Top 4 heart failure apps to reduce readmissions and power self-management

Patients with heart failure (HF) are in need of solid control over their health, especially during the post-discharge recovery phase. If they fail to monitor symptoms, comply with the treatment plan and exercise properly, HF patients risk getting readmitted. Particularly, more than 25% of discharged HF patients will be readmitted within the first 30 days.

To offer patients a caring hand outside the facility and reduce the readmission rate, some providers invest into HF-tailored medical app development to support self-management needs of patients with heart failure.

HF-focused apps prove their efficiency

The Health Recovery Solutions app, called PatientConnect, helped to reduce the 30-day readmission rate for 130 HF patients at Penn Medicine’s Penn Care at Home program by 53 percent. Particularly, within the timeframe between July 2014 and February 2015, the readmission rate fell from 8 percent to 3.8 percent.

With this in mind, we’ve decided to review the available heart failure apps and find the top quad of functional and supportive solutions capable to reduce readmissions in HF patients. We will also explain the pros and cons of these apps, so stay posted.

Score guidelines

We award each app with 40 points maximum. These points lie within 4 categories – basic functionality, synchronization with devices / other apps, sharing capabilities and communication with the provider. Here’s how points are distributed:

1. Functionality musts – 20 points max

• HF-focused therapeutic education (5 max)
• HF-critical vitals recording and analysis (5 max)
• Medication tracking (5 max)
• Appointment scheduling (5 max)

2. Smart sync – 5 points max

• Device sync (3 points)
• App sync (2 points)

3. Sharing – 5 points max

• Yes/no

If yes, what type of sharing is enabled:

• Automatic (3 points) and/or manual (2 points)

4. Secure communication – 10 points max

• Yes/no

If yes, what type of communication is available:

• Text communication (2 points)
• Voice communication (3 points)
• Video communication (5 points)

Now, let’s look at the top 4 heart disease apps according to our scoring.

H2O Overload: Fluid Control for Heart-Kidney Health

App Store

The app is provided by National Kidney Foundation and contains a set of functions to cope with heart failure, hyponatremia and kidney disease, including:

• My diagnosis: here the patient can access the therapeutic education section, which explains the condition and answers the most frequently asked questions. For example, the patient can understand a vicious circle of heart failure and kidney disease, affecting each other and causing the imbalance between fluid and sodium.
• My medications: the patient enters medications and dosages, staying on the track with their treatment plan.
• My health tools: allows the patient to input fluid consumption, weight changes and blood pressure measurements. The patient or their physician can set a target or limit value to automatically notify the medical specialist via email about any health status changes, both negative and positive (depending on the preset values). The patient will get a push notification to review their changes and contact their care team members if needed. There’s also a possibility to trigger an email sending manually if the patient would like to share the latest progress with their physician.
• My doctor appointments: helps the patient to keep all upcoming office visits in mind and not to miss them.
• Questions for my provider: serves as a simple notepad to record any questions that the patient wants to ask within an appointment.
• Nutritional info: a tool with various capabilities, including conversion tables, supported by shopping and cooking tips to reduce sodium consumption.

Final score: 23 / 40

Outtake. Despite the good set of tools available to HF patients, the score isn’t that high. The app misses a few points because it doesn’t allow any secure communication options as well as device sync. Still, it gains one more point for the fluid tracker, because HF patients need to control water consumption to avoid swelling.

HeartMapp

The app created by Health Professionals and Engineers at the USF College of Engineering and USF College of Nursing is designed to facilitate self-management for patients with heart failure. It is in sync with the Bioharness BT external sensor, allowing the measurement of:

• Heart Rate
• Breathing Rate
• Activity level
• Posture
• Skin temperature
• Blood Pressure (optional external sensor)
• SpO2 (optional external sensor)

The app itself contains six modules:

• Exercises: helps patients to perform breathing and walking exercises and keep up with the needed levels of physical activity.
• CHF info: educates HF patients about their condition and all hidden pitfalls on their way.
• Assessment: a questionnaire that allows patients to assess their health status, mood and symptoms on a daily basis and get a feedback.
• Vital signs: synchronizes Bioharness BT and offers a manual way to input vitals.
• Trends: the tool visualizes both real-time and historical patient health data in easy-to-read graphs.
• Medications: helps patients to manage their medications.

HeartMapp places HF patients into either a green, yellow or red zone based on the combination of their vitals, exercises and medications. Green means that the patient is doing well in self-management, while red advises to see a physician or go to the hospital. And the yellow zone is the area of improvements, where patients need to understand what they are lacking in health management and obtain this skill.

In addition, the app is connected to a web app for providers, allowing to access historical and real-time information about their patient’s health status for early intervention and readmission prevention.

Final score: 24 / 40

Outtake. While the original score was 21, the app was able to gain three bonus points for:

• assessment functionality,
• offering specific HF-focused exercises,
• colored zones to explain patients where they stand in the easiest way.

Still, we were surprised not to find any secure in-app option for communication with the provider. The developers have already connected a patient with their physician by automatic real-time updates on vitals and trends, it's curious why they didn’t make one step further.

Heart Failure Storylines

Developed in partnership with the Heart Failure Society of America, this app is destined to ensure that patients with heart failure will get the needed functions to keep their health balanced. The most interesting feature is that patients themselves can build the dashboard and clean up the home page from the functions they don’t need. Within the app, patients can choose from the list of following HF management tools:

• Daily vitals: allows recording and visualizing such vitals as weight, body fat percent, systolic blood pressure, diastolic blood pressure, and pulse.
• Medication tracker: allows inputting medications, setting reminders and tracking the intake.
• Symptom tracker: enables patients to input symptoms and side effects to build patterns that may be essential for the treatment progress estimation.
• Physical activity: ensures that a patient moves and exercises enough.
• Sync a device: allows aggregating data from other mHealth apps and smart devices (e.g., Jawbone, Garmin, Fitbit).
• Low sodium guidelines: advises the patient how to fulfill their nutritional needs with a low-salt diet.
• My journal and daily moods: enables a self-analyzing functionality to make the patient more aware of how their health condition translates into emotions and their environment.
• Appointment calendar: keeps the patient in track with their scheduled appointments, follow-ups, procedures, tests and more.

Additionally, the patient can share the recorded data with their physician, friends and loved ones within their personal circle of support.

Final score: 31 / 40

Outtake. Overall, this application is very useful for patients with heart failure due to rich functionality. Our initial score was 29, and we added two bonus points for a great visualization of trends in vitals and medication intake as well as additional engaging features, such as journal and physical activity. The score could be higher if the app allowed an audio/video chat with the provider and offered an option to automatically send updates on vitals to providers and family members.

PatientConnect (specifically for heart failure)

Created by Health Recovery Solutions, PatientConnect is a bundle of apps targeting different diseases, including diabetes, COPD and heart failure. In the case of HF, the patient gets a tablet containing the heart disease app and a set of smart devices to collect vitals. The in-app functionality includes such tools as:

• Educational materials: the patient can access quizzes, pamphlets, and videos to level up their self-management skills. 
• Care plans: here the patient can get insights about their treatment plan goals.
• Medication reminders: according to the patient’s care plan, he or she gets medication reminders.
• Vitals: the patient can record their weight, blood pressure, temperature, and pulse as well as take images of any injuries or symptoms (e.g., ankle swelling) and share them with their physician or caregiver.
• Daily activity and mood: the patient takes part in surveys and indicates their physical activity level with current emotions.
• Communication: the patient can interact with their physician via voice and video chats with the help of the ClinicianConnect app on the provider’s side. Moreover, a physician gets real-time updates about the patient’s health status changes and can intervene timely.

Final score: 33 / 40

Outtake. We have our winner! No surprise that this heart failure app allowed Penn Medicine to reach 53 percent reduction in readmissions among HF patients. With the functionality similar to other apps in our top, this one stands out because of the opportunity to ensure straightforward conversation between a patient and their provider.

We improved the initial score of 31 with two bonus points for interactive therapeutic education functionality and the approach to the app, where it is already installed and supported by the needed smart devices. The app lost a few points due to its inability to ensure text communication with a physician and caregiver, the absence of the app sync option and the lack of the appointment scheduling functionality.

Final thoughts

While all the reviewed heart failure apps were functional and supportive, none of them made it to the very top. However, we still think that PatientConnect is the closest to a tool that can be used by HF patients to manage their condition daily and balance their health to reduce readmissions. Just a few tweaks and it will become the most comprehensive kit for heart failure management.

In the meantime, we are going to review a number of general apps for self-management and find out if there’s the one that can compete with the HF-targeted apps, so stay tuned.