[论文解读] Empowering Patients Using Smart Mobile Health Platforms: Evidence From A Randomized Field Experiment

Anindya Ghose, Xitong Guo+2 more|arXiv (Cornell University)|Feb 10, 2021

Mobile Health and mHealth Applications参考文献 31被引用 25

一句话总结

本文进行了一项对1,070名糖尿病患者的随机现场实验，评估智能移动健康（mHealth）平台如何影响健康行为与结局，并比较移动端与PC端版本、以及个性化提醒与通用提醒的差异。

ABSTRACT

With today's technological advancements, mobile phones and wearable devices have become extensions of an increasingly diffused and smart digital infrastructure. In this paper, we examine mobile health (mHealth) platforms and their health and economic impacts on the outcomes of chronic disease patients. We partnered with a major mHealth firm that provides one of the largest mHealth apps in Asia specializing in diabetes care. We designed a randomized field experiment based on detailed patient health activities (e.g., exercises, sleep, food intake) and blood glucose values from 1,070 diabetes patients over several months. We find the adoption of the mHealth app leads to an improvement in health behavior, which leads to both short term metrics (reduction in patients' blood glucose and glycated hemoglobin levels) and longer-term metrics (hospital visits and medical expenses). Patients who adopted the mHealth app undertook more exercise, consumed healthier food, walked more steps and slept for longer times. They also were more likely to substitute offline visits with telehealth. A comparison of mobile vs. PC version of the same app demonstrates that mobile has a stronger effect than PC in helping patients make these behavioral modifications with respect to diet, exercise and lifestyle, which leads to an improvement in their healthcare outcomes. We also compared outcomes when the platform facilitates personalized health reminders to patients vs. generic reminders. Surprisingly, we find personalized mobile messages with patient-specific guidance can have an inadvertent (smaller) effect on patient app engagement and lifestyle changes, leading to a lower health improvement. However, they are more like to encourage a substitution of offline visits by telehealth. Overall, our findings indicate the massive potential of mHealth technologies and platform design in achieving better healthcare outcomes.

研究动机与目标

• 通过评估mHealth平台对慢性病患者的健康行为和临床结局的影响来推动本研究。
• 评估在糖尿病护理中使用大规模mHealth应用的健康与经济影响。
• 比较同一应用的移动版本与PC版本在行为改变和健康结局上的有效性。
• 考察个性化与通用健康提醒对参与度和结局的差异性影响。

提出的方法

• 对1,070名糖尿病患者进行数月的随机现场实验。
• 使用关于健康活动（运动、睡眠、饮食摄入）和血糖数值的详细患者数据。
• 与一家在亚洲提供糖尿病专用应用的大型mHealth公司合作。
• 随机分配应用使用与否以识别因果效应。
• 对移动应用版本与PC版本进行比较，以评估平台效应。
• 将个性化健康提醒与通用提醒作为处理变体进行研究。

实验结果

研究问题

• RQ1 采用mHealth平台是否能改善糖尿病患者的健康行为和临床指标？
• RQ2 应用的移动版本在推动行为改变和健康结局方面是否比PC版本更有效？
• RQ3 个性化提醒是否比通用提醒带来更高的参与度和健康改善？
• RQ4 mHealth驱动的变化是否将线下护理替代为远程医疗，对医疗服务利用有何影响？

主要发现

• 采用mHealth应用可改善健康行为，包括增加运动、更健康的饮食、步数更多、睡眠更长。
• 移动应用的行为改变效果比PC版本更强，从而带来更好的医疗保健结局。
• 具有患者特定指导的个性化移动提醒在参与度和生活方式改变方面的效果小于通用提醒，但它们促进了线下就诊向远程医疗的更大替代。
• 应用使用与血糖和糖化血红蛋白水平的短期改善以及更长期的住院次数和医疗费用的下降有关。
• 本研究强调了mHealth平台及周到的设计选择在改善慢性病患者健康结局方面的潜力。