By Kevin McKeough
More than 1,700 Rush patients are using a free smartphone app to track important personal health data they share with their doctor and to get coaching on how to be healthier. 海角原创 co-developed the app with , a San Francisco technology company, and was the first hospital in the country to make it available to patients.
Many Rush patients who have been diagnosed with high blood pressure, diabetes or prediabetes have the option of using the Nuna app to record their blood pressure and blood sugar measurements, which automatically are entered in their electronic medical records at Rush.
In addition, an AI health coach created by Nuna provides reminders to take medication, feedback on meals when users enter what they ate, and other guidance and support. The app also includes a library of medical information developed by a Rush team.
Delivering daily data for better decisions
High blood pressure (also called hypertension) is the greatest risk factor for heart disease, the leading cause of death in the United States, and is present in nearly half of adults in the U.S. It鈥檚 also one of the risks that people are most able to reduce. Yet fewer than 25% of adults with hypertension achieve adequate blood pressure control, despite the availability of medications to treat it and well-established lifestyle interventions like better diet, more exercise and not smoking.
鈥淭he medication adherence and lifestyle changes needed to keep high blood pressure under control can be very difficult to sustain,鈥 says Kristen Pallok, MD. A Rush primary care physician and the medical director of clinical innovation for Rush Health, Pallok oversees Rush鈥檚 use of the Nuna app in patient care.
The app is designed to help patients manage their health conditions and make lifestyle changes. It also enables members of their care team to monitor their health in between appointments with their doctor.
鈥淲hile physicians would love to stay steadily engaged with patients, realistically we only see them every few months and then only have that day鈥檚 reading and patient recollection,鈥 Pallok says.
"Nuna helps us understand what happens outside of the clinic walls. It鈥檚 a window into a patient鈥檚 daily routine and blood control progress,鈥 she continues.
A nurse monitors the blood pressure readings of a group of patients being followed closely and checks on patients with repeated high readings, scheduling clinic appointments as needed. Patients in need of assistance obtaining food, housing or other social determinants of health can get a referral to a Chicago-area community health worker, who can connect them with resources.
Helping patients take care of themselves
The Nuna app also helps patients take greater responsibility for their health. 鈥淚f they aren鈥檛 adherent to their medications, the app will remind them. Sometimes that鈥檚 all that it takes to get something under control,鈥 Pallok says.
鈥淭hey want to do it on their own, and you have to give them the opportunity to do it. It鈥檚 making that daily lifestyle modification, but it鈥檚 also learning how to manage your condition in your busy life.鈥
The medical center began incorporating the Nuna app into patient care in 2024 with small pilot studies of hypertension and diabetes patients. Eventually, Rush enabled primary care physicians to prescribe the app for patients, gradually expanding its availability to include patients at Rush Oak Park Hospital and some of Rush鈥檚 off-campus clinics. (Nuna provides a free blood pressure cuff for the patients to use to take their reading; devices for checking blood sugar are provided as part of regular diabetes care.)
鈥淵ou already have a relationship with the nurse practitioner or physician you're seeing. If someone says, 'I really think this is a good idea for you. I want to see your blood pressures because I want to do a better job taking care of you,' people are far more likely to engage," Pallok says.
Data and patients both say the app helps
A study of Rush patients found that the Nuna app helped them improve their health. In the study, a group of 425 patients already being treated for hypertension used Nuna to track their blood pressure for six months. Their results were compared to their blood pressure levels for the six months prior to the use of the app, and the entire year鈥檚 results were compared to those of another 425 Rush patients who were receiving care for high blood pressure but didn鈥檛 use the app.
Both groups鈥 blood pressure improved overall, but the patients using Nuna achieved greater reductions, particularly those whose blood pressure had reached a level considered uncontrolled. Results of the study were published recently in the
鈥淭he data reflects what patient after patient has been telling us: Using the app has helped them take better control of their health," Pallok says. She and Rush physicians Michael Gottlieb, MD, and Laura Zimmerman, MD, are co-authors of the paper.
鈥淚t helped me make monitoring my blood pressure a daily habit,鈥 recalls Stanley, a 74-year-old patient whose doctor recommended the Nuna app after he suffered a transient ischemic attack (a 鈥渕ini-stroke鈥). 鈥淐hanging what I eat and buy at the store took time. But I would get daily reminders, and then I even learned to ask questions while at the store about which foods were right for me.鈥
Stanley long had battled obesity and weighed more than 200 pounds when he began using the Nuna app. Now he鈥檚 down to 167 pounds and his blood pressure is under control.
鈥淲hen I get up in the morning, it reminds me about meds and diet, being active,鈥 he says. 鈥淚t really seemed to be looking out for me. How could I ignore a friend like that?鈥
Born in Chicago
The Nuna app鈥檚 development began at 海角原创. Its creation originated at a conference where Dr. Omar Lateef, president and CEO of Rush University System for Health, met Jini Kim, Nuna鈥檚 CEO and co-founder, and they discussed a potential partnership. Nuna at the time was a healthcare data and analytics company, but they were interested in creating a health app and drawn to Rush because of a blood pressure monitoring program the medical center already had in place.
A Nuna team flew to Chicago and met with Rush representatives for brainstorming discussions. They decided to start with the data tracker and the health information library, which already had been developed for another Rush project. Over time, the partnership added the meal tracker and health coach.
The Nuna app also incorporates game-like elements 鈥 such as rewarding points 鈥 to keep users engaged. That feature has contributed to 87% of patients still using the app six months after they started with it and roughly three-quarters continuing to use it weekly.
The Nuna app now is available for download to iPhones and Android phones. Other hospitals around the country are using it in patient care, and Nuna is participating in a Centers for Medicare and Medicaid program that reimburses the company if app users achieve health improvements.
Nuna is among many innovations advancing care at Rush
Rush is considering expanding the app鈥檚 monitoring feature to other conditions, including obesity, chronic kidney disease and high cholesterol, and possibly piloting its use with stroke patients with high blood pressure.
鈥淭echnology is pervasive in our lives,鈥 Pallok says. 鈥淭his is an opportunity to give people a resource that鈥檚 in their hand and information that鈥檚 vetted, teaches about their conditions and helps with follow-up.鈥
In addition to encouraging patients to make healthy changes in their behavior, the Nuna app is changing how doctors treat those patients. 鈥淚t鈥檚 making us reframe how we look at chronic condition like blood pressure, because we never had such access to patients before,鈥 Pallok says.
Rush鈥檚 co-development and adoption of the Nuna app is part of the larger portfolio of technological innovations that the health system is using to improve care. They range from an AI assistant that helps schedule appointments to AI transcription of conversations with patients that give doctors more time for care to advanced robotic systems for surgery
鈥淲e鈥檙e committed to finding ways to incorporate technology to enhance care,鈥 Pallok says. 鈥淭hat鈥檚 the goal that at the end of the day all these projects are working towards.鈥
