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Can you be your own doctor from home using mHealth technologies?
Can you be your own doctor from home using mHealth technologies?
Can you be your own doctor from home using mHealth technologies?
Can you be your own doctor from home using mHealth technologies?
Can you be your own doctor from home using mHealth technologies?
Can you be your own doctor from home using mHealth technologies?
Can you be your own doctor from home using mHealth technologies?
Can you be your own doctor from home using mHealth technologies?
Can you be your own doctor from home using mHealth technologies?
Can you be your own doctor from home using mHealth technologies?
Can you be your own doctor from home using mHealth technologies?
Can you be your own doctor from home using mHealth technologies?
Can you be your own doctor from home using mHealth technologies?
Can you be your own doctor from home using mHealth technologies?
Can you be your own doctor from home using mHealth technologies?
Can you be your own doctor from home using mHealth technologies?
Can you be your own doctor from home using mHealth technologies?
Can you be your own doctor from home using mHealth technologies?
Can you be your own doctor from home using mHealth technologies?
Can you be your own doctor from home using mHealth technologies?
Can you be your own doctor from home using mHealth technologies?
Can you be your own doctor from home using mHealth technologies?
Can you be your own doctor from home using mHealth technologies?
Can you be your own doctor from home using mHealth technologies?
Can you be your own doctor from home using mHealth technologies?
Can you be your own doctor from home using mHealth technologies?
Can you be your own doctor from home using mHealth technologies?
Can you be your own doctor from home using mHealth technologies?
Can you be your own doctor from home using mHealth technologies?
Can you be your own doctor from home using mHealth technologies?
Can you be your own doctor from home using mHealth technologies?
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Can you be your own doctor from home using mHealth technologies?

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Presentation given by Joseph C. Kvedar at ISHSH 2013

Presentation given by Joseph C. Kvedar at ISHSH 2013

Published in: Health & Medicine
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  • 1. Can you be your own doctor 
 from home using mHealth technologies?
 Joseph C. Kvedar, MD
 Director
 Center for Connected Health
 Partners HealthCare © 2013 Center for Connected Health – All Rights Reserved Content Confidential – DO NOT DUPLICATE.
  • 2. •  Founder & Director, Center for Connected Health •  Associate Professor, Harvard Medical School •  Co-Founder & Chair of Scientific Advisory Board, Healthrageous •  Board Member, Care Continuum Alliance; Continua Health Alliance Joseph C. Kvedar, MD © 2013 Center for Connected Health – All Rights Reserved Content Confidential – DO NOT DUPLICATE.
  • 3. Connected Health Goal Integrate care into the day-to-day lives of our patients © 2013 Center for Connected Health – All Rights Reserved Content Confidential – DO NOT DUPLICATE.
  • 4. Ideation & Feasibility Connected Health Innovation Process © 2013 Center for Connected Health – All Rights Reserved Content Confidential – DO NOT DUPLICATE. Product develop. r   Program develop. Trial/Test r   Spin-out License CCH Service Internal Hand-off
  • 5. Technology is an enabler to provide care remotely Benefits include improved engagement, outcomes, and efficiencies Mission is to facilitate the adoption of Connected Health About the Center for Connected Health © 2013 Center for Connected Health – All Rights Reserved Content Confidential – DO NOT DUPLICATE.
  • 6. Connected Health Benefits Improved self-care1 Just-in-time care2 © 2013 Center for Connected Health – All Rights Reserved Content Confidential – DO NOT DUPLICATE.
  • 7. Connected Health Components Feedback Loop © 2013 Center for Connected Health – All Rights Reserved Content Confidential – DO NOT DUPLICATE.
  • 8. Heart Failure Monitoring Connected Cardiac Care 50% Drop in Readmissions © 2013 Center for Connected Health – All Rights Reserved Content Confidential – DO NOT DUPLICATE.
  • 9. Data Includes 332 CCCP enrollments among 301 unique patients discharged from the CCCP program prior to July 1, 2009. Results are similar within more recent cohorts of enrollees discharged from the program prior October 1, 2009 and prior to January 1, 2010. Proportion of CCCP Enrollees with One or More Hospitalization 39.80 13.30 58.10 100 One year prior to CCCP enrollment (point estimate and 95% C.I.) One year following CCCP disenrollment (point estimate and 95% C.I.) Percent © 2013 Center for Connected Health – All Rights Reserved Content Confidential – DO NOT DUPLICATE.
  • 10. Average drop of HbA1c: 1.5 69% achieved a drop in BP Diabetes and Blood Pressure Connect © 2013 Center for Connected Health – All Rights Reserved Content Confidential – DO NOT DUPLICATE.
  • 11. Greater engagement is associated with greater pre-post HbA1c change Practice engagement correlates strongly with better patient outcomes • Patients with greater than 15 uploads had average 1.5 pre-post HbA1c change • P< 0.03 between no uploads and uploads groups 0.43 1.34 1.53 0 0.2 0.4 0.6 0.8 1 1.2 1.4 1.6 1.8 no uploads 1 - 15 uploads > 15 uploads DropinHbA1c Average drop HbA1c by # of uploads J Diabetes Sci Technol 2012;6(6):1328-1336 © 2013 Center for Connected Health – All Rights Reserved Content Confidential – DO NOT DUPLICATE.
  • 12. Proportion with 10mmHg or greater drop in SBP C I P<0.05 Decreases in Blood Pressure from Self Monitoring Proportion with 5mmHg or greater drop in DBP P<0.05 C I %ofSubjects %ofSubjects Am Heart J. 2012 Oct;164(4):625-31. © 2013 Center for Connected Health – All Rights Reserved Content Confidential – DO NOT DUPLICATE.
  • 13. •  Most users do not access the website –  “I didn’t look at it online, I didn’t need to, I thought that’s what my provider was doing” •  Provider engagement is very important –  “If I forget to send it in, after a couple of weeks, she calls me.” –  “I stopped using it for my reasons, but no one ever called and asked why I stopped so I never pursued it” Focus Group Feedback © 2013 Center for Connected Health – All Rights Reserved Content Confidential – DO NOT DUPLICATE.
  • 14. Sentinel Effect
  • 15. Components of Self Care Social Networking Gamification Incentives Coaching Feedback Loop © 2013 Center for Connected Health – All Rights Reserved Content Confidential – DO NOT DUPLICATE.
  • 16. Text-message Reminder Participant reads message and applies sunscreen Sends SMS when the tube is opened Tues. Sunny. High 68, Low 53. Please apply your sunscreen today. Remote Monitoring Data Repository (RMDR) Simple Reminders Can Have A Powerful Effect © 2013 Center for Connected Health – All Rights Reserved Content Confidential – DO NOT DUPLICATE.
  • 17. Adherence Rate for Sunscreen Use Weekly Adherence Rates (mean +/- SEM) 0.0% 10.0% 20.0% 30.0% 40.0% 50.0% 60.0% 70.0% Week 1 Week 2 Week 3 Week 4 Week 5 Week 6 Study Period %Adherence Reminder group No Reminder Group Arch Dermatol. 2009;145(11):1230-1236. © 2013 Center for Connected Health – All Rights Reserved Content Confidential – DO NOT DUPLICATE.
  • 18. The Power of Activity and Coaching -20.00 -15.00 -10.00 -5.00 0.00 5.00 10.00 15.00 Q1 Q1-Q2 Q1-Q3 Q1-Q4 PercentChange Quarter (1 Quarter = 3 weeks) Percent Change in Average Daily Steps Per Quarter C, n=30 I, n=27 © 2013 Center for Connected Health – All Rights Reserved Content Confidential – DO NOT DUPLICATE.
  • 19. Habituation
  • 20. © 2013 Center for Connected Health – All Rights Reserved Content Confidential – DO NOT DUPLICATE.
  • 21. © 2013 Center for Connected Health – All Rights Reserved Content Confidential – DO NOT DUPLICATE.
  • 22. Improving physical activity behaviors in T2DM (Text 2 Move) Primary Outcomes: Change in physical activity levels Secondary Outcomes: Change in HbA1c in patients Change in stage of behavior change © 2013 Center for Connected Health – All Rights Reserved Content Confidential – DO NOT DUPLICATE.
  • 23. Customized Program Design Readiness To Change Connected Health Data Practice Location Analytic Engine © 2013 Center for Connected Health – All Rights Reserved Content Confidential – DO NOT DUPLICATE.
  • 24. 0   2000   4000   6000   8000   10000   1/9   1/11   1/13   1/15   1/17   1/19   1/21   1/23   1/25   1/27   1/29   1/31   January   2/1   2/3   2/5   2/7   2/9   2/11   2/13   2/15   2/17   2/19   2/21   2/23   2/25   2/27   February   3/1   3/8   3/15   3/22   3/29   March   Text2Move Contemplation Preparation Action © 2013 Center for Connected Health – All Rights Reserved Content Confidential – DO NOT DUPLICATE.
  • 25. Meet Michael Snyder © 2013 Center for Connected Health – All Rights Reserved Content Confidential – DO NOT DUPLICATE.
  • 26. Genetic Risk Source: Cell 148, 1293–1307, March 16, 2012 © 2013 Center for Connected Health – All Rights Reserved Content Confidential – DO NOT DUPLICATE.
  • 27. Glycated HgA1c (%): (Day Number) Glucose(mg/dL) Day Number -150 200 250 300 350 4000 450 500 550 600 160 150 140 130 120 110 100 90 80 6.4 (329) 6.7 (369) RSV Infection (Day 289-311) Life Style Change (Day 380-Current) HRV Infection (Day 0-21) 4.9 (476) 5.4 (532) 5.3 (546) 4.7 (602) Personalized Prevention in Action Source: Cell 148, 1293–1307, March 16, 2012 © 2013 Center for Connected Health – All Rights Reserved Content Confidential – DO NOT DUPLICATE.
  • 28. Customized Program Design Motivational State Connected Health Data Genetic Profile Analytic Engine © 2013 Center for Connected Health – All Rights Reserved Content Confidential – DO NOT DUPLICATE.
  • 29. Content: Psychological Factors Tactics: Genes Coaching Games/ Contests Health Info & Social Support Incentives/ Punishments Text Rich/ Multi-Media Avatar/ Agent Voice Interactive Software Physiological Functions Behavior Environmental Factors/ Socioeconomic Status Content: Tactics: Specimen Collection EMRs Sensors Text Analysis Online & Offline Behavior Tracking Analytics Input Output © 2013 Center for Connected Health – All Rights Reserved Content Confidential – DO NOT DUPLICATE.
  • 30. Connected Health Benefits Improved self-care1 Just-in-time care2 © 2013 Center for Connected Health – All Rights Reserved Content Confidential – DO NOT DUPLICATE.
  • 31. The cHealth Blog: chealthblog.connectedhealth.org www.connectedhealth.org Annual Symposium: Oct 24-25, 2013; Boston LinkedIn Group: Connected Health Community Twitter: @connectedhealth @jkvedar Ways to “Connect” Contact Me: jkvedar@partners.org © 2013 Center for Connected Health – All Rights Reserved Content Confidential – DO NOT DUPLICATE.

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