Internet helpful in management of chronic illness, study finds

The use of at-home medical devices to connect doctors and patients via the Internet can help patients and their physicians work together more efficiently to manage some chronic conditions, according to results of a pilot project that paired the Cleveland Clinic's electronic health records (EHR) system with Microsoft's online HealthVaultservice.

"Although more research is certainly needed, the results of this observational study are promising, suggesting that at-home medical devices can help patients and doctors better track chronic conditions, coordinate treatment schedules, manage medication regimens, and schedule timely interventions," said C. Martin Harris, MD, chief information officer at the Cleveland Clinic. "Ultimately, such improvements make for more efficient health care, healthier patients, and possibly a reduction in healthcare costs."

More than 250 participants enrolled in the project; 68 percent had hypertension, 26 percent had diabetes, and 6 percent had heart failure. Participants used at-home heart rate monitors, glucometers, scales, pedometers, or blood pressure monitors, depending on their conditions. Data from these devices were uploaded to HealthVault, a web-based data storage platform for patients, which then connected to the patient's personal health record at the Cleveland Clinic (MyChart by Epic Systems) and the EHR system used by the patient's healthcare providers at the Cleveland Clinic (MyPractice by Epic Systems).

Investigators found a significant change in the average number of days between physician office visits for patients. Patients with diabetes or hypertension were able to visit the doctor's office less often; the number of days between appointments increased by 71 percent and 26 percent, respectively. Patients with heart failure, however, visited their doctors more often, decreasing the number of days between visits by 27 percent.

"When treating heart failure patients, timely intervention is crucial when complications arise, so that we can prevent serious problems that may require emergency room visits or readmissions," said Randall C. Starling, MD, MPH, head of the heart failure and cardiac transplant medicine section at the Cleveland Clinic. "The ability to monitor weight, blood pressure, and activity levels of heart failure patients on a regular basis ensures more timely doctor visits and avoidance of more expensive interventions."

The results of the pilot project suggest that some healthcare activities that traditionally have occurred only in a physician's office one day may occur wherever a patient may be, including at home or at work, according to the researchers.