The Challenge
Despite the growth of and media hype about mobile health (mHealth), there is a paucity of literature supporting the effectiveness of widespread implementation of mHealth technologies. This work commissioned by the Houston Methodist Hospital aimed to assess whether an innovative technology system with several overlapping purposes can impact (1) clinical outcomes (ie, readmission rates, revisit rates, and length of stay) and (2) patient-centered care outcomes (ie, patient engagement, patient experience, and patient satisfaction).
The Solution
The 30 day, 60 day and 90 day inpatient hospital readmission rates were lower when the mobile health technology was used with orthopedic surgery patients
• Hospital length of stay was lower by 35% when the mobile health technology was deployed.
• Majority of patients indicated high satisfaction with using mHealth technology to support their care.
We found that a novel, multicomponent mHealth technology can positively impact patient outcomes and patient-reported experiences. These technologies empower patients to play a more active and meaningful role in improving their outcomes. Hospitals can enhance their quality ratings while improving staff satisfaction and reducing staff workload.
Outcomes
The inpatient readmission rates for the nonparticipating group when compared with the participating group were higher and demonstrated higher odds ratios (ORs) for 30-day inpatient readmissions (nonparticipating group 106/2636, 4.02% and participating group 54/2048, 2.64%; OR 1.48, 95% CI 1.03 to 2.13; P=.04), 60-day inpatient readmissions (nonparticipating group 194/2636, 7.36% and participating group 85/2048, 4.15%; OR 1.79, 95% CI 1.32 to 2.39; P<.001), and 90-day inpatient readmissions (nonparticipating group 261/2636, 9.90% and participating group 115/2048, 5.62%; OR 1.81, 95% CI 1.40 to 2.34; P<.001). The length of stay for the nonparticipating cohort was longer at 1.90 days, whereas the length of stay for the participating cohort was 1.50 days (mean 1.87, SD 2 vs mean 1.50, SD 1.37; P<.001). Patients treated by participating surgeons received and read text messages using mHealth 83% of the time and read emails 84% of the time. Patients responded to 60% of the text messages and 53% of the email surveys. Patients were least responsive to digital monitoring questions when the hospital asked