Stanford Children's Uses mHealth to Keep Young Patients at Home

With the ongoing coronavirus pandemic curtailing in-person care, physicians at Stanford Children’s Health are using mHealth devices and telehealth platforms to monitor some of their youngest and most vulnerable patients.

Scott Ceresnak, MD, a pediatric cardiologist specializing in electrophysiology and arrhythmia and head of the health system’s EKG monitoring program, is mailing mHealth patches to his patients so that he can monitor them at home. Through the patch and an accompanying mHealth app, he’s able to manage care on a daily basis for roughly 25 patients, giving him a real-time look into their heart activity.

“I’m communicating with them in a way where they’re not driving up to four hours to see me,” he says.

Seda Tierney, MD, a pediatric cardiologist and director of the Pediatric Vascular Research Laboratory at Stanford Children’s Health, began using portable echocardiography devices for her heart transplant patients several years ago. She started with a small, handheld device that had been used in the Emergency Department and ICU, and gradually worked up to the point where she could send the device home with a patient and his or her caregivers.

With COVID-19 reducing visits to her office, Tierney now schedules virtual visits with the family and an echo stenographer to help conduct the tests at home.

“Telehealth has given us more freedom to expand care to the home,” says Tierney, who co-authored a recent study in the Journal of the American Society of Echocardiography on a pilot program that enabled parents to use the mHealth device to capture echo readings at home. “It doesn’t replace (in-person care), but it will definitely be a part of the care we give as cardiologists.”

One particular benefit is that the technology being used now is much better than what was available just a few years back. Ceresnak notes that early mHealth technology wasn’t nearly as good at capturing accurate cardiac data as today’s patches and devices – EKG devices that once allowed single to three-lead monitoring can now accommodate 12 leads. And Tierney says today’s portable echo devices are much easier and more accurate than older models.

Ideally, they say, the healthcare ecosystem is moving toward mHealth apps and telehealth platforms that will allow them to capture data from devices seamlessly and transfer relevant data for their particular needs directly into the electronic medical record.

Both Ceresnak and Tierney say the connected health tools and platforms they use reduce the stress on families who’ve had a lot on their plates, especially with the pandemic at hand. Having the opportunity to collaborate with them on care in their own homes reduces that stress, and has the potential to boost clinical outcomes as well.

“It’s always nice to see these kids in their own environment,” says Ceresnak. “You can see them in a different way than when they’re in your office.” And that makes a difference in both how they feel and act and how physicians can treat them.

“We have the tools now to reach out to them and see them more often,” says Tierney. “And I don’t want to see them suffer just so they can come and see me (in the office).”

While the pandemic has pushed healthcare providers across the country to adopt and expand telehealth and mHealth programs, many are discovering benefits that will extend beyond the crisis. Ceresnak says his patients and their caregivers are “overwhelmingly positive” in rating virtual care, and neither he nor they expect to dial back all that much after the pandemic.

“The pandemic really sparked a movement forward,” he says, “We really needed to think outside the box, and now that we’ve done that it’s hard to think about going back.”

“We’re using these tools to empower patients in their care,” adds Tierney. “And that really means a lot.”