A new study from Columbia Nursing suggests that mobile integrated health (MIH) may help heart failure patients make a smoother transition from hospital to home—and may offer extra benefits for women and younger patients.
Heart failure is one of the leading reasons older adults are hospitalized in the United States. Around 25% of Medicare patients who are admitted for heart failure end up back in the hospital within 30 days.
Finding better ways to support these patients after they leave the hospital is an important step in preventing readmissions and improving recovery.
The study, published in JAMA Internal Medicine, was led by Professor Ruth Masterson Creber, Ph.D., director of the Center for Community-Engaged Informatics and Data Science at Columbia. She and her team looked at whether MIH could improve care compared to a more traditional follow-up method.
In the study, called the Mighty-Heart trial, more than 2,000 patients from 11 New York City hospitals were randomly assigned to two groups. One group received a standard transition of care coordinator (TOCC) service, where a nurse called the patient within 48 to 72 hours after hospital discharge.
The other group received both TOCC and MIH services. These additional services included nurse care coordination, home visits by community paramedics, and telehealth consultations with emergency doctors.
At the 30-day mark, about 20% of patients in both groups had been readmitted to the hospital, showing no major difference in overall readmissions, health status, or use of health services between the two groups. However, when the researchers looked more closely, they found that MIH did appear to help certain patients more.
For example, patients under the age of 70 who received MIH support had better health outcomes than those who only got the follow-up phone call. Women in the MIH group were also less likely to be readmitted.
In fact, women who received MIH were 30% less likely to return to the hospital for any reason and 36% less likely to be admitted again specifically for heart failure.
Professor Masterson Creber believes that MIH may be especially helpful for patients who face extra challenges at home. These could include financial stress, trouble getting transportation, or not having anyone at home to help care for them.
“Patients facing greater social and economic barriers—like financial stress or lack of caregiving support—may gain the most from mobile integrated health,” she said.
She also emphasized that the results show how complex it is to design care programs for people with heart failure. A one-size-fits-all approach may not work for everyone, and different groups of patients may need different kinds of support.
In conclusion, while MIH may not reduce hospital readmissions for all heart failure patients, it seems to offer meaningful benefits for women and those under 70. The study highlights the need to continue exploring new ways to deliver personalized care, especially for those who face extra difficulties after leaving the hospital.
If you care about heart health, please read studies about a new cause of heart rhythm disorders and eating just one cup of nitrate-rich vegetables daily can reduce heart disease risk.
For more about heart health, please read studies about blood thinners that may not prevent stroke in people with heartbeat problems and this diabetes drug may protect heart health in older veterans.
The study is published in JAMA Internal Medicine.
Copyright © 2025 Knowridge Science Report. All rights reserved.
