Researchers at the Mayo Clinic have released the results of their study of Fitbit as a tool to predict how quickly older patients can start moving around again after surgery.
The idea was to test how wireless monitoring devices could assess mobility. The research team worked with a group of patients who had elective surgery, were older than 50, and were expected to be in the hospital from 5 – 7 days. The team put an antenna in each patient room and connected it to the computer in the room. Fitbit recommends putting the accelerometer on the upper arm, but that wasn’t practical for “shuffling patients using walkers.” The patients in this study wore the tracker on a disposable ankle strap. The device was also configured to the shortest possible stride length. The movement data went to the Fitbit web site and then to a cloud-based data system and dashboards that doctors used. Tracking started after the patients left the intensive care unit.
The study, Functional Recovery in the Elderly After Major Surgery: Assessment of Mobility Recovery Using Wireless Technology, also tracked where the patients went after discharge: home, home with home health care, or skilled-nursing facilities. On recovery day 2, people who were going home took an average of 675 steps while people in the other two discharge groups took only 108 steps.
The team concluded that patients who were moving more on recovery day two were more likely to be discharged early or discharged to their homes. The team saw tremendous potential to use this data to set expectations for the speed of recovery and to design care plans more carefully for individuals. The report said:
Once we know the expected mobility by day for a 70-year-old female coronary artery bypass grafting, total hip arthroplasty, or colectomy patient, we can early identify pending recovery failure and triggers for intervention(s).
Collecting data continuously and directly from the patient replaces the intermittent data found in nursing notes, the study concluded.
One drawback was interoperability. The Fitbit data and associated dashboards were not integrated with the hospitals EHR system. To get around this, each surgical service had an iPad and a link to the dashboard. Patient data was password protected and open only to doctors on the patient’s surgical team.
A Deep-dive Into Specialty Pharma
A specialty drug is a class of prescription medications used to treat complex, chronic or rare medical conditions. Although this classification was originally intended to define the treatment of rare, also termed “orphan” diseases, affecting fewer than 200,000 people in the US, more recently, specialty drugs have emerged as the cornerstone of treatment for chronic and complex diseases such as cancer, autoimmune conditions, diabetes, hepatitis C, and HIV/AIDS.
According to the study, this was the first one to test wireless accelerometry to monitor daily mobility recovery during hospitalization after major surgery. The research team included David J. Cook, MD, Jeffrey E. Thompson, MHA, Sharon K. Prinsen, RN, Joseph A. Dearani, MD, and Claude Deschamps, MD. The results of the study were published in the September issue of The Annals of Thoracic Surgery.
[Image is from The Society of Thoracic Surgeons. Copyright 2013. Reprinted with permission.]
