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Published on: August 8, 2019
Mobile health monitoring of children with CHDs
Megan E LeBlanc1, Sarah Tallent2, Christoph P Hornik3
1Department of Pediatrics, Duke University Medical Center, Durham, NC, USA.
Insights
Mobile health monitoring with the KidsHeart app improves care for infants with congenital heart disease (CHD). This technology enables earlier interventions, tracks growth and feeding, and monitors neurodevelopmental outcomes.
Area of Science:
- Pediatric Cardiology
- Digital Health
- Congenital Heart Disease
Background:
- Mobile health (mHealth) offers potential to enhance healthcare quality, accessibility, and efficiency.
- The KidsHeart app was evaluated for its benefits in monitoring infants with congenital heart disease (CHD).
Purpose of the Study:
- To assess the advantages of mHealth monitoring via the KidsHeart app in an infant CHD population.
- To evaluate a novel mHealth red flag scoring system, growth/feed tracking, and neurodevelopmental outcome tracking.
Main Methods:
- Retrospective review of data from the KidsHeart app for infants with high-risk CHD lesions post-intervention.
- Analysis of mHealth red flag notifications, growth/feeding data, and neurodevelopmental questionnaires.
Main Results:
- 69 infants with CHD were monitored for a median of 137 days.
- 245 red flag violations led to 116 interventions, including 34 hospital admissions.
- 91% of subjects submitted growth data, leading to 31 feeding adjustments; 68% submitted neurodevelopment questionnaires.
Conclusions:
- mHealth monitoring with the KidsHeart app enhances interstage surveillance for infants with CHD.
- The app facilitates earlier interventions, remote tracking of growth and feeding, and longitudinal neurodevelopmental outcome assessment.
Background:
Mobile health has been shown to improve quality, access, and efficiency of health care in select populations. We sought to evaluate the benefits of mobile health monitoring using the KidsHeart app in an infant CHD population.
Methods:
We reviewed data submitted to KidsHeart from parents of infants discharged following intervention for high-risk CHD lesions including subjects status post stage 1 single ventricle palliation, ductal stent or surgical shunt, pulmonary artery band, or right ventricular outflow tract stent. We report on the benefits of a novel mobile health red flag scoring system, mobile health growth/feed tracking, and longitudinal neurodevelopmental outcomes tracking.
Results:
A total of 69 CHD subjects (63% male, 41% non-white, median age 28 days [interquartile range 20, 75 days]) were included with median mobile health follow-up of 137 days (56, 190). During the analytic window, subjects submitted 5700 mobile health red flag notifications including 245 violations (mean [standard deviation] 3 ± 3.96 per participant) with 80% (55/69) of subjects submitting at least one violation. Violations precipitated 116 interventions including hospital admission in 34 (29%) with trans-catheter evaluation in 15 (13%) of those. Growth data (n = 2543 daily weights) were submitted by 63/69 (91%) subjects and precipitated 31 feed changes in 23 participants. Sixty-eight percent of subjects with age >2 months submitted at least one complete neurodevelopment questionnaire.
Conclusion:
In our initial experience, mobile health monitoring using the KidsHeart app enhanced interstage monitoring permitting earlier intervention, allowed for remote tracking of growth feeding, and provided a means for tracking longitudinal neurodevelopmental outcomes.
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