title: Lessons from a community-based mHealth diabetes self-management program: "it's not just about the cell phone".
abstract: Cell phone-assisted self-management of diabetes offers a new approach to improving chronic care; however, introducing this new technology presents many challenges to a health care team. The George Washington University-District of Columbia Cell Phone Diabetes Project enrolled 32 patients with Type 2 diabetes from a community clinic using patients' cell phones connected to the Well Doc Diabetes Manager System with monitoring by case managers and monthly reports to primary care providers. Despite monetary incentives (cell phone rebates), dropout rate was high (50%), because of lack of use or inability to afford low-cost cell phone service. Active patients had sustained system use with improved diabetes standard-of-care goals and reduced hospitalizations and emergency department visits. On the basis of this pilot program, the authors assessed the multiple links in the chain (patients, case managers, primary care providers, support staff, medical record systems, disease management software, cell phones) that affect the success of a mHealth chronic care strategy.
authors.affiliation: Department of Medicine, The George Washington University School of Medicine, Washington, District of Columbia 20037, USA. rkatz@mfa.gwu.edu
authors.forename: Richard
authors.initials: R
authors.lastname: Katz
authors.forename: Tsega
authors.initials: T
authors.lastname: Mesfin
authors.forename: Karen
authors.initials: K
authors.lastname: Barr
mesh_terms: D000328:Adult; D040421:Cell Phone; D003153:Community Health Services / Q000458:organization & administration*; D003924:Diabetes Mellitus, Type 2 / Q000628:therapy*; D004219:District of Columbia; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D010352:Patient Dropouts / Q000706:statistics & numerical data; D010865:Pilot Projects; D015397:Program Evaluation; D012648:Self Care / Q000379:methods*; D017216:Telemedicine / Q000379:methods*