SMART Mobile Application Technology Utilization in the Treatment of Sickle Cell Disease Post Day Hospital Discharge
SMART Mobile Application Technology Utilization in the Treatment of Sickle Cell Disease Post Day Hospital Discharge
The purpose of this study is to test a web-aided, mobile-based PHR (Personal Health
 Reporting) service to enhance SCD outpatient treatment after discharge from an acute care
 setting, such as Duke University Medical Center's Day Hospital. SMART is a new mobile
 application created by SickleSoft to increase patient involvement in their treatment and
 improve patient to doctor communication. SMART is a self-monitoring and management service
 for SCD patients and their treatment doctors. This study will test whether or not use of the
 SMART mobile application will help develop the type of patient-doctor relationships that lead
 to better health outcomes and a decrease in readmission to an acute care facility.
All patients seen for acute care of painful episodes in our Adult Sickle Cell Day Hospital
 will be screened for eligibility. Currently, there are >450 patients actively followed by
 staff in our adult Comprehensive Sickle Cell Center, with an average of 60-70 patient day
 hospital visits per month.

 Intervention and control group. Patients enrolled will be alternately assigned to each group
 to ensure randomization and equal numbers of patients to each arm. All patients will be given
 a return appointment within 12 days of Day Hospital visit. The control group will get
 standard of care, including a printed plan for medications to be taken, phone number to call
 for questions or issues, and the return date for visit.

 SMART Overview. SMART, a mobile phone-based self-monitoring service to enhance outpatient
 treatment in chronic illness will be tested for its utility to help reduce acute care
 utilization rates for patients given SMART following acute care visits at the Sickle Cell Day
 Hospital. SMART will enable symptom monitoring with a particular emphasis on pain measures,
 co-symptoms, and related interventions aided by provider daily monitoring and support guided
 by patient report via SMART to provide a Sickle Cell Disease Information interchange (SCDi)
 service. Instead of using their current routine of triaging phone messages daily, assessing
 patients' need for intervention, providers will instead monitor patients' entries via SMART
 daily. Our current clinicians, a nurse practitioner or medical doctor, will review data
 generated from patients' reports, as well as patient phone calls. Data entered daily by
 patients will be viewable by our clinicians. Rather than only listening to voice mails, a
 clinician from our provider team will view an electronic record and communicate with patients
 electronically by push notification, text messaging, secure email, or via the app. Our
 clinicians may also call patients by telephone, as they would do as necessary when responding
 to voice mails. .
Inclusion Criteria:

 -  documented Hgb SS, SC, or HgbS-beta0 thalassemia

 -  age 18 years old or older

 -  seen during an acute care visit at the Duke Day Hospital

 Exclusion Criteria:

 -  incapable of giving informed consent

 -  greater than 20 acute care visits within the past year

 -  patients on chronic RBC transfusions (scheduled transfusions)

 -  patients admitted to the hospital from the day hospital