Two recent articles take a look at how some small devices - smartphones and tablets - can be used to foster patient engagement.
The smartphone project tackled a tough problem - supporting patients with chronic disease (in this case, HIV) and heavy alcohol use to reduce their drinking. Expanding on their previous approaches using Interactive Voice Response (IVR) telephone calls, Deborah S Hasin, Efrat Aharonovich and Eliana Greenstein from Columbia University enrolled 43 alcohol dependent HIV-infected patients and followed them for 60 days. The average number of drinks fell from 9.3 per day to 3.9. An impressive 25.6% were alcohol-free at the end of the two months. You can get all the details from their report in Addiction Science & Clinical Practice.
The second article provides the early experience with a tablet system that was given to 30 hospitalized patients at the University of California, San Francisco. The iPad2 tablets had an educational program about patient safety and a link to the hospital's patient web portal. The 30 patients were able to use the devices and liked having them. This preliminary report didn't address any changes in outcomes that wiring up inpatients might bring, so it is a little soon to endorse this approach, but they overcame the first hurdles (getting the machines in the hands of the patients and getting the patients to use them). The authors (S. Ryan Greysen, Raman R. Khanna, Ronald Jacolbia, Herman M. Lee, and Andrew D. Auerbach) do promise that they will investigate post-discharge outcomes in future work. You can find this in The Journal of Hospital Medicine.
These innovations have potential. I'm looking forward to some solid assessments (randomized clinical trials, anyone?) in the next few years to help us separate the effective approaches from the marketing chatter.
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