"We have found there are many gaps in care in patients recovering from a heart attack," said lead author William Yang, MD, a resident in internal medicine at Johns Hopkins University in Baltimore. "We wanted to engage patients in their own care, and help them transition from the hospital to home using existing technology."
‘Corrie: A new mobile app reduces hospital readmission in heart attack patients and it helps them to keep track of their medications, appointments and diet.’
The "Corrie" app, developed for iPhone, is the first cardiology app for the Apple CareKit platform. The app is designed to help patients navigate the hospital discharge process by educating them about heart disease. The app allows them to keep track of medications, follow-up appointments and lifestyle changes needed after a heart attack.
"Many heart attack patients are started on new medications in the hospital," Yang said. "This app helps them keep track of all their medications, including how much to take and at what time. They may suddenly have new doctors and more medical visits, including cardiac rehab, and the app helps them track and centralize all those appointments."
Researchers at Johns Hopkins Hospital and Johns Hopkins Bayview Medical Center studied 60 patients hospitalized with a heart attack who agreed to use the app in the hospital and for 30 days after discharge. Because not all patients have the same type of phone, the hospital purchased phones to loan to patients who did not have iPhones as part of a pilot program to maximize patient reach. All participants were loaned an Apple Watch. Equipment was returned after 30 days. Yang said patients with their own iPhones can continue to use the app past 30 days, but researchers are not continuing to follow their progress past that time.
Of the 60 participants, 3 percent were readmitted for any reason within 30 days, compared with 19 percent of all heart attack patients at Johns Hopkins. The readmission rate for patients using "Corrie" was similar for patients who owned iPhones and those who borrowed them.
"We're really encouraged by the results so far," Yang said.
The app syncs with the Apple Watch to monitor heart rate and keep track of how much they are walking and with a Bluetooth blood pressure monitor.
Because the hospital does not receive Medicare reimbursement for patients readmitted within 30 days, this difference in readmission rates represents a cost savings of $262,500 in readmission penalties, the researchers calculated.
Yang said the app has proven useful to patients even while they're still in the hospital. He noted two patients using "Corrie" realized they didn't have a stent card after seeing them mentioned on the app and asked for one. These cards state the patient has a stent, describes what type and lists when it was implanted. These cards are useful if the patient is treated at another hospital that does not have the patient's medical records. The app allows patients to take a picture of their stent card, insurance card and other important medical information and store it on the app.
The researchers are continuing to use patient feedback to refine the app to make it easier to use and more helpful for patients recovering from a heart attack, Yang said. One such change has been the way in which the app reminds patients to take their medicine.
"In an earlier version, each medication reminder popped up separately, but patients who had to take a number of medications at the same time said that was overwhelming. So, we changed it, and now patients receive one notification for all the medications they need to take at the same time," Yang said.
Other modifications included adding a notes section to appointments, so patients can write down questions to ask their doctors; including pictures of doctors in addition to their names; and allowing a one-click phone call to doctors' offices.
"'Corrie' is a prescription-strength app we are deploying in the hospital," Yang said. "It is intended to make a difference while in the hospital, where patients are engaged the most, have the most time, with their family at their bedside, and pre-discharge planning is possible."
The researchers are actively working to expand access to "Corrie."
"We think this is a readily scalable program," Yang said. "We're already working with several other hospitals who are very interested in bringing 'Corrie' to their institutions."