Evidence map›Paper›PMID 37541655›Full record

ArticleApplied clinical informatics2023

Buy or Build: Challenges Developing Consumer Digital Health Interventions.

Barry G Saver, Jenna L Marquard, Jeremy Gummeson, Joanne Stekler, James M Scanlon

Open access · hybridAbstract read
In one paragraph

Article in Applied clinical informatics, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
0.7field-weighted citation impact, top 28% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 3 citations in OpenAlex.

  1. Review
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 5 institutions in 1 country.

Barry G SaverSwedish Family Medicine Residency Cherry Hill, Swedish Health Services, Seattle, Washington, United States.
Jenna L MarquardSchool of Nursing, University of Minnesota, Minneapolis, Minnesota, United States.
Jeremy GummesonElectrical and Computer Engineering, University of Massachusetts Amherst, Amherst, Massachusetts, United States.
Joanne SteklerDivision of Infectious Diseases, University of Washington School of Medicine, Seattle, Washington, United States.
James M ScanlonSwedish Center for Research and Innovation, Swedish Health Services, Seattle, Washington, United States.
Swedish Family Medicine Residency - Cherry Hill · USSwedish Medical Center · USUniversity of Massachusetts Amherst · USUniversity of Minnesota · USUniversity of Washington · US

Funding

Unobtrusive Sensing of Medication Intake ("USE-MI")R01MH109319 · NIMH · SWEDISH MEDICAL CENTER, FIRST HILL · PI MARQUARD, JENNA LOUISE, SAVER, BARRY G · 2015 to 2018
$2.9M
CONtrolling Disease Using Inexpensive IT Hypertension in Diabetes: CONDUIT-HIDR18HS018461 · AHRQ · UNIV OF MASSACHUSETTS MED SCH WORCESTER · PI SAVER, BARRY G · 2010 to 2013
$2.0M
AHRQ HHS R18 HS018461NIMH NIH HHS R01 MH109319
6 · The paper itself

Abstract

backgroundDigital health interventions offer opportunities to improve collaborative care between clinicians and patients. Designing and implementing digital health interventions requires decisions about buying or building each technology-related component, all of which can lead to unanticipated issues.

objectivesThis study aimed to describe issues encountered from our "buy or build" decisions developing two digital health interventions over different timeframes, designed to use patient-generated health data to: (1) improve hypertension control and (2) measure and improve adherence to HIV-related medications.

methodsCONDUIT-HID (CONtrolling Disease Using Information Technology-Hypertension In Diabetes) was developed during 2010 to 2015 to allow patients receiving care from a multispecialty group practice to easily upload home blood pressure readings into their electronic health record and trigger clinician action if mean blood pressure values indicated inadequate control. USE-MI (Unobtrusive SEnsing of Medication Intake) was developed from 2016 to 2022 to allow entry of patients' HIV-related medication regimens, send reminders if patients had not taken their medications by the scheduled time(s), attempt to detect medication ingestion through machine learning analysis of smartwatch motion data, and present graphical adherence summaries to patients and clinicians.

resultsBoth projects required multiple "buy or build" decisions across all system components, including data collection, transfer, analysis, and display. We used commercial, off-the-shelf technology where possible, but virtually all of these components still required substantial custom development. We found that, even though our projects spanned years, issues related to our "buy or build" decisions stemmed from several common themes, including mismatches between existing and new technologies, our use case being new or unanticipated, technology stability, technology longevity, and resource limitations.

conclusionThose designing and implementing digital health interventions need to make numerous "buy or build" decisions as they create the technologies that underpin their intervention. These "buy or build" decisions, and the ensuing issues that will arise because of them, require careful planning, particularly if they represent an "edge case" use of existing commercial systems.

Indexed as

Diabetes MellitusHIV InfectionsHypertensionDigital HealthElectronic Health RecordsHumans

Identifiers

PMID37541655
PMCPMC10567137
OpenAlexW4385566838

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.