title: Utility and efficacy of a smartphone application to enhance the learning and behavior goals of traditional cardiac rehabilitation: a feasibility study.
abstract: OBJECTIVE
  Most eligible patients do not participate in traditional clinic-based cardiac rehabilitation (CR) despite well-established benefits. Novel approaches to overcome logistic obstacles and increase efficiencies of learning, behavior modification, and exercise surveillance may increase CR participation. In an observational study, the feasibility and utility of a mobile smartphone application for CR, Heart Coach (HC), were assessed as part of standard care. Ultimately, innovative CR models incorporating HC may facilitate better CR usage and value.
  
  
  METHODS
  Twenty-six patients enrolled in CR installed HC. Over the next 30 days, they were prompted by HC to complete a daily "task list" that included medications, walking, education (text and videos), and surveys. Cardiac rehabilitation providers monitored each patient's progress through a HC-based Web dashboard and also sent them personalized feedback and support. Completion of the tasks and feedback (qualitative and quantitative) from patients and clinicians were tracked.
  
  
  RESULTS
  Patients engaged with HC 90% of days during the study period, with uniformly favorable impact on compliance and adherence. Eighty-three percent of patients reported a positive/very positive HC experience. Providers reported that HC enhanced their provision of therapy by improving communication, clinical insight, patient participation, and program efficiency.
  
  
  CONCLUSIONS
  Integrating a mobile care delivery platform into CR was feasible, safe, and agreeable to patients and clinicians. It enhanced patient perceptions of CR care and physician perceptions of the CR caregiving process. Mobile-enabled technologies hold promise to extend the quality and reach of CR, and to better achieve contemporary accountable care goals.
authors.affiliation: Division of Cardiovascular Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts (Dr Forman); VA Boston Healthcare System, New England Geriatrics, Research, Education and Clinical Center, Boston, Massachusetts (Dr Forman, Ms Allsup, and Mr Manning); Department of Cardiac and Pulmonary Rehabilitation, South Shore Hospital, South Weymouth, Massachusetts (Ms LaFond); Massachusetts Association of Cardiovascular and Pulmonary Rehabilitation (Ms LaFond), Falmouth; and Wellframe Inc, Boston, Massachusetts (Drs Panch and Sattelmair).
authors.forename: Daniel E
authors.initials: DE
authors.lastname: Forman
authors.forename: Karen
authors.initials: K
authors.lastname: LaFond
authors.forename: Trishan
authors.initials: T
authors.lastname: Panch
authors.forename: Kelly
authors.initials: K
authors.lastname: Allsup
authors.forename: Kenneth
authors.initials: K
authors.lastname: Manning
authors.forename: Jacob
authors.initials: J
authors.lastname: Sattelmair
mesh_terms: D000328:Adult; D000368:Aged; D040421:Cell Phone; D005240:Feasibility Studies; D005260:Female; D006040:Goals; D015438:Health Behavior; D006331:Heart Diseases / Q000534:rehabilitation*; D006801:Humans; D008297:Male; D008875:Middle Aged; D063731:Mobile Applications; D010349:Patient Compliance; D010353:Patient Education as Topic / Q000379:methods*; D010865:Pilot Projects