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International Journal of Telemedicine and Applications
Volume 2012 (2012), Article ID 871925, 8 pages
http://dx.doi.org/10.1155/2012/871925
Research Article

Using Mobile Health to Support the Chronic Care Model: Developing an Institutional Initiative

1Section of General Internal Medicine, Department of Medicine, University of Chicago, Chicago, IL 60637, USA
2Chicago Center for Diabetes Translation Research, University of Chicago, Chicago, IL 60637, USA
3College of Physicians and Surgeons, Columbia University, New York, NY 10032, USA
4Department of Pediatric Endocrinology, University of Illinois at Chicago, Chicago, IL 60612, USA
5University of Chicago Health Plan, Burr Ridge, IL 60527, USA

Received 10 August 2012; Revised 29 September 2012; Accepted 19 October 2012

Academic Editor: Kamal Jethwani

Copyright © 2012 Shantanu Nundy et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background. Self-management support and team-based care are essential elements of the Chronic Care Model but are often limited by staff availability and reimbursement. Mobile phones are a promising platform for improving chronic care but there are few examples of successful health system implementation. Program Development. An iterative process of program design was built upon a pilot study and engaged multiple institutional stakeholders. Patients identified having a “human face” to the pilot program as essential. Stakeholders recognized the need to integrate the program with primary and specialty care but voiced concerns about competing demands on clinician time. Program Description. Nurse administrators at a university-affiliated health plan use automated text messaging to provide personalized self-management support for member patients with diabetes and facilitate care coordination with the primary care team. For example, when a patient texts a request to meet with a dietitian, a nurse-administrator coordinates with the primary care team to provide a referral. Conclusion. Our innovative program enables the existing health system to support a de novo care management program by leveraging mobile technology. The program supports self-management and team-based care in a way that we believe engages patients yet meets the limited availability of providers and needs of health plan administrators.