heartMAP is an innovative, scalable program harnessing low-cost mobile technology to reduce stroke-related death and disability among low-literacy patients in resource-scarce settings. We project that heartMAP will lower monthly costs of anticoagulation by 60%, and reduce death and disability from stroke among our target population by 37%.
heartMAP is an innovative medical adherence program that remotely manages patients receiving long-term therapy with anticoagulants (blood-thinners) to reduce the risk of stroke. It is comprised of three components:
- a literacy-sensitive training module,
- a commercially available point-of-care diagnostic tool, and
- an interactive information technology-enabled “virtual anticoagulation clinic”
An innovative education and skills module provides low literacy patients the knowledge required for safe and effective anticoagulation. These skills are introduced in a small-group session where patients and caregivers watch a soap-opera style, culturally sensitive video and receive a literacy-sensitive photobook-style manual.
Feasibility testing and validation was performed in more than 200 hours of fieldwork in Bangalore, India in 2012-13. Tests demonstrated excellent comprehension and recall in patients using these two teaching instruments. The module is available in Kannada, with 7 additional Indian planned.
Patients will be provided a commercially available point-of-care device to monitor their response to anticoagulation. This device will allow patients to access high-quality lab tests at home and eliminates the high cost of transportation and health-related absenteeism associated with obtaining tests at a local laboratory.
heartMAP uses low-cost mobile technology to establish a “virtual anticoagulation clinic”: a centralized service powered by voice- and text-based decision-support software that provides personal dosing recommendations. Automated text reminders encourage and remind patients to adhere to the program.