Objective: To assess the feasibility, clinical value, and impact of a smartphone based platform capturing longitudinal, objective digital measures of Parkinson’s disease (PD) in the UK and US.

Background: The prevalence of PD is increasing. This challenges clinicians ability to monitor symptoms frequently and adjust treatment effectively. Traditional in clinic assessments provide limited temporal resolution. Digital tools enabling remote, repeated measurement may improve clinical decision making, empower patients, and reduce pressure on healthcare systems.

Method: A smartphone platform was implemented across UK hospitals and US healthcare providers. The application collected objective measures of gait, balance, rest and postural tremor, alternating finger tapping, reaction time, and sustained phonation via brief self-administered tasks. Cognitive performance was assessed using digital tests of processing speed, executive function, immediate and delayed recall. 850 individuals with idiopathic PD completed remote assessments over 6–24 months. An additional cohort of patients contributed matched clinical ratings to train models estimating clinical scores and predicting outcomes including 18-month fall risk. Principal component analysis was used to risk stratify patients. Clinicians accessed a dashboard summarising trends to support real-time management decisions.

Results: Over 1,000,000 smartphone derived data points were collected. Digital features showed significant correlations with clinician rated assessments and captured symptom variability. Predicted fall risk aligned with observed fall rates, supporting model performance. Digital phenotypes identified clinically meaningful patient subgroups associated with specific cognitive deficits and symptom profiles. Dashboard insights informed medication adjustments, and more proactive patient management. Sites also observed reductions in unplanned PD related care, including emergency presentations. Patients reported increased confidence in self-management and positively rated usability.

Conclusion: Smartphone based remote monitoring for PD is feasible, acceptable to patients, and clinically actionable. Digital measures provide meaningful insight into patient phenotypes, symptom changes, treatment optimisation, and may improve workflow efficiency while reducing acute care needs. This scalable approach complements traditional neurological care pathways.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/real-world-digital-tracking-of-parkinsons-disease/