Feasibility of Electronic Health Record Integration of a SMART Application to Facilitate Patient-Provider Communication for Medication Management

Strengthening Cybersecurity for Patient Data Protection in Europe

The health care sector experiences 76% of cybersecurity breaches due to basic web application attacks, miscellaneous errors, and system intrusions, resulting in compromised health data or disrupted health services. The European Commission proposed the European Health Data Space (EHDS) in 2022 to enhance care delivery and improve patients' lives by offering all European Union (EU) citizens control over their personal health data in a private and secure environment. The EU has taken an important step in homogenizing the health data environment of the European health ecosystem, although more attention needs to be paid to keeping the health data of EU citizens safe and secure within the EHDS. The pooling of health data across countries can have tremendous benefits, but it may also become a target for cybercriminals or state-sponsored hackers. State-of-the-art security measures are essential, and the current EHDS proposal lacks sufficient measures to warrant a cybersecure and resilient environment.

A randomized controlled trial of mobile health intervention in patients with heart failure and diabetes

BACKGROUND

Mobile health (mHealth) platforms can affect health behaviors but have not been rigorously tested in randomized trials.

OBJECTIVES

We sought to evaluate the effectiveness of a pragmatic mHealth intervention in patients with HF and DM Methods: We conducted a multicenter randomized trial in 187 patients with both HF and DM to assessing a mHealth intervention to improve physical activity and medication adherence compared to usual care. The primary endpoint was change in mean daily step count from baseline through 3 months. Other outcomes included medication adherence, health related quality of life, and metabolomic profiling.

RESULTS

The mHealth group had an increase in daily step count of 151 steps/day at 3 months whereas the usual care group had a decline of 162 steps/day (LS-mean between-group difference = 313 steps/day; 95% CI: 8, 619, p = 0.044). Medication adherence measured using the Voils Adherence Questionnaire did not change from baseline to 3 months (LS-mean change -0.08 in mHealth vs. -0.15 in usual care, p = 0.47). The mHealth group had an improvement in Kansas City Cardiomyopathy Questionnaire Overall Summary Score (KCCQ-OSS) compared to the usual care group (LS-mean difference = 5.5 points, 95% CI: 1.4, 9.6, p = 0.009). Thirteen metabolites, primarily medium- and long-chain acylcarnitines, changed differently between treatment groups from baseline to 3 months (p < 0.05).

CONCLUSIONS

In patients with HF and DM, a 3-month mHealth intervention significantly improved daily physical activity, health related quality of life and metabolomic markers of cardiovascular health, but not medication adherence.

CLINICALTRIALS

gov Identifier: NCT02918175 Condensed Abstract: Heart failure (HF) and diabetes (DM) have overlapping biologic and behavioral risk factors. We conducted a multicenter randomized, clinical trial in 187 patients with both HF (regardless of ejection fraction) and DM to assess whether a mHealth intervention could improve physical activity and medication adherence. The mHealth group had an increase in mean daily step count and quality of life but not medication adherence. Medium- and long-chain acylcarnitines changed differently between treatment groups from baseline to 3 months (p < 0.05). These data have important implications for designing effective lifestyle interventions in HF and DM.