MOBILE-BASED SYMPTOM MANAGEMENT FOR PALLIATIVE CARE

Presented by Dr. Md. Munirul Haque, Computer and Information Sciences, University of Alabama at Birmingham

Sponsored by the Discovery Park Cyber Center and Regenstrief Center for Healthcare Engineering

Abstract:

The goal of palliative care is to improve the quality of life of terminally ill patients through the management of pain and

other symptoms. Though the term ‘palliative care’ is well known in the developed world, it is relatively a new term in the

developing world. In this presentation, we elaborate on the challenges faced by the rural breast cancer (BC) patients of

Bangladesh and a mobile phone based solution for their palliative care treatment. Breast cancer patients need traditional

treatment as well as long term monitoring through an adaptive feedback-oriented treatment mechanism. Based on

detailed field studies, we have developed and deployed a mobile-based remote symptom monitoring and management

system named e-ESAS. Design of e-ESAS has evolved through continuous feedback from both the patients and doctors. e-

ESAS has been used by 10 breast cancer patients to submit symptom values from their home for 10 months (Nov ’11- Sep

’12). Our results show how e-ESAS with motivational videos not only helped the patients to have a ‘dignified’ life but also

helped the doctors to achieve the goals of palliative care. We have also shown how ‘motivation’ and ‘automation’ have

been integrated in e-ESAS and creating a unique motivation-persuasion-motivation cycle where the motivated patients

become proactive change agents by persuading others. e-ESAS demonstrates the potential to positively impact the cancer

care by (1) helping the doctors with graphical charts of long symptom history (automation), (2) facilitating timely

interventions through alert generation (automation) and (3) improving three way communications (doctor-patient-attendant)

for a better decision making process (motivation) and thereby improving the quality of life of BC patients. Also

the analyzed results are shown in four categories to appropriately measure the contribution of e-ESAS in improving the

quality of life.