Presented by: james johannes MD
Lehigh Valley Health Network

Introduction

Remote medical monitoring and testing is rapidly developing due to medical access challenges and emphasis on value based care.  We tested a novel machine learning based smartphone app for following post-HOLEP patients uroflowmetry and IPSS.

Materials

Patients within the first year of HOLEP recovery performed at home uroflowmetry using the Emano Flo app (EF).  These results were compared to digital weight sensor uroflowmetry in the office.

EF is a smartphone based app using AI to generate a flow curve based on acoustics of a urine stream contacting the toilet bowl water.  Prior to voiding into a toilet, the patient opens the app on his phone and presses record.  The phone is placed on any surface. After the void is complete, the patient answers standard IPSS questions.  Data is accumulated over a 7-10 day period of voids, aggregated, and reported to the ordering physician.

Results

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11 patients underwent both in-office uroflowmetry/PVR/IPSS and remote EF.  8 patients performed at the 1 month post-op visit, 3 at 3 months, 1 at 12 months postop.  Results are in Table 1.  Patients performing the EF averaged 47.4 voids per report.  The average voided volume (VV) was lower in the EF patient population, 164.3 vs 204.3.  Qmax and Qmean between EF vs In-Office were almost identical, 23.3 vs 20.7 and 12.0 vs 11.0 respectively.  Excluding flows <125ml, EF VV increased to 215.1, Qmax 24.4, and Qmean 13.1.  Similarly, the >125ml office patients had an average VV 362, Qmax 28.1, and Qmean 16.3.  For the 4 patients who had >125ml voided with both modalities, the average VV EF vs office was 261.1 vs 351, Qmax 25.1 vs 26.9, Qmean 14.4 vs 15.4.  One more patient achieved a VV of 125 using the app vs in office.

IPSS scores were similar between EF and office, 7.6 total/QOL 0.9, vs 7.9 total/QOL 1.6 and consistent regardless of VV.

Conclusion

Using a smartphone based app to perform at home uroflowmetry has many potential applications.  In our post-HOLEP patients, we found the EF results were similar to in office-based uroflowmetry.  Further study is necessary to determine if smartphone based uroflowmetry can supplant in-office studies.  This has potential impact in reducing patient visits to the office which can help improve access and reduce healthcare costs.

Funding

none

Co-Authors

Alexis Brown, PA-C
Lehigh Valley Health Network

Jaylon Hartley, PA-C
Lehigh Valley Health Network