Leveraging Connected Health to Improve Mobility in Hospitalized Seniors

Principal Investigators: Ryan Greyson, MD and Mitesh Patel, MD, MBA, MS

Hospitalization is a common occurrence for older adults; approximately 6.8 million Medicare seniors experience an admission for acute care in any given year. This is often a sentinel event in the overall health trajectory of older adults that is complicated by functional impairment, Skilled Nursing Facility placement, and hospital readmissions. While a robust literature shows low mobility during acute care is an important mediator of these outcomes, there are surprisingly few interventional studies to increase mobility. These existing interventional studies have been limited by a lack of precision in mobility goals and unit-based approaches (rather than hospital-wide) which are resource-intensive and difficult to scale. We are carrying out a quasi-experimental trial with lead-in and washout periods to study mobility for hospitalized seniors at HUP using an existing mobility protocol on 2 floors (1 intervention, 1 control) prior to its planned hospital-wide roll-out. Our proposal will address limitations above. First, we will use wearable sensors for precision in measuring mobility (steps per day) achieved by patients in response to a mobility protocol which recommends one of 5 levels of mobility levels directly to patients (ranging from 0=totally bed-bound to 4=90% out-of-bed). Second, we will take advantage of the Way To Health platform to enroll patients, collect/aggregate sensor data, and communicate with participants. Finally, we will utilize Apple HealthKit integration features in the MyPennMedicine mobile application to import mobility data directly from wearable sensors into PennChart where it will be visible to all providers. We will use this as pilot data to support funding applications (R01 or PCORI) for a larger pragmatic RCT.