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Mobile health monitoring of children with CHDs

Published online by Cambridge University Press:  10 October 2024

Megan E. LeBlanc*
Affiliation:
Department of Pediatrics, Duke University Medical Center, Durham, NC, USA
Sarah Tallent
Affiliation:
Department of Pediatric Cardiology, Duke University Medical Center, Durham, NC, USA
Christoph P. Hornik
Affiliation:
Department of Pediatric Cardiac Surgery, Duke University Medical Center, Durham, NC, USA
Michael G.W. Camitta
Affiliation:
Department of Pediatric Cardiology, Duke University Medical Center, Durham, NC, USA
Anne C. Schmelzer
Affiliation:
Department of Pediatric Cardiology, Duke University Medical Center, Durham, NC, USA Department of Neonatology, Duke University Medical Center, Durham, NC, USA
Lillian Kang
Affiliation:
Department of Surgery, Duke University Medical Center, Durham, NC, USA
Kevin D. Hill
Affiliation:
Department of Pediatric Cardiology, Duke University Medical Center, Durham, NC, USA
*
Corresponding author: Megan E. LeBlanc; Email: [email protected]

Abstract

Background:

Mobile health has been shown to improve quality, access, and efficiency of health care in select populations. We sought to evaluate the benefits of mobile health monitoring using the KidsHeart app in an infant CHD population.

Methods:

We reviewed data submitted to KidsHeart from parents of infants discharged following intervention for high-risk CHD lesions including subjects status post stage 1 single ventricle palliation, ductal stent or surgical shunt, pulmonary artery band, or right ventricular outflow tract stent. We report on the benefits of a novel mobile health red flag scoring system, mobile health growth/feed tracking, and longitudinal neurodevelopmental outcomes tracking.

Results:

A total of 69 CHD subjects (63% male, 41% non-white, median age 28 days [interquartile range 20, 75 days]) were included with median mobile health follow-up of 137 days (56, 190). During the analytic window, subjects submitted 5700 mobile health red flag notifications including 245 violations (mean [standard deviation] 3 ± 3.96 per participant) with 80% (55/69) of subjects submitting at least one violation. Violations precipitated 116 interventions including hospital admission in 34 (29%) with trans-catheter evaluation in 15 (13%) of those. Growth data (n = 2543 daily weights) were submitted by 63/69 (91%) subjects and precipitated 31 feed changes in 23 participants. Sixty-eight percent of subjects with age >2 months submitted at least one complete neurodevelopment questionnaire.

Conclusion:

In our initial experience, mobile health monitoring using the KidsHeart app enhanced interstage monitoring permitting earlier intervention, allowed for remote tracking of growth feeding, and provided a means for tracking longitudinal neurodevelopmental outcomes.

Type
Original Article
Copyright
© The Author(s), 2024. Published by Cambridge University Press

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References

WHO. Global Strategy on Digital Health 2020–2025. World Health Organization, Geneva, 2021.Google Scholar
Borges do Nascimento, I, Abdulazeem, HM, Vasanthan, LT et al. The global effect of digital health technologies on health workers’ competencies and health workplace: an umbrella review of systematic reviews and lexical-based and sentence-based meta-analysis. Lancet Digit Health 2023; 5:e534e544.CrossRefGoogle ScholarPubMed
Jacobs, JP, Wernovsky, G, Elliott, MJ. Analysis of outcomes for congenital cardiac disease: can we do better?. Cardiol Young 2007; 17:145158.CrossRefGoogle ScholarPubMed
Bingler, M, Erickson, LA, Reid, KJ et al. Interstage outcomes in infants with single ventricle heart disease comparing home monitoring technology to three-ring binder documentation: a randomized crossover study. World J Pediatr Congenit Heart Surg 2018; 9:305314.CrossRefGoogle ScholarPubMed
Cross, R, Steury, R, Randall, A, Fuska, M, Sable, C. Single-ventricle palliation for high-risk neonates: examining the feasibility of an automated home monitoring system after stage I palliation. Future Cardiol 2012; 8:227235.CrossRefGoogle ScholarPubMed
Foster, CC, Steltzer, M, Snyder, A et al. Integrated multimodality telemedicine to enhance in-home care of infants during the interstage period. Pediatr Cardiol 2021; 42:349360.CrossRefGoogle ScholarPubMed
Rudd, NA, Ghanayem, NS, Hill, GD et al. Interstage home monitoring for infants with single ventricle heart disease: education and management: a scientific statement from the American Heart Association. J Am Heart Assoc 2020; 9: e014548,CrossRefGoogle ScholarPubMed
Vergales, J, Peregoy, L, Zalewski, J, Plummer, ST. Use of a digital monitoring platform to improve outcomes in infants with a single ventricle. World J Pediatr Congenit Heart Surg 2020; 11: 753759.CrossRefGoogle ScholarPubMed
Sheldrick, RC, Perrin, EC. Evidence-based milestones for surveillance of cognitive, language, and motor development. Acad Pediatr 2013; 13: 577586.CrossRefGoogle ScholarPubMed
Alhussein, G, Hadjileontiadis, L. Digital health technologies for long-term self-management of osteoporosis: systematic review and meta-analysis. JMIR Mhealth Uhealth 2022; 10: e32557 CrossRefGoogle ScholarPubMed
Liu, S, Feng, W, Chhatbar, PY, Liu, Y, Ji, X, Ovbiagele, B. Mobile health as a viable strategy to enhance stroke risk factor control: a systematic review and meta-analysis. J Neurol Sci 2017; 378: 140145.CrossRefGoogle ScholarPubMed
Martinez-Millana, A, Zettl, A, Floch, J et al. The potential of self-management mHealth for pediatric cystic fibrosis: mixed-methods study for health care and app assessment. JMIR Mhealth Uhealth 2019; 7: e13362.CrossRefGoogle Scholar
Mitsuya, M., et al., An mHealth App for the Non-contact Measurement of Pulmonary Function Using the Smartphone’s Built-in Depth Sensor. Annu Int Conf IEEE Eng Med Biol Soc, 2022 : p. 3357-3360.CrossRefGoogle Scholar
Schliemann, D, Tan, MM, Hoe, WMK et al mHealth Interventions to Improve Cancer Screening and Early Detection: Scoping Review of Reviews.. J Med Internet Res 2022; 24: e36316.CrossRefGoogle ScholarPubMed
Tripoliti, EE, Karanasiou, GS, Kalatzis, FG, Naka, KK, Fotiadis, DI. The evolution of mHealth solutions for heart failure management. Adv Exp Med Biol 2018; 1067: 353371.CrossRefGoogle ScholarPubMed
Webb, TL, Joseph, J, Yardley, L, Michie, S. Using the internet to promote health behavior change: a systematic review and meta-analysis of the impact of theoretical basis, use of behavior change techniques, and mode of delivery on efficacy. J Med Internet Res 2010; 12 : e4.CrossRefGoogle Scholar
Welke, KF, Pasquali, SK, Lin, P et al. Hospital distribution and patient travel patterns for congenital cardiac surgery in the United States. Ann Thorac Surg 2019; 107 :574581.CrossRefGoogle ScholarPubMed
Bird, M, Li, L, Ouellette, C, Hopkins, K, McGillion, MH, Carter, N. Use of synchronous digital health technologies for the care of children with special health care needs and their families: scoping review. JMIR Pediatr Parent 2019; 2 e15106.CrossRefGoogle ScholarPubMed
Blair, L, Vergales, J, Peregoy, L, Seegal, H, Keim‐Malpass, J. Acceptability of an interstage home monitoring mobile application for caregivers of children with single ventricle physiology: toward technology-integrated family management. J Spec Pediatr Nurs 2022; 27: e12372.CrossRefGoogle ScholarPubMed
Erickson, LA, Emerson, A, Russell, CL. Parental mobile health adherence to symptom home monitoring for infants with congenital heart disease during the single ventricle interstage period: a concept analysis. J Spec Pediatr Nurs 2020; 25: e12303.CrossRefGoogle ScholarPubMed
Hartman, D, Ebenroth, E, Farrell, A. Utilizing technology to expand home monitoring to high-risk infants with CHD. Cardiol Young 2023; 33 : 11241128.CrossRefGoogle ScholarPubMed
Kauw, D, Koole, MAC, van Dorth, JR et al. eHealth in patients with congenital heart disease: a review. Expert Rev Cardiovasc Ther 2018;16 : 627634.CrossRefGoogle ScholarPubMed
Anderson, JB, Beekman, RH, Kugler, JD et al. Improvement in interstage survival in a national pediatric cardiology learning network. Circ Cardiovasc Qual Outcomes 2015; 8 : 428436.CrossRefGoogle Scholar
Castellanos, DA, Herrington, C, Adler, S, Haas, K, Ram Kumar, S, Kung, GC. Home monitoring program reduces mortality in high-risk sociodemographic single-ventricle patients. Pediatr Cardiol 2016; 37 : 15751580.CrossRefGoogle ScholarPubMed
Ghanayem, NS, Hoffman, GM, Mussatto, KA et al. Home surveillance program prevents interstage mortality after the Norwood procedure. J Thorac Cardiovasc Surg 2003; 126 :13671377.CrossRefGoogle ScholarPubMed
Hehir, DA, Ghanayem, NS. Single-ventricle infant home monitoring programs: outcomes and impact. Curr Opin Cardiol 2013; 28 :97102.CrossRefGoogle ScholarPubMed
Oster, ME, Ehrlich, A, King, E et al. Association of interstage home monitoring with mortality, readmissions, and weight gain: a multicenter study from the national pediatric cardiology quality improvement collaborative. Circulation 2015; 132 :502508.CrossRefGoogle ScholarPubMed
Staehler, H, Schaeffer, T, Wasner, J et al. Impact of home monitoring program on interstage mortality after the norwood procedure. Front Cardiovasc Med 2023; 10: 123947,CrossRefGoogle ScholarPubMed
Van den Eynde, J, Bartelse, S, Rijnberg, FM et al. Somatic growth in single ventricle patients: a systematic review and meta-analysis. Acta Paediatr 2023; 112:, 186199.CrossRefGoogle ScholarPubMed
Williams, RV, Zak, V, Ravishankar, C et al. Factors affecting growth in infants with single ventricle physiology: a report from the pediatric heart network infant single ventricle trial. J Pediatr 2011; 159 :10171022.e2.CrossRefGoogle ScholarPubMed
Kugler, JD, Beekman Iii, RH, Rosenthal, GL et al . Development of a pediatric cardiology quality improvement collaborative: from inception to implementation. From the Joint Council on Congenital Heart Disease Quality Improvement Task Force.. Congenit Heart Dis 2009; 4 :318328.CrossRefGoogle ScholarPubMed
Wali, S, Remtulla Tharani, A, Balmer-Minnes, D et al. Exploring the use of a digital therapeutic intervention to support the pediatric cardiac care journey: qualitative study on clinician perspectives. PLOS Digit Health 2023; 2 : e0000371.CrossRefGoogle ScholarPubMed
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