Closing the Loop for Patients with Chronic Diseases - from Problems to a Solution Architecture

There is growing evidence that mobile health (mHealth) applications can assist patients with chronic conditions. However, most mHealth apps are isolated from healthcare professional (HCP) workflows and IT infrastructure. The resulting fragmentation of digital support in healthcare calls for integrating architectures. They would benefit patients, HCPs, product managers, and software developers. Our analysis of existing architectures has revealed valuable architectural elements, but none of the analyzed architectures provided sufficient integration for the chronically ill. Therefore, we propose an architecture for integrated mHealth solutions. We followed a design science research approach and performed all activities of the DSRM Process Model. By forming a closed control loop and engaging HCPs, the architecture is designed to improve patient adherence to treatment, health literacy, and recall of recommendations and information. The resulting Closing-the-Loop Architecture (LoopArt) deploys three software agents: a Health Literacy Agent, an Adherence Agent, and a Conversational Agent. For demonstration purposes, the Health Literacy Agent was implemented for obese patients as an integrated system consisting of a mHealth app and a collaboration tool as part of the electronic medical record (EMR).