Date Published: April 16, 2019
Publisher: Public Library of Science
Author(s): Jill Waalen, Melissa Peters, Daya Ranamukhaarachchi, Jenny Li, Gail Ebner, Julia Senkowsky, Eric J. Topol, Steven R. Steinhubl, Bobak Mortazavi.
A wide range of personal wireless health-related sensor devices are being developed with hope of improving health management. Factors related to effective user engagement, however, are not well-known. We sought to identify factors associated with consistent long-term use of the Scanadu Scout multi-parameter vital sign monitor among individuals who invested in the device through a crowd-funding campaign. Email invitations to join the study were sent to 4525 crowd-funding participants from the US. Those completing a baseline survey were sent a device with follow-up surveys at 3, 12, and 18 months. Of 3872 participants receiving a device, 3473 used it during Week 1, decreasing to 1633 (47 percent) in Week 2. Median time from first use of the device to last use was 17 weeks (IQR: 5–51 weeks) and median uses per week was 1.0 (IQR: 0.6–2.0). Consistent long-term use (defined as remaining in the study at least 26 weeks with at least 3 recordings per week during at least 80% of weeks) was associated with older age, not having children in the household, and frequent use of other medical devices. In the subset of participants answering the 12-month survey (n = 1222), consistent long-term users were more likely to consider the device easy to use and to share results with a healthcare provider. Thirty percent of this subset overall reported improved diet or exercise habits and 25 percent considered medication changes in response to device results. The study shows that even among investors in a device, frequency of device usage fell off rapidly. Understanding how to improve the value of information from personal health-related sensors will be critical to their successful implementation in care.
The potential for mobile health technology (mHealth) to transform approaches to health on both a personal and population level has long been recognized.[1,2] On the personal health level, mHealth technology continues to produce increasing numbers of devices that are ever smaller and more wearable and capable of measuring increasing numbers of physiologic parameters. Smartphones alone or linked to a range of wireless sensors can routinely monitor activity in the form of steps, heart rate and rhythms, sleep duration and quality, temperature, oxygen saturation and blood pressure. Smart watches and other wearables are making the monitoring simpler, continuous and less obtrusive.
Among a cohort of individuals self-identified as having very high interest in self-monitoring and digital health technologies in general, and the Scanadu Scout in particular, with high levels of interest and confidence in using devices for health-related purposes, we found an overall surprisingly low actual device usage, with the number of participants using the device dropping by 46% by the second week of the trial and less than 3% of participants overall remaining consistent users over the 18 month duration of the trial. In context, the participant cohort might be considered an outlier in the sense that they had even invested funds in the technology, which makes the findings noteworthy.