In a study at Johns Hopkins, the Corrie app produced impressive results. As always, however, accessibility remains a question for digital interventions.
Screenshot of Corrie Health app listing in Apple App Store.
Readmissions are a massive burden on the American healthcare system, representing billions of dollars in often-avoidable expenditures. At Johns Hopkins in Baltimore, Maryland, nearly 20% of heart attack patients are readmitted within 30 days of first hospitalization.
In a new study, a smartphone app helped bring that rate down to 3%.
Corrie, an application developed by Johns Hopkins and built on Apple’s CareKit platform, was designed to help patients navigate their life with cardiac disease post-discharge. It contains information and tracking programs to encourage healthier heart habits, provides recovery resources, and crunches analytics on biometric data gleaned from Apple Watch and a Bluetooth blood pressure monitor.
The team at Johns Hopkins Bayview Medical Center prescribed the app to 60 patients prior to discharge following a heart attack, loaning all participants a Watch and providing iPhones to those who did not have them for the 30-day duration of the study.
"We're really encouraged by the results so far," lead study author William Yang, MD, said in a statement.
Since hospitals lose out on Medicare reimbursement for patients readmitted within 30 days, the substantial reduction in readmissions among participating patients represents over $250,000 in savings, according to the researchers.
Yang highlighted multiple benefits, like prescription adherence reminders, and even noted that 2 patients were alerted to the fact that they didn’t have stent cards by seeing them mentioned in the app. Patient feedback is being used to inform refinements, too: The medication reminders have been streamlined since earlier incarnations, and the platform now includes notes sections for appointments and the ability to call their doctor with a single button.
"We wanted to engage patients in their own care, and help them transition from the hospital to home using existing technology," yang said, calling Corrie “a prescription strength app.”
As always with smartphone interventions, however, accessibility may be a question. While heart attacks can strike at any age, they are more common after age 50. And while smartphone adoption has grown in all age groups, older individuals are less likely to own them.
Corrie is built on a platform proprietary to Apple, and smartphone brand ownership also divides on demographic lines: iPhone owners tend to be younger, whiter, and wealthier than other platforms. It remains to be seen if an Android version of Corrie is in the works, or if hospitals are willing to give patients devices (and teach them how to use them) for similar digital interventions.
Participants in the study ranged in age from 33 to 79, with a mean age of 57.8 years old. Only 30% owned personal iPhones.
Still, Yang said, the team thinks the program is “readily scalable,” adding that "We're already working with several other hospitals who are very interested in bringing 'Corrie' to their institutions."
The findings were announced at the American College of Cardiology’s annual Cardiovascular Summit this week in Las Vegas. Earlier this year, an overview of Corrie’s development was published in the Journal of Medical Internet Research Cardiology.