Baseball revolutionized the use of data collection and statistics for team management and development. Billy Beane and the Oakland A’s are most often credited with the genesis of this and is now commonly referred to as sabermetrics. Sabermetrics is the empirical analysis of baseball, especially baseball statistics that measure in-game activity, allowing managers to make more informed decisions on player personnel decisions. This is now commonplace for the majority of professional sports teams.
More recently professional sports teams and Division 1 college athletic programs have been utilizing mobile phone apps and wearable technology to collect data on their players. The data collection includes things such as sleep, nutrition, pain, recovery, training, and heart rate. This data is then analyzed in an attempt to improve player performance, promote health, and prevent injury. Many non-contact injuries have been found to be directly correlated to fatigue, so using these apps to monitor fatigue has helped coaches and sports medicine professionals make better decisions on participation and training limits in an attempt to prevent injury — and it’s working. Prior to using this technology, the Toronto Raptors were one of the most injured teams in the NBA (based on player games lost). Two years later, they were one of the teams least impacted by injuries.
Medical groups and providers have slowly begun to incorporate the mobile applications for health management of patients. A study published this year (DeCock et al) showed that commercial fitness and nutrition apps utilization was associated with healthier eating behaviors and BMI in adolescents. Similar research has found a positive effect on calcium intake in young women, prevention and management of type 2 diabetes, medication management and adherence, smoking cessation, and weight loss. These mobile applications not only serve to improve health-related outcomes but also significantly decrease the overall cost of health care.
Physical therapy and rehabilitation medicine is an emerging area for the use of mobile applications. Home exercise programs are critically important compliments to clinic-based physical therapy visits, but effectiveness can be severely limited by poor adherence and poor execution. A study by Schneiders in 1998 showed that when verbal information was given the nonadherence rate was 62%. A study of patients with low back pain in 2016 found that the home exercise program adherence to written information was 54% and the percentage of correct exercise execution was even less. Another rehab study found 24% of patients were nonadherent, 35% were mostly adherent and the remaining 41% of the sample were only partially adherent to their home exercise program. The bottom line is the current, and historical, adherence rate to home exercise programs is not adequate to ensure cost-effective, quality-based health care that gets patients back to work, sport and their daily activities.
The blame does not all fall on the patient. Despite the consistent problem with adherence over the past 40 years, most health care institutions continue to provide written and verbal patient instructions that lack engagement, interaction, monitoring and appropriate education. A white paper from The Beryl Institute revealed a 10% increase in patient satisfaction and a 40% plus improvement in satisfaction with educational materials (such as home exercise programs) at hospitals when interactive technology is provided.
Kiio’s solutions break down the barriers to home exercise program comprehension and adherence. Kiio FLEX provides an interactive exercise library for health care providers and patients. Providers can select and customize exercises and routines for specific patient needs. These programs are “published” to the patient’s phone or tablet, giving them visual and audio feedback for correct execution. At the same time, Kiio provides instantaneous feedback to the health care provider about patient adherence, execution, pain or other concerns the patient may have. Patients feel more engaged and supported. Providers feel more informed and efficient. These factors directly impact some of the primary predictors of adherence to physical therapy home exercise programs – low physical activity levels, low self-efficacy, depression, anxiety, helplessness, lack of support and pain.
Albert Einstein once said the definition of insanity was continuing to do the same thing yet expecting a different result. It’s time for health care to stop doing the same thing. It’s time to use technology to improve patient engagement and adherence to achieve better outcomes at lower cost.