Abstract and Introduction
Abstract
Use of health information technology (IT) integrated with clinical services has the potential to empower self-management and decrease health care utilization for chronic disorders such as fibromyalgia (FM). However, the appropriate methodology that systematically facilitates the integration of health IT with clinical services between patients and nurses partnering to manage FM is unclear. The purpose of this study was to determine the feasibility of technology-enhanced monitoring that engages FM patients using a mobile device. A quantitative and qualitative descriptive design was used in a convenience sample of 20 FM patients. Patients used a mobile monitoring device for one week; nurses responded to patient e-mailed symptom reports on a daily basis. Analysis was primarily descriptive—percent, frequencies, and means for individual questionnaire items and subscales were calculated. For qualitative data, a 1 hour focus group was audio-recorded, transcribed verbatim, and then analyzed using content analysis. All participants used a mobile phone in their daily lives; half used a smart phone. Participants were interested in using a smart phone to monitor their health and to communicate with health care providers. Participants used the study mobile device an average of 5.2 days out of the 7 day study period. Most participants (80%) reported that monitoring symptoms using the device was easy to do. Sixty-five percent felt that using the device helped them to promptly address their symptoms. Results from this study indicated that health IT integrated with clinical services is feasible to monitor FM symptoms and to communicate with the care team.
Introduction
Health information technology (IT)-focused system redesign is transforming the delivery of care for individuals with chronic conditions in the United States (Coye, Haselkorn, & DeMello, 2009). Technology used for health applications includes the Internet, smart phones, text messaging, and e-mail to facilitate electronic patient monitoring, education, and support programs (Boland, 2007). Health IT-based models of care, however, need to be individualized to the needs of disease specific populations (Brennan et al., 2006).
Fibromyalgia (FM) is a resource intensive chronic pain disorder requiring substantial health care resources (Berger, Dukes, Martin, Edelsberg, & Oster, 2007; Berger et al., 2010; Sanchez et al., 2011; Thompson et al., 2011). Use of health IT for chronic conditions such as FM has the potential to decrease health care utilization while empowering patients in appropriate self-management. The purpose of our study was to determine the feasibility of adding technology-enhanced self-management support for symptom monitoring in patients with FM to the standard clinical care. Specifically, we sought to achieve the following: Aim 1, determine participant's current use and perceived value of technology to support self-management; Aim 2, evaluate the use of a mobile device to monitor and manage symptoms; and Aim 3, determine the feasibility of study procedures.
Theoretical Framework
This study is grounded in the theoretical and empirically based Chronic Care Model developed by Wagner et al. (2001) in response to the recognition of widespread inefficiencies and ineffectiveness of chronic illness care and the effectiveness of a multifaceted, evidence-based model that includes self-management support and use of health IT.