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DIGITAL HEALTH

Stepping with the Oldies

An off-the-shelf pedometer gives new depth to hospital data.

MICHAEL FITZHUGH

The Burrill Report

Any fitness buff will tell you that 10,000 steps is the daily rule of thumb for walking your way to good health. But what about a couple hundred steps?

For a Mayo Clinic team armed with a batch of FitBits, each step proved meaningful. The team, led by David Cook, used the off-the-shelf fitness monitor to measure the daily mobility of more than a hundred older patients after heart surgery. Their findings, published in the September issue of the American Journal of Thoracic Surgery showed that not only was the wireless monitoring easy and practical, but it showed a significant relationship between the number of steps taken in early recovery, length of stay, and readiness for hospital discharge.

“As we began to aggregate the data we saw big differences in early mobility from patients and got a good idea about who was going to go home early and who wasn’t,” says Cook.

With daily step-counts transmitted wirelessly from the ankle-mounted FitBits to an in-room computer, providers were able to monitor patients with a new level of consistent, reliable, and accessible data. Instead of leaning on busy nurses to walk with patients, record data, and later share it, doctors were able to review data on a cloud-based dashboard, helping them see trends in patient recovery.

“Wireless monitoring of mobility after major surgery creates an opportunity for early identification and intervention in individual patients,” Cook wrote in the Journal. The ability to use simple inexpensive consumer technology allows not just the bypass of expensive and complex of health information systems, he says, but also an important tool for evaluating and improving care and outcomes once patients are discharged from the hospital.

The system was by no means perfect. Data provided by the FitBits was not integrated into Mayo’s electronic medical records system and did not work for shuffling patients using walkers.

But by piecing together the step data with other information collected from the iPads Mayo gives surgery patients, such as self-reported pain-scores and data about whether patients have completed daily tasks assigned to aid their recovery, Cook and his co-authors write that the door is open for changing recovery models and improving outcomes in surgical practice.

Cook is equally excited about the potential for consumer technology to aid home care and monitoring outside of the already data-rich hospital setting. “The value there is extraordinary,” he says. “There are huge sections of time and space where we’re blind to what’s happening to patients.”

Those blind spots are rapidly diminishing as ever more sophisticated sensors make their way into our everyday lives. The creative repurposing and reuse of those technologies intended for one function but good enough for another will inevitably expand the volume and consistency of data we can collect. Using it to steer us toward better healthcare outcomes, such as Cook and his colleauges are doing, will be key to providing the care we all deserve.



September 12, 2013
http://www.burrillreport.com/article-stepping_with_the_oldies.html

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