(8.6)
Fitbit Updates
We’ve updated our Fitbit connector to get even more data. This includes:
New! Activity data (e.g. biking, yoga, running)*
New! Intraday heart rate data for tracking minute-by-minute heart rate values.*
Our sleep data now includes stages of sleep (deep, light, rem ,wake) in addition to classic categories (asleep, restless, awake).
More fields associated with step tracking (e.g. goals, calories). Please note: the fitbit_goal column was renamed to goal_steps.
For active projects and studies, this new data will not be backfilled, but we can update your configuration to start tracking it now.
Submit a request to turn on these new data feeds.
Withings Updates
We have updated our Withings connectertoo! This includes:
New! Daily heart rate data*
New! Intraday data for for steps, heart rate and sleep.*
As with the new Fitbit data, active projects and studies will need to submit a request to turn on these new data feeds.
Re-Enroll in a W2H Intervention
Re-enrollment in a Way to Health intervention is now available in PennChart. Heart Safe Motherhood, a blood pressure monitoring program for moms after childbirth needed this feature because mom’s often experience high blood pressure for multiple pregnancies. This feature is not only for HSM though! Any intervention that enrolls through PennChart can use this feature as well. Please let your W2H liaison know if you would like to implement this for your program.
Progress towards upcoming major releases
The ability to deliver Way to Health interventions in Spanish is in the works. Release scheduled for late February.
A customizable participant dashboard is underway. Release scheduled for early February.
Behind the Scenes
Sensu PMACS Testing Failing Health Check for Fitbit Queue
Add queue specifically for all Fitbit devices
Use Accept-language header in request to Fitbit API
Fix: Can't (re)schedule event block for today, Change behavior for event blocks when trigger = TODAY
(HF to dev) Missing logos for new Withings/Fitbit data sources
Update Fitbit Sleep API
(8.3-8.5)
Close event block logic action
Event blocks provide a framework for creating modules within a single intervention. We’ve added a new logic action that allows you to end the event block based off a scheduled rule. For example, you might want to end a daily monitoring check-in for post-surgery drains when a patient reports output over a specified value.
Most recent data in adherence snapshot
You now have the option to show the most recent participant data first in the adherence snapshot. Originally the data appeared from oldest → newest. We switched it up allowing you to choose to show the most recent data first.
We can now show variables and individual survey responses in the adherence snapshot
For example, you could show a calculated gestational week variable above a weekly blood pressure in order to track a participant’s blood pressure over time.
Use global variables in conversations and surveys
You can use global variables in conversations and surveys to make them even more customized to your participants. This could include personalized dates, names or goals.
Calculate values in surveys and conversations
Calculating values in surveys and conversations will allow you “score” or aggregate specific responses. This is helpful in many clinical scoring tools, like the PHQ-9, in which a total number based on participant responses is relevant to their care.
Access multiple sources in participant data
Variables can now look at multiple sources in order to give you more flexibility in updating participant data as needed. For example, if you needed to make a second version of a survey after your intervention has launched. You could make the single variable look at both the answers from version 1 and version 2 of the survey in order to make sure all participants are assigned the proper variable in logic.
Update survey and conversation responses in Manage Data
In Manage Data, we have standardized the way we display missing values:
not answered ( . )
not asked ( - )
error ( ? )
Progress towards upcoming major releases
A customizable participant dashboard is underway. Release scheduled for early February.
We are taking flexible scheduling to the next level by adding date variables. Date variables will allow you to calculate, display and schedule event blocks based on dates customized for each participant. Release scheduled for early February.
The ability to deliver Way to Health interventions in Spanish is in the works. Release scheduled for late February.
We are working on making re-enrollment in a Way to Health intervention available in PennChart. Heart Safe Motherhood, a blood pressure monitoring program for moms after childbirth.
Behind the Scenes
Add appropriate logic actions to W2H sections
Add noncompliant logic action to Enrollment Block events
Add assignStudyGroup logic action to Arm Event
Add ClassifyData (Set adherence snapshot category) to Enrollment Block events
Refactor: remove unnecessary stuff from our layout.php templates
Quarterly upgrade of composer/PHP dependencies
Quarterly upgrade of yarn/JS dependencies
What happened
Information Systems & Computing (ISC) was conducting a planned network upgrade over the weekend. The upgrade was scheduled for January 4th from 3-3:30am. This update would cut off all network connectivity for this thirty minute period for most, if not all PMACS servers including the ones that host Way to Health. However, the servers did not come back online until 10:30am. Additionally, based on our logs, the offline period began as early at 1:00am, not 3:30am as had been communicated. This meant that while the servers themselves were running, they could not communicate to any external internet service to collect incoming data, or send out messaging during that time period.
The estimated offline period for Way to Health was: 1/4/2020 1:00am - 10:30am.
What does this mean for your clinical program or research trial?
In most cases, incoming data was queued and then collected late. Outbound messaging was queued and sent late, or failed to send entirely. A detailed description by incoming data and outgoing messaging is listed below.
Incoming data (Epic feeds)
Epic feeds were unaffected because they are within the internal network and the servers were not shut down. Only communication with the external world was cut off.
Incoming data (MMS/SMS)
Incoming text and picture messages were not delivered to the Way to Health platform. Participants received an automated response from Twilio that read “Due to a system error, your message was not received. Please try again in a few minutes.”
Those queued messages are accessible by the Way to Health Team. If you wish to receive an Excel file for your project, please place a service request via our Help Desk. The volume of inbound messages during this window of time was very low.
Incoming data (Fitbit, Withings, Hidrate Spark)
Data feeds for these devices were queued by the vendor during the offline window and sent to Way to Health when internet access was restored. You can view this in Manage Data and filter on a timestamp of 1/3/2020 (previous day’s data), sorting by “Received in WTH” date/time to get a full history of incoming data.
Outbound messaging (SMS)
Outbound SMS messages were queued by Way to Health during the offline window. When internet access was restored, the platform attempted to send out the entire queue of messages. Because of the large volume across the platform, some messages that originally failed were sent, while others remained in a failed state. To view a list of all failed messages for your study or clinical program, got to Manage Participants > Text Messages. Filter by timestamp between 1/4/2020 1:00am and 1/4/2020 10:30am, and by status of “Failed”. You can also export a full list of text messages from Reports and find the Text Messages export under General Category.
Outbound messaging (email)
Outbound email messages were queued by Way to Health during the offline period. When internet access was restored, the platform sent those emails.
Linking late data with feedback messaging
Because the evaluation time point for most daily device data (e.g. steps, fluid intake) occurs during the overnight hours, it is very possible that participants received late incorrect messaging on January 4th regarding their progress in the study or program from the previous day (January 3rd). For example, an 8am morning message about reaching a goal may have evaluated the participant as non-compliant ,or not reaching their goal, simply because the data didn’t come through until the next morning when Way to Health came back online. The system had already evaluated and the message was queued for delivery prior to the new device data coming in after 10:30am that morning.
Most study and clinical teams have standard processes for manually adjusting data as needed (e.g. adjusting points, levels, financial incentives). You should continue to follow these processes. If you need assistance, please place a service request via our Help Desk.
Lessons learned and next steps
We are evaluating a range of options to see what can be done to mitigate issues like this going forward. We also intend to work with PMACS and Corp IS to come up with some approaches and strategies to avoid such scenarios.
We do apologize for the inconvenience that this must have caused you. Please do not hesitate to reach out to us with any requests for help or support.