College of Nursing, University of South Florida, Tampa, FL 33612, United States.
College of Nursing, University of South Florida, Entrepreneurial Lead for the NSF I-Corps Project, United States; Society of Acute Care Nurse Practitioner Students at USF, United States.
Appl Nurs Res. 2018 Feb;39:26-33. doi: 10.1016/j.apnr.2017.10.018. Epub 2017 Oct 19.
Heart failure (HF) causes significant symptom burden and human suffering with considerable economic burden due to hospital readmissions. Targeted interventions to encourage and support self-management behavior is warranted.
To test the proof of concept of a mobile application (HeartMapp) in improving self-care management of patients with heart failure.
An exploratory inquiry used a field study strategy with purposeful sampling and constant comparative analysis to test the proof of concept of HeartMapp using The Business Model Canvas framework.
A total of 125 individuals, who were identified as potential candidates to use the HeartMapp completed the interview over a seven-week period in 2016. Constant comparative analysis indicated themes that Skilled Nursing Facilities had increased readmissions. Participants from Skilled Nursing Facilities reported concern on lack of staffing, star rating, and malpractice claims. Two types of patients were identified as early adapters of technology and those in denial. Health care facilities reported challenges on transitional care, nurses struggle with engagement of patients on self-care management. To avoid readmission penalty, hospitals task home care agencies to keep the patients home for 30-days. While home care agencies rely on remote telemonitoring reported that current telemonitoring devices are costly to maintain, thus exploring novel technology.
The Business Model Canvas provided directions for future testing of HeartMapp for its usability as an adjunct device in home health setting to improve self-management and enhance communication with providers, and ultimately reduce readmissions.
心力衰竭（HF）导致显著的症状负担和人类痛苦，由于医院再次入院，造成了相当大的经济负担。有必要进行有针对性的干预，以鼓励和支持自我管理行为。
测试移动应用程序（HeartMapp）在改善心力衰竭患者自我护理管理方面的概念验证。
采用探索性调查，使用实地研究策略进行有目的的抽样和恒定性比较分析，使用商业模式画布框架测试 HeartMapp 的概念验证。
共有 125 名被认为有潜力使用 HeartMapp 的人在 2016 年的七周内完成了访谈。恒定性比较分析表明，熟练护理设施的再入院率有所增加。来自熟练护理设施的参与者报告了对人员配备不足、星级评定和医疗事故索赔的担忧。确定了两种类型的早期技术采用者和那些否认的患者。医疗机构报告了在过渡护理方面的挑战，护士在参与患者自我护理管理方面存在困难。为了避免再次入院的惩罚，医院要求家庭护理机构将患者留在家中 30 天。虽然家庭护理机构依赖远程远程监测，但报告称目前的远程监测设备维护成本高昂，因此正在探索新的技术。
商业模式画布为未来在家庭健康环境中测试 HeartMapp 的可用性提供了方向，作为辅助设备，以改善自我管理并加强与提供者的沟通，最终减少再入院率。
