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Utility and Efficacy of a Smartphone Application to Enhance the Learning and Behavior Goals of Traditional Cardiac Rehabilitation: A FEASIBILITY STUDY

Forman, Daniel E. MD; LaFond, Karen MSN, RN; Panch, Trishan MD, MPH; Allsup, Kelly BS; Manning, Kenneth MS; Sattelmair, Jacob MSc, DSc

Journal of Cardiopulmonary Rehabilitation and Prevention: September/October 2014 - Volume 34 - Issue 5 - p 327–334
doi: 10.1097/HCR.0000000000000058
Cardiac Rehabilitation

PURPOSE: Most eligible patients do not participate in traditional clinic-based cardiac rehabilitation (CR) despite well-established benefits. Novel approaches to overcome logistic obstacles and increase efficiencies of learning, behavior modification, and exercise surveillance may increase CR participation. In an observational study, the feasibility and utility of a mobile smartphone application for CR, Heart Coach (HC), were assessed as part of standard care. Ultimately, innovative CR models incorporating HC may facilitate better CR usage and value.

METHODS: Twenty-six patients enrolled in CR installed HC. Over the next 30 days, they were prompted by HC to complete a daily “task list” that included medications, walking, education (text and videos), and surveys. Cardiac rehabilitation providers monitored each patient's progress through a HC-based Web dashboard and also sent them personalized feedback and support. Completion of the tasks and feedback (qualitative and quantitative) from patients and clinicians were tracked.

RESULTS: Patients engaged with HC 90% of days during the study period, with uniformly favorable impact on compliance and adherence. Eighty-three percent of patients reported a positive/very positive HC experience. Providers reported that HC enhanced their provision of therapy by improving communication, clinical insight, patient participation, and program efficiency.

CONCLUSIONS: Integrating a mobile care delivery platform into CR was feasible, safe, and agreeable to patients and clinicians. It enhanced patient perceptions of CR care and physician perceptions of the CR caregiving process. Mobile-enabled technologies hold promise to extend the quality and reach of CR, and to better achieve contemporary accountable care goals.

To assess feasibility and utility of a novel smartphone application for cardiac rehabilitation (CR) and its usability and impact (task completion and qualitative feedback) over 30 days on a phase 2 program. Patients and providers reported positive experiences; it was feasible, enhancing, and agreeable to CR patients and clinicians.

Division of Cardiovascular Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts (Dr Forman); VA Boston Healthcare System, New England Geriatrics, Research, Education and Clinical Center, Boston, Massachusetts (Dr Forman, Ms Allsup, and Mr Manning); Department of Cardiac and Pulmonary Rehabilitation, South Shore Hospital, South Weymouth, Massachusetts (Ms LaFond); Massachusetts Association of Cardiovascular and Pulmonary Rehabilitation (Ms LaFond), Falmouth; and Wellframe Inc, Boston, Massachusetts (Drs Panch and Sattelmair).

Correspondence: Daniel E. Forman, MD, Division of Cardiovascular Medicine, Brigham and Women's Hospital, Harvard Medical School, 75 Francis St, Boston, MA 02115 (

The authors declare no conflicts of interest.

© 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins