01 August 2014

mHealth: What do we do with all the data?

Monitoring EKG rhythms with portable ambulatory monitors for 30 days improves stroke treatment, reports this month’s New England Journal of Medicine (NEJM).

Background: A leading, preventable cause of recurrent strokes is atrial fibrillation (AF), the most common abnormal heart rhythm and one that can cause clots to travel to the brain. It can be very difficult to initially diagnose AF because it tends to be paroxysmal, or “come and go.” So, it is a silent risk that easily evades detection. In recent years, continuously reported diagnostic data from implanted pacemakers and defibrillators has dramatically increased our knowledge of how prevalent AF is.

The trends are clear: Health care providers today and in the future will have unprecedented opportunities for ambulatory monitoring.
NEJM published results of a Canadian randomized clinical trial (RCT) that focused on patients who had strokes of unknown cause. It found AF was diagnosed five times as frequently in patients who wore special monitors for 30 days than for those who underwent conventional 24-hour testing. The findings led to better secondary interventions.

The ambulatory EKG monitors were attached to the chest with a non-adhesive, “dry” electrode belt. Patients were encouraged to wear it as often as possible over the course of 30 days. The study proved that this was a feasible and affordable intervention that improves care. The American Heart Association recently came out in support of prolonged EKG monitoring for “prevention of future stroke among survivors of ischemic stroke or transient ischemic attack.”

Imagine the monitoring possibilities we will have as mobile-device technology continues its exponential growth. Already, the mobile phone you carry in your pocket has more computing power than NASA did when it put the first man on the moon.

As reported in my previous post, the U.S. Food and Drug Administration has already approved a $200 case that turns your iPhone into an EKG monitor. But that’s barely the tip of the iceberg. Mobile monitoring services are the “dominant and fastest growing” segment within mobile health (mHealth) and revenues are projected to reach $49 billion by 2020. Click here to read the full report titled “mHealth Market Analysis and Segment Forecasts to 2020.”

The trends are clear: Health care providers today and in the future will have unprecedented opportunities for ambulatory monitoring. The question now becomes, “What do we do with all that data?”

Big data may be about to overwhelm the healthcare system,” writes Lindsay Alexander of MedCity News. “A little healthcare business intelligence tip: Data by itself won’t drive value and outcomes. Smart healthcare analytics will.”

Nurse leaders today must be creative thinkers. We must design the methodology and analytics to transform practice by using these technologies in ways that will change outcomes and improve health.

Technology is always changing, and existence of a new gadget will not necessarily impact care positively. The key to actualizing real and lasting change that matters is leadership, rooted in nursing knowledge and wisdom.

What are you doing to learn more about mHealth? What are your ideas about how these tools can improve practice?

For Reflections on Nursing Leadership (RNL), published by the Honor Society of Nursing, Sigma Theta Tau International. Comments are moderated. Those that promote products or services will not be posted.

No comments:

Post a Comment