Outcomes Research in Review

Technology-Supported Apprenticeship in the Management of Hypertension: A Randomized Controlled Trial

Journal of Clinical Outcomes Management. 2014 March;21(3)

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Conclusions

This study provides encouraging evidence that, in the management of hypertension, technology-supported apprenticeship can improve the outcomes, cost, and experience of care. By embracing the potential of patients while at the same time optimizing support from clinicians and leveraging information technology for cost-effective scaling, it has the potential to have a tremendous impact across the spectrum of chronic disease.

Three core tenants of technology-supported apprenticeship have surfaced as the product of this work, and they may serve as a useful guide to other efforts improving care delivery: First, patients are the most underutilized resource in health care. Technology-supported apprenticeship harnesses the contribution of the patient and values the development of self-efficacy to the extent that apprentices can become masters. It supports patients in achieving a pinnacle of patient empowerment.

Second, health takes place in the everyday lives of patients, not in a doctor’s office or hospital. Technology-supported apprenticeship appreciates that situated learning is the key to mastery of chronic disease management and strives to support patients continuously in the context of their lives.

Third, collaboration and information transparency, not just information access, are critical. Technology-supported apprenticeship embraces information technology to maximize collaboration among novices and masters and to provide common ground through complete transparency.

Acknowledgments: This study was completed as part of John O. Moore’s PhD thesis at the MIT Media Lab. Mitchel Resnick, PhD, and Pattie Maes, PhD, were members of the thesis committee along with authors Franklin H. Moss, PhD, and David C. Judge, MD, and their advice was critical in the development of the technology-supported apprenticeship approach.

Corresponding author: John O. Moore, MD, PhD, johnomoore@gmail.com

Funding/support: This work was supported, in part, by the CIMIT Prize for Primary Healthcare from the Center for Integration of Medicine & Innovative Technology, Boston, MA.

Financial disclosures: John O. Moore, Frank Moss, and Scott Gilroy have a health information technology company focused on building software solutions for improving chronic disease management. This company does not yet have a product for sale.