Browsing by Author "Chin, Marshall H"
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- ItemFeasibility and usability of a text message-based program for diabetes self-management in an urban African-American population.(2011-10-26) Dick, Jonathan J; Nundy, Shantanu; Solomon, Marla C; Bishop, Keisha N; Chin, Marshall H; Peek, Monica EPURPOSE We pilot tested a text message based diabetes care program in an urban African American population in which automated text messages were sent to participants with personalized medication foot care and appointment reminders and text messages were received from participants on adherence METHODS Eighteen patients participated in a 4 week pilot study Baseline surveys collected data about demographics historical cell phone usage and adherence to core diabetes care measures Exit interview surveys using close coded and open ended questions were administered to patients at the end of the program A 1 month follow up interview was conducted surveying patients on perceived self efficacy Wilcoxon signed rank tests were used to compare baseline survey responses about self management activities to those at the pilot s end and at 1 month follow up RESULTS Eighteen urban African American participants completed the pilot study The average age was 55 and the average number of years with diabetes was 8 Half the participants were initially uncomfortable with text messaging Example messages include Did you take your diabetes medications today and How many times did you check your feet for wounds this week Participants averaged 220 text messages with the system responded to messages 80 of the time and on average responded within 6 minutes Participants strongly agreed that text messaging was easy to perform and helped with diabetes self care Missed medication doses decreased from 1 6 per week to 0 6 p 003 Patient confidence in diabetes self management was significantly increased during and 1 month after the pilot p 002 p 008 CONCLUSIONS Text messaging may be a feasible and useful approach to improve diabetes self management in urban African Americans
- ItemMobile phone diabetes project led to improved glycemic control and net savings for Chicago plan participants.(2014-02-04) Nundy, Shantanu; Dick, Jonathan J; Chou, Chia-Hung; Nocon, Robert S; Chin, Marshall H; Peek, Monica EEven with the best health care available patients with chronic illnesses typically spend no more than a few hours a year in a health care setting while their outcomes are largely determined by their activities during the remaining 5 000 waking hours of the year As a widely available low cost technology mobile phones are a promising tool to use in engaging patients in behavior change and facilitating self care between visits We examined the impact of a six month mobile health mHealth demonstration project among adults with diabetes who belonged to an academic medical center s employee health plan In addition to pre post improvements in glycemic control p 0 01 and patients satisfaction with overall care p 0 04 we observed a net cost savings of 8 8 percent Those early results suggest that mHealth programs can support health care organizations pursuit of the triple aim of improving patients experiences with care improving population health and reducing the per capita cost of health care
- ItemUsing mobile health to support the chronic care model: developing an institutional initiative.(2013-01-10) Nundy, Shantanu; Dick, Jonathan J; Goddu, Anna P; Hogan, Patrick; Lu, Chen-Yuan E; Solomon, Marla C; Bussie, Arnell; Chin, Marshall H; Peek, Monica EBackground Self management support and team based care are essential elements of the Chronic Care Model but are often limited by staff availability and reimbursement Mobile phones are a promising platform for improving chronic care but there are few examples of successful health system implementation Program Development An iterative process of program design was built upon a pilot study and engaged multiple institutional stakeholders Patients identified having a human face to the pilot program as essential Stakeholders recognized the need to integrate the program with primary and specialty care but voiced concerns about competing demands on clinician time Program Description Nurse administrators at a university affiliated health plan use automated text messaging to provide personalized self management support for member patients with diabetes and facilitate care coordination with the primary care team For example when a patient texts a request to meet with a dietitian a nurse administrator coordinates with the primary care team to provide a referral Conclusion Our innovative program enables the existing health system to support a de novo care management program by leveraging mobile technology The program supports self management and team based care in a way that we believe engages patients yet meets the limited availability of providers and needs of health plan administrators