Technical Guidance for Clinicians Interested in Partnering With Engineers in Mobile Health Development and Evaluation

Abstract

The explosion of mobile health (mHealth) interventions has prompted significant investment and exploration that has extended past industry into academia. Although research in this space is emerging, it focuses on the clinical and population level impact across different populations. To realize the full potential of mHealth, an intimate understanding of how mHealth is being used by patients and potential differences in usage between various demographic groups must also be prioritized. In this viewpoint, we use our experiences in building an mHealth intervention that incorporates an iOS app, Bluetooth-enabled blood pressure cuff, and Apple Watch to share knowledge on (1) how user interaction data can be tracked in the context of health care privacy laws, (2) what is required for effective, nuanced communication between clinicians and engineers to design mHealth interventions that are patient-centered and have high clinical impact, and (3) how to handle and set up a process to handle user interaction data efficiently.

Keywords: cardiology; mHealth; myocardial infarction; personalized medicine.

Conflict of interest statement

Conflicts of Interest: There was no specific funding for this paper. EMS has received the following financial support for research, authorship, and/or publication: NIH/NINR F31 NR017328, Ruth L Kirschstein National Research Service Award and NIH/NINR T32 NR012704, Pre-Doctoral Fellowship in Interdisciplinary Cardiovascular Health Research. The sponsor had no role in study design, collection, analysis, and interpretation of data, writing the report, and the decision to submit the report for publication. SSM reports receiving grants and research support from the PJ Schafer Cardiovascular Research Fund, the David and June Trone Family Foundation, American Heart Association, Aetna Foundation, Maryland Innovation Initiative, Nokia, iHealth, Google, and Apple, as well as receiving personal fees for serving on scientific advisory boards for Amgen, Sanofi/Regeneron, Quest Diagnostics, Esperion, Novo Nordisk, Akcea Therapeutics. In addition, SSM reports having patent applications pending. FAM and SSM are founders of and hold equity in Corrie Health, which intends to further develop the platform. This arrangement has been reviewed and approved by the Johns Hopkins University in accordance with its conflict of interest policies. Furthermore, the Corrie Health Digital Platform has received material support from Apple and iHealth, and funding from the Maryland Innovation Initiative, Wallace H Coulter Translational Research Partnership, Louis B Thalheimer Fund, and JH Individualized Health Initiative. Corrie Health, as described in this work, was developed by FAM, MAL, and SSM. They are also founders of and hold equity in Corrie Health, which intends to further develop the digital platform. This arrangement has been reviewed and approved by the Johns Hopkins University in accordance with its conflict of interest policies.

©Lochan M Shah, William E Yang, Ryan C Demo, Matthias A Lee, Daniel Weng, Rongzi Shan, Shannon Wongvibulsin, Erin M Spaulding, Francoise A Marvel, Seth S Martin. Originally published in JMIR Mhealth and Uhealth (http://mhealth.jmir.org), 15.05.2019.

Figures

Figure 1

An example of view controllers and their use in user interaction tracking.

Figure 2

An example of data collection and product considerations when developing a new feature.

Figure 3

Progression of user-interaction data management and extraction. CSV: comma separated value; JSON: JavaScript Object Notation.

Figure 4

Key takeaways. CSV: comma separated value; JSON: JavaScript Object Notation; EMR: electronic medical record.