ago

The major challenge will be to establish an infrastructure around these. Just like there became a whole system of dealing with the mobile phone from Networks, Software apps and interactive systems.
The task is to create a ecosystem that encourages self care through self monitoring with support from the pre-existing healthcare system.

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BHUVANA K.B 1 month ago

Thanks Douglas for raising challenge and giving suggestion. Yes, We need to integrate this with preexisting health care system. Definitely not establishing as a whole new thing. We need to generalize and include this even in the remote places with both hospital and community based programs.

How can we integrate this with existing policies and government initiated programs? This we need to answer I guess.

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BHUVANA K.B 1 month ago

Are there any government initiated programs in Africa for tackling chronic conditions including non communicable diseases?

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DOUGLAS ORAMIS 1 month ago

Yes there are. These are focused on targeted campaigns through printed media and Audiovisual communications. Most of the time they coincide with World Celebrations. The effective programs are coming from the Private Sector with local and international companies organizing events such as Walks and Marathons to raise awareness

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BHUVANA K.B 1 month ago

Thanks Douglas. Point noted.

Just to share and add a note on Indian scenario. Please find the link below. On existing national programs in India to tackle chronic non communicable disease and existing foundation and their partners to tackle these chronic conditions.

http://dghs.gov.in/content/1363_3_NationalPro...ionControl.aspx

http://www.ccdcindia.org/

http://chroniccareindia.org/

Thanks again for your response.

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BHUVANA K.B 1 month ago

Thanks Douglas. Point noted.

Just to share and add a note on Indian scenario. Please find the link below. On existing national programs in India to tackle chronic non communicable disease and existing foundation and their partners to tackle these chronic conditions.

http://dghs.gov.in/content/1363_3_NationalPro...ionControl.aspx

http://www.ccdcindia.org/

http://chroniccareindia.org/

Thanks again for your response.

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Andy Bleaden 1 month ago

You might also be aware of the work undertaken by the European Connected Health
Alliance (ECHAlliance) who are working closely with the Commonwealth Centre for Digital Health (CWCDH)

You can read about our joint work on European and Commonwealth collaboration to bring the benefits of digital health to 3 billion people here:

https://echalliance.com/news/news.asp?id=4103...commonwealth%22

The European Connected Health Alliance (ECHAlliance) and the Commonwealth Centre for Digital Health (CWCDH) announce a strategic partnership to accelerate and drive the international deployment of digital health at scale, facilitate greater collaboration for international digital health projects and create economic opportunities.

Digital technologies offer huge opportunities to strengthen health systems and improve the way health care is delivered. To realize the full potential of digital health, collaboration across the health and ICT sectors, both public and private, is essential.

Together, the ECHAlliance and CWCDH, connect 78 Countries with a combined population of approximately 3 billion, 40% of the world’s population. Given the number and diversity of the countries, and the different stages of digital development, this unique partnership will facilitate and enable the identification, sharing and application of best practices and innovations.

The partnership will also provide public and private funders of digital health with a coherent international network and organisations to deploy digital health and provide quality and sustainable healthcare services. The Commonwealth provides the opportunity for governments, health systems, industry and academia to compare, and contrast, needs, and opportunities, across a significant international network and population.

Prof Vajira Dissanayake, Chair of the CWCDH said

“As we implement the exciting plans for the CWCDH across the 53 Commonwealth countries we are delighted to partner with the ECHAlliance, who have long experience in establishing an International Network and have created an effective delivery mechanism through their successful multi stakeholder Ecosystem Network. Joining forces and leveraging this experience will enable us to accelerate our plans to deliver and scale digital health innovations.”

Brian O’Connor, Chair of ECHAlliance commented

“We have learned a lot in establishing the existing International Networks in Europe, Canada and China. We are delighted not only to share those experiences with CWCDH but to learn from the many Digital Health Innovations that already exist in the Commonwealth. We also believe the partnership opens up real business opportunities for two ways trade between Europe and the Commonwealth. What I really like about this Partnership is we share the same determination to be practical and not another talking shop”

CWCDH and ECHAlliance have formed an Implementation Group to ensure this Partnership delivers on the opportunities. A further announcement will be made shortly which will present the next practical steps to ensure success.

About Commonwealth Centre for Digital Health

The Commonwealth Centre for Digital Health (CWCDH) is a not for profit organisation, working closely with the Commonwealth Medical Association, working together to link Commonwealth countries and realise the potential for digital health to transform and strengthen their health systems.

The Commonwealth is made up of 53 independent countries with a combined population of 2.4 billion, of which more than 60 per cent is aged 29 or under. The Commonwealth spans the globe and includes both advanced economies and developing countries. It encompasses Africa (19 countries), Asia (7), the Caribbean and Americas (13), Europe (3), and the Pacific (11).
www.cwcdh.org

About the European Connected Health Alliance

The European Connected Health Alliance (ECHAlliance) is the trusted connector, facilitating multi-stakeholder connections around ecosystems, driving sustainable change and disruption in the delivery of health and social care. Our community gathers over 650+ member organizations and more than 16,500 experts -- including government, health & social care providers, leading companies and start-ups, researchers, insurances, patients and citizens, and the investment community -- through ecosystems meetings (100+ per year), international events and online platform, "Connector." Active in more than 25 regions/countries (Europe, USA, Canada, China), ECHAlliance members develop innovative solutions around mobile health, chronic diseases, active and healthy ageing, Internet of Things, wearables, personalized medicine, genomics, Big Data, virtual reality and artificial intelligence.

www.echalliance.com

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BHUVANA K.B 1 month ago

Dear Andy, I was not aware of this ECHAlliance. Thanks for letting us know about this.

It's great to know about you and about the alliance.

I visited the links you have provided. I have just applied for the membership filling up minimum essential details.

As you can see the ideas posted and comments on other ideas. I am working and passionate to work around chronic conditions, self care, remote monitoring, telehealth. I am interested to extend to medical devices and higher technology.

Digital medicine clinical trials has been evaluation for conditions such as asthma (Barrett, Health affairs, April 2018), Hypertension (Morawaski, JAMA Internal Med 2018), Diabetes (Wild et al, PLOS Medicine, 2016), Heart failure (Koehler, Lancet 2018), Inflammatory bowel disease (De Jong, Lancet 2017), Cancer (Denis, ASCO 2018), Headaches (Muller, Neurology, 2017), Visual impairment (Rono, Lancet Global Health, 2018), Insomnia (Freeman, Lancet Psychiatry 2017), Attention deficit disorder (Kollins, December 2017 and Proof of concept PLOS One , 2018), Scizophrenia (Craig, Lancet Psychiatry 2017). It has been proved to be effective with positive impact.

Thanks for sharing this

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Davis Ntwiga 1 month ago

Self care can further be improved by possibly sending the data to a database that alerts the health care providers on the dangers facing a certain patient.

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lauren clarke 2 weeks ago

Status label added: 1st Submission Bronze Trophy

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BHUVANA K.B 2 weeks ago

Hi Bundi, Yes you are right. We will have alert systems for health care provider and non physician health workers as well.

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BHUVANA K.B 2 weeks ago

@Pamela @Kellen, Please let us know your thoughts on this.

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