title: A feasibility pilot using a mobile personal health assistant (PHA) app to assist stroke patient and caregiver communication after hospital discharge.
abstract: BACKGROUND
  Recent advancements have lowered national acute stroke mortality, yet posthospital care and readmission rates remain challenges. A personal health assistant (PHA) may help manage the spectrum of posthospital care. We hypothesized that a PHA application (app) would be associated with high poststroke patient care satisfaction and might prevent hospital readmission.
  
  
  METHODS
  This is a case series of acute stroke patients admitted to a single, tertiary care, comprehensive stroke center (Mayo Clinic, Jacksonville, Florida) who were offered a personal health assistance through a smart phone app. Patients were screened based on having a cerebrovascular event and the ability to use a necessary device. All patients received the standard poststroke discharge protocol, the PHA app, and the 30-day Likert scale survey.
  
  
  RESULTS
  We screened 21 patients and enrolled 3 (14%) before premature financial closure. Two of the 3 patients rated the app highly, and the third patient had not started using it. Of the ineligible patients, 4 had no device, 3 declined enrollment, and 2 were not able to use the device. One of the 2 patients who used the PHA app was readmitted for new stroke symptoms.
  
  
  CONCLUSIONS
  Both patients who used the app were very satisfied with the PHA and their posthospital care coordination. This study had an enrollment rate of about 14% due to various factors, including limited access or utilization of necessary technology. Though limited by final patient sample size and early termination from funding, this study provides useful information about developing future mobile health apps for acute stroke patients.
authors.affiliation: Department of Neurology, Mayo Clinic, Jacksonville, FL, USA.
authors.forename: Jason
authors.initials: J
authors.lastname: Siegel
authors.affiliation: Department of Computer Science, University College Cork, Cork, Ireland.
authors.forename: Emily
authors.initials: E
authors.lastname: Edwards
authors.affiliation: School of Nursing, University College Cork, Cork, Ireland.
authors.forename: Lesia
authors.initials: L
authors.lastname: Mooney
authors.affiliation: School of Medicine, University College Cork, Cork, Ireland.
authors.forename: Christina
authors.initials: C
authors.lastname: Smith
authors.affiliation: Department of Neurology, Mayo Clinic, Jacksonville, FL, USA.
authors.forename: J Brent
authors.initials: JB
authors.lastname: Peel
authors.affiliation: Remote Health Services, Palo Alto, CA, USA.
authors.forename: Adam
authors.initials: A
authors.lastname: Dole
authors.affiliation: Remote Health Services, Palo Alto, CA, USA.
authors.forename: Paul
authors.initials: P
authors.lastname: Maler
authors.affiliation: Department of Neurology, Mayo Clinic, Jacksonville, FL, USA;; School of Medicine, University College Cork, Cork, Ireland;; School of Pharmacy, University College Cork, Cork, Ireland.
authors.forename: W David
authors.initials: WD
authors.lastname: Freeman
keywords: Applications (apps); mobile health; personal health assistant (PHA); stroke