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iMHere (interactive Mobile Health and Rehabilitation) is an mHealth platform for providing clinician guided self-care to patients with chronic diseases. The system connects patient apps with a web-based clinician portal over a secure two-way Internet bridge. iMHere consists of a smartphone app, a web-based clinician portal, and a two-way communication connecting the two. The app was designed to empower patients to perform preventive self-care and was tailored to each patient’s needs and daily routine. Instead of existing as an isolated local app, the app was designed to send monitoring data to the portal and also receive self-care regimens being pushed from the portal. In this study, using a web-based portal, the clinician (typically a nurse coordinator, social worker, case manager, or patient advocate) could monitor patients’ compliance with regimens and send self-care regimens that would then be delivered to the patient via the app. This allowed the clinician to monitor a patient’s status and intervene as needed. Clinicians could use the portal to tailor a regimen or treatment plan for each and every patient (e.g. scheduled medication, wound care instructions, etc.) and the portal would push the plan to the smartphone app in real time, an advancement over existing health portals, which cannot push data to the app. The combination of interactive, real-time medical monitoring with patient self-care offers a powerful, unique solution for patients living with chronic illnesses, where cognitive as well as physical disabilities present significant barriers to effective self-care.
Results of clinical implementation suggest that iMHere app was successful in delivering values for patients and in engaging patients to comply with treatment regimens. In the first 6 months of the clinical implementation, patients have been consistently used the app to do self-management tasks and to follow the regimes set up by clinicians. We observed that the daily usage increased significantly in the first two months (from approximately 1.3 times a day to over three times a day), and then plateau at around 3.5 times a day per patient. This pattern of increasing usage in the first two months and the subsequent plateau is relatively consistent in all patients. The app is currently available in Android platform, with an iPhone version under development.
Bambang Parmanto, Gede Pramana, Daihua Xie Yu, Andrea D Fairman, Brad E Dicianno, and Michael P McCue. 2013. “iMHere: A Novel mHealth System for Supporting Self-Care in Management of Complex and Chronic Conditions.” JMIR Mhealth and Uhealth 1 (2) (July 11): e10. doi:10.2196/mhealth.2391. http://mhealth.jmir.org/2013/2/e10/.
Daihua X. Yu, Bambang Parmanto, Brad E. Dicianno, Valerie J. Watzlaf & Katherine D. Seelman (2015): Accessibility needs and challenges of a mHealth system for patients with dexterity impairments, Disability and Rehabilitation: Assistive Technology: http://dx.doi.org/10.3109/17483107.2015.1063171
Dicianno BE, Fairman AD, McCue M, Parmanto B, Yih E, McCoy A, Pramana G, Yu DX, McClelland J, Collins DM, Brienza D: Feasibility of using mobile health to promote self-management in spina bifida. Am J Phys Med Rehabil 2015;00:00Y00: DOI: 10.1097/PHM.0000000000000400