title: Integration of a mobile-integrated therapy with electronic health records: lessons learned.
abstract: BACKGROUND
  Responses to the chronic disease epidemic have predominantly been standardized in their approach to date. Barriers to better health outcomes remain, and effective management requires patient-specific data and disease state knowledge be presented in methods that foster clinical decision-making and patient self-management. Mobile technology provides a new platform for data collection and patient-provider communication. The mobile device represents a personalized platform that is available to the patient on a 24/7 basis. Mobile-integrated therapy (MIT) is the convergence of mobile technology, clinical and behavioral science, and scientifically validated clinical outcomes. In this article, we highlight the lessons learned from functional integration of a Food and Drug Administration-cleared type 2 diabetes MIT into the electronic health record (EHR) of a multiphysician practice within a large, urban, academic medical center.
  
  
  METHODS
  In-depth interviews were conducted with integration stakeholder groups: mobile and EHR software and information technology teams, clinical end users, project managers, and business analysts. Interviews were summarized and categorized into lessons learned using the Architecture for Integrated Mobility® framework.
  
  
  RESULTS
  Findings from the diverse stakeholder group of a MIT-EHR integration project indicate that user workflow, software system persistence, environment configuration, device connectivity and security, organizational processes, and data exchange heuristics are key issues that must be addressed.
  
  
  CONCLUSIONS
  Mobile-integrated therapy that integrates patient self-management data with medical record data provides the opportunity to understand the potential benefits of bidirectional data sharing and reporting that are most valuable in advancing better health and better care in a cost-effective way that is scalable for all chronic diseases.
authors.affiliation: WellDoc, 1501 St. Paul St., Baltimore, MD 21202, USA. mpeeples@welldocinc.com
authors.forename: Malinda M
authors.initials: MM
authors.lastname: Peeples
authors.forename: Anand K
authors.initials: AK
authors.lastname: Iyer
authors.forename: Joshua L
authors.initials: JL
authors.lastname: Cohen
mesh_terms: D040421:Cell Phone; D003924:Diabetes Mellitus, Type 2 / Q000628:therapy*; D057286:Electronic Health Records; D006801:Humans; D033181:Information Dissemination / Q000379:methods; D063731:Mobile Applications; D019114:Remote Consultation / Q000295:instrumentation / Q000379:methods; D012648:Self Care / Q000295:instrumentation / Q000379:methods; D012984:Software; D017216:Telemedicine / Q000295:instrumentation / Q000379:methods