With today’s technological advancements, mobile phones and wearable devices have become extensions of an increasingly diffused and smart digital infrastructure. In this paper, we examine mobile health (mHealth) platforms and their health and economic impacts on the outcomes of chronic disease patients. To do so, we partnered with a major mHealth firm that provides one of the largest mobile health app platforms in Asia specializing in diabetes care. We designed and implemented a randomized field experiment based on detailed patient health activities (e.g., steps, exercises, sleep, food intake) and blood glucose values from 1,070 diabetes patients over several months. Our main findings show that the adoption of the mHealth app leads to an improvement in health behavior, which in turn leads to both short term metrics (such as reduction in patients’ blood glucose and glycated hemoglobin levels) and longer-term metrics (such as hospital visits and medical expenses). Patients who adopted the mHealth app undertook higher levels of exercise, consumed healthier food with lower calories, walked more steps and slept for longer times on a daily basis. They also were more likely to substitute offline visits with telehealth. A comparison of mobile versus PC-enabled versions of the same app demonstrates that the mobile version has a stronger effect than PC version in helping patients make these behavioral modifications with respect to diet, exercise, and lifestyle, which ultimately leads to an improvement in their healthcare outcomes. We also compared outcomes when the platform facilitates personalized health reminders to patients vis-à-vis generic (non-personalized) reminders. Surprisingly, we found that personalized mobile messages with patient-specific guidance can have an inadvertent (smaller) effect on patient app engagement and lifestyle changes, leading to a lower health improvement. However, they are more like to encourage a substitution of offline visits by telehealth. Overall, our findings indicate the massive potential of mHealth technologies and platform design in achieving better healthcare outcomes.

中文翻译：

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使用智能移动健康平台赋予患者权力：随机现场实验的证据

随着当今技术的进步，手机和可穿戴设备已成为日益普及和智能的数字基础设施的延伸。在本文中，我们研究了移动健康 (mHealth) 平台及其对慢性病患者预后的健康和经济影响。为此，我们与一家大型 mHealth 公司合作，该公司提供亚洲最大的移动健康应用平台之一，专门从事糖尿病护理。我们根据详细的患者健康活动（例如，步数、锻炼、睡眠、食物摄入）和数月内 1,​​070 名糖尿病患者的血糖值，设计并实施了一项随机现场实验。我们的主要发现表明，采用 mHealth 应用程序可以改善健康行为，这反过来又会导致短期指标（例如降低患者的血糖和糖化血红蛋白水平）和长期指标（例如医院就诊和医疗费用）。采用 mHealth 应用程序的患者每天进行更高水平的运动，食用更健康的低卡路里食物，步行更多步数，并且每天睡眠时间更长。他们也更有可能用远程医疗代替线下就诊。对同一应用程序的移动版本与 PC 版本的比较表明，在帮助患者在饮食、锻炼和生活方式方面进行这些行为改变方面，移动版本比 PC 版本具有更强的效果，最终导致他们的改善医疗保健结果。我们还比较了平台为患者提供个性化健康提醒与通用（非个性化）提醒时的结果。令人惊讶的是，我们发现带有患者特定指导的个性化移动消息可能会对患者应用程序的参与和生活方式的改变产生无意（较小）的影响，从而导致健康改善较低。然而，他们更喜欢鼓励用远程医疗代替线下就诊。总体而言，我们的研究结果表明移动医疗技术和平台设计在实现更好的医疗保健结果方面具有巨大潜力。然而，他们更喜欢鼓励用远程医疗代替线下就诊。总体而言，我们的研究结果表明移动医疗技术和平台设计在实现更好的医疗保健结果方面具有巨大潜力。然而，他们更喜欢鼓励用远程医疗代替线下就诊。总体而言，我们的研究结果表明移动医疗技术和平台设计在实现更好的医疗保健结果方面具有巨大潜力。