Smartphone-Based Geofencing to Ascertain Hospitalizations

Area of Science:

• Digital Health
• Mobile Health (mHealth)
• Health Informatics

Background:

• Accurate hospitalization data is crucial for assessing healthcare quality and treatment outcomes.
• Ubiquitous smartphone technology has not been fully utilized for tracking hospitalizations.
• This study explores smartphone-based geofencing as a novel method for hospitalization ascertainment.

Purpose of the Study:

• To evaluate the effectiveness of smartphone-based geofencing for identifying and tracking hospitalizations.
• To assess the accuracy and feasibility of using mobile applications for real-time hospitalization monitoring.
• To determine the potential of this technology in healthcare research and patient care.

Main Methods:

• Developed a mobile application using GPS and cell tower triangulation to geofence hospitals.
• The app triggered a questionnaire when users remained in a geofenced hospital area for over 4 hours.
• Validated application-detected hospitalizations against electronic medical records in an in-person cohort and analyzed data from a remote cohort.

Main Results:

• In the in-person arm, the application detected 77% of hospitalizations (sensitivity).
• Application-reported length of stay correlated positively with electronic medical record data (r=0.53, P=0.03).
• In the remote arm, 243 hospital visits were detected, with a positive predictive value of 65%.

Conclusions:

• Smartphone geofencing can ascertain hospitalizations with modest accuracy, representing a novel approach.
• This proof-of-concept study demonstrates the potential of mobile applications in healthcare research.
• The geofencing technique may be adaptable for monitoring other health-related behaviors and locations.