Partners pilots connected health interventions

BOSTON—Partners HealthCare is experimenting with a number of mobile health pilots to move high-risk patients toward healthier behaviors and better disease management, according to speakers at the 2014 Center for Connected Health Symposium.

One pilot implemented at Massachusetts General Hospital’s Charlestown healthcare center successfully utilized FitBit Zip wireless trackers to help patients with metabolic syndrome better manage their health conditions, according to Rajani LaRocca, MD, an internist at the center.

Patients participated in six weekly groups, and were taught good sleep practices, stress management techniques and healthy eating, and given the FitBit tracker to monitor their activity. This group included nine patients who were between 60-75 years old and had a BMI of higher than 25, she said.

Before the intervention began, third-fourths of the patients had exercised for 60 minutes or less during the course of the previous week. While wearing their trackers, activity levels—as measured by number of steps— increased for all nine patients. Eight months after the pilot, five out of the nine patients still wore their trackers. Some stopped using it because the habits had become engrained and they no longer needed it, LaRocca said.

“The people who loved it the most were those who couldn’t have afforded it,” she said, adding, “We had success because these types of devices made exercise fun.”

Although she’s a physician, LaRocca said one of her goals is to “unmedicalize health”—and provide easier ways for people to make healthy choices. She also participated in the intervention with the group, which she feels improved the patient-physician relationships and helped motivate the participants.

Another Partners initiative harnessed telemonitoring to help high-risk, medically complex congestive heart failure patients manage their conditions at primary care practices. Many of these patients had two or three comorbidities and many took more than a dozen medications, according to Mary Neagle, MSW, program manager of the integrated care management program at Mass General Hospital.

“Everyone knows their name,” she said of these patients who sought frequent care.

The initiative requires the patients to take their weight and document how they feel on a daily basis. These data were shared with the primary care physician, care manager and nurse. This “gave us the ability to understand challenges the patients were experiencing,” she said. Another component was the use of coaches to help patients manage their medications and understand their data.

Overall, it has been “very successful” for many patients, Neagle said.  “Some patients do not want to give up their telemonitoring machine, they are so attached to the feedback. It helps them understand what they can or cannot do and it’s been positive for them.”

Another pilot sought to improve birth outcomes and improve engagement in prenatal care at Partners’ health centers, according to Kristen Barnicle, MA, director of community health.

The project involved a text messaging program designed to engage patients. Two to five times per week, participants received messages on the baby’s development as well as appointment reminders and other advice, like buying a car seat. The people most likely to sign up were single, younger women, Barnicle said.

While the complete results are still pending, satisfaction has been “through the roof,” she said. “The best thing is it makes the patients feel like we love them, especially the young pregnant women. It makes them more engaged with the care team and seek care where they need it."