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A prospective randomized trial examining health care utilization in individuals using multiple smartphone-enabled biosensors

Cinnamon S. Bloss, Nathan E. Wineinger, Melissa Peters, Debra L. Boeldt, Lauren Ariniello, Ju Young Kim, Judy Sheard, Ravi Komatireddy, Paddy Barrett, Eric J. Topol
doi: https://doi.org/10.1101/029983
Cinnamon S. Bloss
1 Scripps Genomic Medicine, Scripps Translational Science Institute, and Scripps Health; La Jolla, CA, USA
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Nathan E. Wineinger
1 Scripps Genomic Medicine, Scripps Translational Science Institute, and Scripps Health; La Jolla, CA, USA
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Melissa Peters
1 Scripps Genomic Medicine, Scripps Translational Science Institute, and Scripps Health; La Jolla, CA, USA
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Debra L. Boeldt
1 Scripps Genomic Medicine, Scripps Translational Science Institute, and Scripps Health; La Jolla, CA, USA
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Lauren Ariniello
1 Scripps Genomic Medicine, Scripps Translational Science Institute, and Scripps Health; La Jolla, CA, USA
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Ju Young Kim
1 Scripps Genomic Medicine, Scripps Translational Science Institute, and Scripps Health; La Jolla, CA, USA
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Judy Sheard
1 Scripps Genomic Medicine, Scripps Translational Science Institute, and Scripps Health; La Jolla, CA, USA
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Ravi Komatireddy
1 Scripps Genomic Medicine, Scripps Translational Science Institute, and Scripps Health; La Jolla, CA, USA
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Paddy Barrett
1 Scripps Genomic Medicine, Scripps Translational Science Institute, and Scripps Health; La Jolla, CA, USA
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Eric J. Topol
1 Scripps Genomic Medicine, Scripps Translational Science Institute, and Scripps Health; La Jolla, CA, USA
2 Department of Molecular and Experimental Medicine, The Scripps Research Institute; La Jolla, CA, USA
3 Scripps Clinic; San Diego, CA, USA
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  • For correspondence: etopol@scripps.edu
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ABSTRACT

Background Mobile health and digital medicine technologies are becoming increasingly used by individuals with common, chronic diseases to monitor their health. Numerous devices, sensors, and apps are available to patients and consumers – some of which have been shown to lead to improved health management and health outcomes. However, no randomized controlled trials have been conducted which examine health care costs, and most have failed to provide study participants with a truly comprehensive monitoring system.

Methods We conducted a prospective randomized controlled trial of adults who had submitted a 2012 health insurance claim associated with hypertension, diabetes, and/or cardiac arrhythmia. The intervention involved receipt of one or more mobile devices that corresponded to their condition(s) and an iPhone with linked tracking applications for a period of 6 months; the control group received a standard disease management program. Moreover, intervention study participants received access to an online health management system which provided participants detailed device tracking information over the course of the study. This was a monitoring system designed by leveraging collaborations with device manufacturers, a connected health leader, health care provider, and employee wellness program – making it both unique and inclusive. We hypothesized that health resource utilization with respect to health insurance claims may be influenced by the monitoring intervention. We also examined health-self management.

Results & Conclusions There was little evidence of differences in health care costs or utilization as a result of the intervention. Furthermore, we found evidence that the control and intervention groups were equivalent with respect to most health care utilization outcomes. This result suggests there are not large short-term increases or decreases in health care costs or utilization associated with monitoring chronic health conditions using mobile health or digital medicine technologies. Among secondary outcomes there was some evidence of improvement in health self-management which was characterized by a decrease in the propensity to view health status as due to chance factors in the intervention group.

Disclosure of Funding This research is funded in part by a NIH/NCATS flagship Clinical and Translational Science Award Grant (1UL1 TR001114), Qualcomm Foundation Scripps Health Digital Medicine Research Grant, and Scripps Health’s Division of Innovation and Human Capital and Division of Scripps Genomic Medicine. Support for the study is also provided by HealthComp Third Party Administrator, Sanofi, AliveCor, and Accenture.

Trial Registration: clinicaltrials.gov Identifier NCT01975428

Footnotes

  • cbloss{at}scripps.edu, wineinger.nathan{at}scrippshealth.org, peters.melissa{at}scrippshealth.org, boeldt{at}scripps.edu, ariniello.lauren{at}scrippshealth.org, kkamburi{at}scripps.edu, sheard.judith{at}scrippshealth.org, ravikomatireddy1{at}gmail.com, pod9955{at}yahoo.ie, etopol{at}scripps.edu

Copyright 
The copyright holder for this preprint is the author/funder, who has granted bioRxiv a license to display the preprint in perpetuity. It is made available under a CC-BY 4.0 International license.
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Posted January 14, 2016.
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A prospective randomized trial examining health care utilization in individuals using multiple smartphone-enabled biosensors
Cinnamon S. Bloss, Nathan E. Wineinger, Melissa Peters, Debra L. Boeldt, Lauren Ariniello, Ju Young Kim, Judy Sheard, Ravi Komatireddy, Paddy Barrett, Eric J. Topol
bioRxiv 029983; doi: https://doi.org/10.1101/029983
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A prospective randomized trial examining health care utilization in individuals using multiple smartphone-enabled biosensors
Cinnamon S. Bloss, Nathan E. Wineinger, Melissa Peters, Debra L. Boeldt, Lauren Ariniello, Ju Young Kim, Judy Sheard, Ravi Komatireddy, Paddy Barrett, Eric J. Topol
bioRxiv 029983; doi: https://doi.org/10.1101/029983

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