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Using Location-Based Smartphone Alerts Within a System of Care Coordination

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A smartphone app that uses location data to notify PCPs when a patient arrives in the hospital or ER is a simple, potentially scalable approach to improve care coordination after a hospital visit.

Project Details -
Completed

Coordination of care across the health system is an essential component of high-quality primary care. However, primary care providers (PCPs) often do not know when their patients are in the hospital or emergency department (ED), preventing them from providing important followup care. These circumstances may disproportionately harm vulnerable populations, who are likely to frequently visit the ED and have comorbid medical and social needs that put them at risk for poor outcomes.

To address this issue, a research team from Northwestern University developed a smartphone application (app) that notifies PCPs when one of their patients arrives in the hospital or ED. The app asks patients to confirm “Are you a patient in the ED/hospital now?” when real-time location data in their smartphone indicate that they are at a hospital. If the patient confirms, the app securely notifies their PCP through the electronic health record, thereby providing an opportunity for rapid followup and care coordination activities.

The specific aims of this research were as follows:

  • Develop a care coordination system in which a novel smartphone app facilitates information transfer and care coordination following inpatient admissions and ED visits. 
  • Conduct a feasibility study examining the system’s preliminary impacts and implementation in a care management program for high-risk patients. 

The app was developed through a team-based process that included feedback collected through focus groups with patients and provider interviews. Fifteen patients were observed using the app during beta testing. Findings were used to improve the app, including development of a Spanish-language version. The app was further tested with 62 patients at Erie Family Health Centers, a Chicago-area federally qualified health center serving a predominantly low-income and minority population.

Study participants liked the simplicity of the app, felt it would improve their care, and did not report many barriers to using it. PCPs learned their patients received emergency care at many area hospitals that otherwise were not communicating information about the hospital visit to them. When the app notified primary care practices that a patient was in the hospital, a care manager followed up within 2 days 92 percent of the time. This study showed that smartphones may be effective for facilitating information transfer and care coordination in vulnerable populations.

Using Smartphone Location Data for Care Coordination

Using Smartphone Location Data for Care Coordination

A smartphone app that uses location data to notify PCPs when a patient arrives in the hospital or ER is a simple, potentially scalable approach to improve care coordination after a hospital visit.

Principal Investigator: Liss, David T.
Organization: Northwestern University
Research Profile: Using Location-Based Smartphone Alerts Within a System of Care Coordination
Funded Amount: $300,000

Care coordination: essential but challenging

Coordination of care across the health system is an essential component of high-quality primary care. However, PCPs often do not know when their patients are in the hospital or emergency room (ER), preventing them from providing important followup care. Dr. David Liss and his research team at Northwestern University wanted to address this problem. Dr. Liss asks “If I can use Uber, bike sharing, and other apps that enable my phone to communicate my location, why can’t we do this in healthcare?”

A primary care practice can’t properly coordinate care unless they are aware of the events and care that need to be addressed. Notifications from a smartphone can enable this coordination to happen. We want to facilitate the transfer of this information to the right people.”
– Dr. Liss

Developing an app for care coordination

Dr. Liss and his team developed a smartphone app that notifies PCPs when one of their patients arrives in the hospital or ER. The app asks patients to confirm “Are you a patient in the ER/hospital now?” when real-time location data in their smartphone indicates that the patient is at a hospital. If the patient confirms they are in the hospital or ER, the app securely notifies their PCP through the EHR, thereby providing an opportunity for rapid followup and care coordination activities.

The app was developed through a team-based process that included feedback collected through focus groups with patients and provider interviews.

Fifteen patients were observed using the app during beta testing. Findings were used to improve the app, including development of a Spanish-language version. “Smart phones are a tool that we are learning more and more about, and it is important to work with patients to understand what works for them, and then build the software around them,” notes Dr. Liss. He stresses the importance of keeping the patient front and center in the design and the modification process. “There were challenges,” continues Dr. Liss, “but none were impossible to overcome if you know what patients want and how they are using the technology.”

A simple app can improve healthcare

The app was further tested with 62 patients at Erie Family Health Centers, a Chicago-area federally qualified health center serving a predominantly low-income and minority population. Study participants liked the simplicity of the app and felt it would improve their care. Dr. Liss and his team were surprised and happy to hear patients didn’t have many barriers to using the app. PCPs learned their patients received emergency care at many area hospitals that otherwise were not communicating information about the hospital visit to the PCP. When the app notified primary care practices that a patient was in the hospital, a care manager followed up within 2 days 92 percent of the time. Dr. Liss thinks that smartphone location data can be an important part of many new approaches to improving public health, including efforts to track the spread of COVID-19.