Mobile Integrated Health and Post-Hospital Discharge Heart Failure Care
Abstract
Importance: Mobile integrated health (MIH) is a promising model for improving transitions of care for patients with heart failure (HF). National implementation remains limited due to insufficient understanding of barriers and facilitators to adoption and sustainability.
Objective: To identify factors associated with the implementation of an MIH program for patients with HF in an urban setting, using the Reach, Effectiveness, Adoption, Implementation, Maintenance (RE-AIM) framework.
Design, setting, and participants: This qualitative study was embedded in the Using Mobile Integrated Health and Telehealth to Support Transitions of Care Among Heart Failure Patients (MIGHTy-Heart) randomized clinical trial conducted from January 2021 to September 2024 at 2 large urban health systems in New York, New York. Qualitative data were generated through semistructured interviews with patients and stakeholders (clinicians, paramedics, caregivers, and program leaders). Data were analyzed from January 2022 through August 2023.
Exposure: The MIH intervention included home visits from community paramedics, ongoing nurse care coordination, and facilitated telehealth consultations.
Main outcomes and measures: Five RE-AIM domains were assessed using directed content analysis of interview data. Quantitative reach was measured by comparing adults with HF offered access to MIH to all adults with HF receiving care at the health systems during the study period, and effectiveness data were summarized…
How strong is the evidence?
Evidence Hub reads this as a randomized trial, done in people. Its evidence level is 2 of 5 (High · randomized trial). Randomized trials of a reasonable size are the strongest single-study design. Reported size: 73 participants or records.
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