Cirrhosis affects more than 5 million Americans, of whom a substantial percentage requires frequent hospitalization. Several federally studies have demonstrated an unacceptably high rate of preventable readmission in cirrhotics due to consistently identified risk factors. These readmissions are a tremendous burden on patients, caregivers and society. However, the dissemination of measures to prevent readmission in practice using interfaces that improve patient-caregiver and clinician interaction through mobile health technology is limited. Patient Buddy(tm) is a HIPAA-compliant innovative smartphone application developed by our technology partner CITI. This App has separate patient and caregiver interfaces focused on several aspects that impacting readmissions while promoting communication and education. Given this immense gap in knowledge in the prevention of re-hospitalization, our central hypothesis is: Patient Buddy, a mobile patient-caregiver-clinician interface, will effectively reduce readmissions in decompensated cirrhotic patients within 30 days of discharge. We propose to test this using the following two specific aims:
Specific aim 1 : To perform a pilot and feasibility study of disseminating current knowledge of readmission prevention in cirrhosis by using the Patient Buddy App with patient and caregiver interfaces. Eighty subjects (40 cirrhotic inpatients and 40 caregivers) will be enrolled and trained on the Patient Buddy at discharge. The App focuses on daily communication between patient/caregivers and the study team based on previously identified risk factors associated with readmission. The study team will initiate measures to prevent readmission using these communications. A detailed analysis of 30-day readmissions and input of the patients, caregivers and nurse manager will be performed to improve the App.
Specific aim 2 : To incorporate the opinion of key stakeholders (patients, caregivers and case managers) towards improving the Patient Buddy App in the prevention of readmission in cirrhosis. The input of the key stakeholders and the analysis of readmissions prevented during the pilot study will be used to update the App for preventing readmissions in future studies This research will improve health quality by accelerating implementation of patient- centered outcomes research on prevention of readmissions, which will make health care safer and more affordable and efficient by preventing unnecessary re-hospitalizations in cirrhosis through an innovative mobile health Application, Patient Buddy.
Patients with cirrhosis, which is the end-stage of liver disease, are very likely to be hospitalized over and over again for conditions that can potentially be treated with better communication between the clinical staff, patients and their companions. In this research we hope to study Patient Buddy, an iPhone App that promotes communication about common problems that patients with cirrhosis face, to reduce the multiple readmissions to the hospital.
| Ganapathy, Dinesh; Acharya, Chathur; Lachar, Jatinder et al. (2017) The patient buddy app can potentially prevent hepatic encephalopathy-related readmissions. Liver Int 37:1843-1851 |
