Hospital’s mHealth Project Finds Value in Fitbit Data

Reposted from mHealthIntelligence by Eric Wiklund

Children’s Hospitals and Clinics of Minnesota is using the popular fitness wearable to measure activity and sleep in its young diabetic patients.

A Minnesota hospital is tapping into Fitbit to better understand how activity and sleep patterns affect its young diabetic patients.

Children’s Hospitals and Clinics of Minnesota is using the popular fitness wearable to study the habits of 114 type 1 diabetic patients at home. The hospital, with campuses in both Minneapolis and St. Paul, is targeting children between the ages of 8 and 17 who’ve lived with the chronic condition for at least a year and are using insulin pumps.

Dr. Laura Gandrud, MD, a pediatric endocrinologist at the hospital, says the Fitbits give providers a window to the daily activities of their young patients and might help determine what has an impact on their A1c levels. That, in turn, would enable them to create better, more personalized care management plans that improve clinical outcomes.

“We need to capitalize on new technology that allows us to look at their data more frequently than every three months” when they come in for their regularly scheduled checkup, she said. “There’s a lot going on that we don’t know about.”

Those enrolled in the pilot program (they’re supplied with Fitbits if they don’t have one) are asked to upload their activity data once a week to a portal. Their doctors review that information alongside data collected from the patients’ Medtronic pumps. Using an online engagement platform designed by Welkin Health, a San Francisco-based startup, providers can communicate with patients and other care team members in real-time using phone, text or e-mail.

The hospital is also partnering with Optum and UnitedHealthcare to use predictive analytics, in hopes of spotting trends in A1c and blood glucose readings that signal health issues before they occur.

Gandrud said Children’s Minnesota chose Fitbits because of their popularity, especially with younger patients. While some within the healthcare industry have questioned whether data from consumer-facing devices is reliable, she said the activity and sleep data gathered by the Fitbits is good enough to spot trends.

While Fitbit has established itself in partnerships with a number of large employers and health plans in wellness programs, Children’s Minnesota is one of a small – but growing – number of health systems looking to find that link between consumer-facing fitness devices and clinical uses.  Other parties include research facilities like Northwestern University, which launched a program last year to track the recovery time of spine surgery patients through their Fitbits.

Last month, Los Angeles-based Cedars-Sinai Medical Center launched a small study using Fitbits to help its oncologists determine whether their patients are active enough to withstand chemotherapy treatments. On the other side of the country, Carolinas HealthCare recently launched an app platform that allows consumers to download data from more than 70 mobile devices – including Fitbits – to a patient portal that they can then share with their doctors.

“We evaluated a number of commercially available activity tracking devices in the summer of 2015,” said Jeff Weness, senior director of innovation and partnerships at Children’s Minnesota.  “Fitbit was the best match for our patients and our study needs at that time.  We made the choice primarily on the wearability, safety and … ability to securely access the data produced by devices.”

“We’ve never been able to objectively look at data from home,” Gandrud added. “Yes, this is kind of a home-grown protocol in that regard … but it does allow us to compare active and less active days and look for patterns.”

She also pointed out that the study involves not just the diabetic patient but the entire care team, including parents. Messages sent on the Welkin platform are directed to the parents (patients between 15 and 17 years of age can choose to receive the messages).

“This is a family disease,” she said. “It’s important to bring the family into the conversation” on care management.

Chase Hensel, Welkin’s co-founder and CEO, said the company’s platform “bridges the gap” between remote monitoring devices at home and the clinical care teams at the hospital or clinic. All that data being collected by the Fitbits and insulin pumps and analyzed by clinicians won’t be of use to either group unless they have the opportunity to communicate and collaborate. That’s especially true in chronic disease populations where self-management is part of the protocol.

Gandrud says the pilot project should start producing results this summer. By that time, they may start analyzing other data collected by the Fitbits, such as heart rate. They may also adapt the pilot to young diabetic who don’t wear insulin pumps.

“This is only the first step,” she said.