A Clinically Integrated mHealth App and Practice Model for Collecting Patient-Reported Outcomes between Visits for Asthma Patients: Implementation and Feasibility
Open accessAbstract
Objective Mobile health (mHealth) apps may prove to be useful tools for supporting chronic disease management. We assessed the feasibility of implementing a clinically integrated mHealth app and practice model to facilitate between-visit asthma symptom monitoring as per guidelines and with the help of patient-reported outcomes (PRO). Methods We implemented the intervention at two pulmonary clinics and conducted a mixed-methods analysis of app usage data and semi-structured interview of patients and clinician participants over a 25-week study period. Results Five physicians, 1 physician's assistant, 1 nurse, and 26 patients participated. Twenty-four patients (92%) were still participating in the intervention at the end of the 25-week study period. On average, each patient participant completed 21 of 25 questionnaires (84% completion rate). Weekly completion rates were higher for participants who were female (88 vs. 73%, p = 0.02) and obtained a bachelor's degree level or higher (94 vs. 74%, p = 0.04). On average, of all questionnaires, including both completed and not completed (25 weekly questionnaires times 26 patient participants), 25% had results severe enough to qualify for a callback from a nurse; however, patients declined this option in roughly half of the cases in which they were offered the option. We identified 6 key themes from an analysis of 21 patients and 5 clinician interviews. From the patient's perspective, these include more awareness of asthma, more connected with provider, and app simplicity. From the clinician's perspective, these include minimal additional work required, facilitating triage, and informing conversations during visits. Conclusion Implementation of a clinically integrated mHealth app and practice model can achieve high patient retention and adherence to guideline-recommended asthma symptom monitoring, while minimally burdening clinicians. The intervention has the potential for scaling to primary care and reducing utilization of urgent and emergency care.
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User adherence is crucial to the effectiveness of DHT applications in the real world, which can be affected by convenience, user experience, and true benefits brought by this technology.
“User adherence is crucial to the effectiveness of DHT applications in the real world, which can be affected by convenience, user experience, and true benefits brought by this technology (for example, helping them decide when to contact their provider, being more aware of their symptoms, and feeling more connected to their provider).138,139”
From Artificial intelligence in diabetes management: Advancements, opportunities, and challenges (2023) · cites this paper as [139]
The Patient Themes section (page not available) reports that patients valued the app’s simplicity, symptom awareness, and connection to their provider; the discussion (p. 789) says its core features helped patients decide when to seek care. The Clinical Relevance Statement reports questionnaire adherence, but this single-app feasibility study does not establish that adherence is crucial to the real-world effectiveness of DHT applications generally, or that the listed benefits caused adherence. (LLM, conf=0.83)
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Awasthi, R., Mahavar, A., Shah, S., Patel, D. A., Patel, M., Shah, D. A., & Patel, A. D. (2024) · Current Bioinformatics · doi:10.2174/0115748936320525240915050640
Smith, M., Leeson, M., Konieczny, K., Rodriguez, J. A., Rudin, R. S., Garabedian, P. M., Plombon, S., Edelen, M. O., & Dalal, A. K. (2026) · doi:10.2196/preprints.100761
Self-citationSturman, N. J., Nikles, J., Worthy, P., Fjaagesund, S., Elphinston, R. A., Andrews, N. E., Sterling, M. M., & Konigorski, S. (2026) · JMIR Research Protocols · doi:10.2196/79810
Sukriti, K. C., Hopkinson, N. S., Neves, A. L., Majeed, A., & Laverty, A. A. (2026) · Online Journal of Public Health Informatics · doi:10.2196/83483
Smith, M., Konieczny, K., Leeson, M., Rodriguez, J. A., Garabedian, P. M., Plombon, S., Rudin, R. S., Edelen, M. O., & Dalal, A. K. (2026) · medRxiv · doi:10.64898/2026.08.11.26360182
Self-citation
- Authors
- Rudin, R. S., Fanta, C. H., Qureshi, N., Duffy, E., Edelen, M. O., Dalal, A. K., & Bates, D. W.
- Affiliations
- RAND Corporation (US)
- Brigham and Women's Hospital (US)
- Corresponding author
- Rudin, Robert S.
- Venue
- Applied Clinical Informatics
- Publisher
- Georg Thieme Verlag KG
- Published
- 2019-10
- Volume
- 10
- Issue
- 05
- Pages
- 783-793
- ISSN
- 1869-0327 (ISSN-L)
- PMC
- PMC6795530
- OpenAlex
- W2980390049
- Cited by
- 37
- References
- 54
- Citations by year
- 2026: 4 · 2025: 5 · 2024: 6 · 2023: 5 · 2022: 9 · 2021: 5 · 2020: 3
- FWCI
- 5.79
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Applied Clinical Informatics (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Agency for Healthcare Research and Quality (R21 HS023960)
- Topics
- Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
- Health Sciences › Medicine › Physiology › Asthma and respiratory diseases
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- Keywords
- mobile health apps, asthma, patient-reported outcomes, chronic disease management, clinical practice model, implementation feasibility, patient retention, clinician workload, nurse triage, patient-provider relationship, app usability
- MeSH terms
- Patient Reported Outcome Measures, Ambulatory Care, Asthma, Feasibility Studies, Female, Humans, Male, Telemedicine, Mobile Applications
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