title: Testing the Feasibility of Remote Patient Monitoring in Prenatal Care Using a Mobile App and Connected Devices: A Prospective Observational Trial.
abstract: BACKGROUND
  Excessive weight gain and elevated blood pressure are significant risk factors for adverse pregnancy outcomes such as gestational diabetes, premature birth, and preeclampsia. More effective strategies to facilitate adherence to gestational weight gain goals and monitor blood pressure may have a positive health benefit for pregnant women and their babies. The impact of utilizing a remote patient monitoring system to monitor blood pressure and weight gain as a component of prenatal care has not been previously assessed.
  
  
  OBJECTIVE
  The objective of this study is to determine the feasibility of monitoring patients remotely in prenatal care using a mobile phone app and connected digital devices.
  
  
  METHODS
  In this prospective observational study, 8 women with low risk pregnancy in the first trimester were recruited at an urban academic medical center. Participants received a mobile phone app with a connected digital weight scale and blood pressure cuff for at-home data collection for the duration of pregnancy. At-home data was assessed for abnormal values of blood pressure or weight to generate clinical alerts to the patient and provider. As measures of the feasibility of the system, participants were studied for engagement with the app, accuracy of remote data, efficacy of alert system, and patient satisfaction.
  
  
  RESULTS
  Patient engagement with the mobile app averaged 5.5 times per week over the 6-month study period. Weight data collection and blood pressure data collection averaged 1.5 times and 1.1 times per week, respectively. At-home measurements of weight and blood pressure were highly accurate compared to in-office measurements. Automatic clinical alerts identified two episodes of abnormal weight gain with no false triggers. Patients demonstrated high satisfaction with the system.
  
  
  CONCLUSIONS
  In this pilot study, we demonstrated that a system using a mobile phone app coupled to remote monitoring devices is feasible for prenatal care.
authors.affiliation: George Washington University School of Medicine and Health Sciences, Washington, DC, United States.
authors.forename: Kathryn I
authors.identifier: http://orcid.org/0000-0002-5647-8228
authors.initials: KI
authors.lastname: Marko
authors.affiliation: OB Hospitalist Group, Baylor All-Saints Medical Center, Dallas, TX, United States.
authors.forename: Jill M
authors.identifier: http://orcid.org/0000-0002-8695-0570
authors.initials: JM
authors.lastname: Krapf
authors.affiliation: Center for Healthcare Innovation and Policy Research, George Washington University School of Medicine and Health Sciences, Washington, DC, United States.
authors.forename: Andrew C
authors.identifier: http://orcid.org/0000-0001-5971-8314
authors.initials: AC
authors.lastname: Meltzer
authors.affiliation: The Jackson Laboratory, Farmington, CT, United States.
authors.forename: Julia
authors.identifier: http://orcid.org/0000-0002-5534-7023
authors.initials: J
authors.lastname: Oh
authors.affiliation: George Washington University School of Medicine and Health Sciences, Washington, DC, United States.
authors.forename: Nihar
authors.identifier: http://orcid.org/0000-0002-8913-662X
authors.initials: N
authors.lastname: Ganju
authors.affiliation: George Washington University School of Medicine and Health Sciences, Washington, DC, United States.
authors.forename: Anjali G
authors.identifier: http://orcid.org/0000-0001-9076-6197
authors.initials: AG
authors.lastname: Martinez
authors.affiliation: George Washington University School of Medicine and Health Sciences, Washington, DC, United States.
authors.forename: Sheetal G
authors.identifier: http://orcid.org/0000-0001-5512-2898
authors.initials: SG
authors.lastname: Sheth
authors.affiliation: George Washington University School of Medicine and Health Sciences, Washington, DC, United States.
authors.forename: Nancy D
authors.identifier: http://orcid.org/0000-0002-0473-6838
authors.initials: ND
authors.lastname: Gaba
keywords: mobile app; pregnancy; prenatal care; remote pateint monitoring