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Mobile Device Connectivity

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Part 3 of the series discusses benefits of Mobile Device Connectivity

Part 3 of the series discusses benefits of Mobile Device Connectivity

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Mobile Device Connectivity Mobile Device Connectivity Presentation Transcript

  • Part 3: Mobile Device Connectivity Benefits JOHN R. ZALESKI, PHD, CPHIMSCase Study 2 VICE PRESIDENT OF CLINICAL APPLICATIONS & CTOSupporting Technologies JZALESKI@NUVON.COM C: +1 484 319 7345Summary O: +1 215 966 6142
  • MOBILE HEALTHCARE NEED (PWC HRI STUDY, 2010 HEALTHCARE UNWIRED) – SURVEY OF 1000 PHYSICIANS, 2000 CONSUMERS – MORE THAN 30% OF PHYSICIANS: MAKE DECISIONS ON INCOMPLETE INFORMATION – 40% OF PHYSICIANS: COULD ELIMINATE FROM 11%30% OF OFFICE VISITS THROUGH USE OF MOBILE HEALTH TECHNOLOGIES – PATIENT COMPLIANCE: 88% OF PHYSICIANS WOULD LIKE PATIENTS TO BE ABLE TO MONITOR THEIR HEALTH (WEIGHT, BLOOD SUGAR) 2Sunday, May 29, 2011
  • MOBILE HEALTHCARE TECHNOLOGY IMPEDIMENTS (PWC HRI STUDY, 2010 HEALTHCARE UNWIRED) – INTEGRATION: >60% OF PHYSICIANS IN SURVEY USE PERSONAL DEVICES FOR MOBILE HEALTH SOLUTIONS THAT ARE NOT CONNECTED TO THEIR PRACTICE OR HOSPITAL SYSTEMS (E.G.: EMAIL) – SECURITY: >30% OF PCPS AND >40% OF SPECIALISTS SURVEYED CONCERNED ABOUT PRIVACY & SECURITY – BANDWIDTH: CONCERN OVER EXISTING HEALTH ENTERPRISE NETWORKS TO SUPPORT ADDED BANDWIDTH 3Sunday, May 29, 2011
  • ARE THE BENEFITS REAL? • CLEVELAND CLINIC & MICROSOFT: – DECEMBER 2008 PILOT PROJECT, 250 PARTICIPANTS (26% DIABETES, 6% HF, 68% HYPERTENSION) • ADVAMED (M.E. STACHURA, MD & E.V. KHASANSHINA, MD, PHD): - OCTOBER 2007, SURVEY INCLUSIVE OF 426 PATIENTS WITH DM, CHF, COPD • CCF, ADVAMED, PWC HRI REPORTS: Condition Activity Effect Diabetes monitoring (PA, Post-discharge 71% increase in days OH) monitoring using WiFi between visits; 42% drop transmitter of vital signs in overall cost/patient CHF (Trans-European) Home Care Management 35% drop in LoS; 10% of patients with reduction in office visits; implanted cardiac 65% drop in home health defibrillators visits COPD (CANADA) Remote monitoring of Reduced hospital respiratory illness admissions by 50% “Cleveland Clinic/Microsoft Pilot Promising; Home Health Services May Benefit Chronic Disease Management” 3/1/2010 4Sunday, May 29, 2011
  • WIDESPREAD REMOTE MONITORING CAN CUT CHRONIC CARE COSTS BY ~$200B1 “Savings largely attributable Condition Estimated 25-Yr Cost to better management… Saving because widespread Congestive Heart Failure $102.5B implementation … means key vital signs can be transmitted (CHF) to a caregiver or data center Diabetes $54.4B in real-time and trigger instant alerts when readings Chronic Obstructive $24.1B change in a medically Pulmonary Disease (COPD) different way.” Chronic Skin Ulcers $16B --Robert Litan, Page 2. Patients with chronic illness account for ~80% of increases in Medicare costs -Lisa Remington, 2008 MegaTrends Predictions and Forecasts Across the Healthcare Delivery System (Jan/Feb 2008) 1Tim Rowan reporting on AT&T Study, and conducted by Brookings Institution economist Robert Litan. Study presented by Better Health Care Together Coalition. 5Sunday, May 29, 2011
  • ATTRACTIVENESS, USEFULNESS OF WIFI TECHNOLOGIES TO CLINICIANS EMR Access 83% PCPs 88% Specialists Prescribing Meds 86% PCPs 82% Specialists InPatient Monitoring 69% PCPs 75% Specialists Referral Initiation/Track 65% PCPs 62% Specialists Patient Communication 61% PCPs 59% Specialists Remote Monitoring 65% PCPs 54% Specialists 56% Indicated mobile health access would expedite decision making Source: PwC HRI Physician Survey, 2010 6Sunday, May 29, 2011
  • Standards Based WiFi Technology Spectrum (From Home Healthcare Horizons) Source: JT Adams, L. Schmitt, J. Zaleski. “Simple, Interoperable, Wireless Connectivity Solutions for Home Healthcare.” Home Healthcare Horizons, 2010. Page 41 7Sunday, May 29, 2011
  • Standards Based WiFi Technology Spectrum (Example: Zigbee Mesh Networking) Source: ZigBee Wireless Sensor Applications for Health, Wellness and Fitness . March 2009, Page 9. http://www.zigbee.org 8Sunday, May 29, 2011
  • Summing Up 9Sunday, May 29, 2011
  • MORE CONTINUOUSLY AVAILABLE INFORMATION UNDERGIRDS BETTER CARE • EVOLUTION FROM EPISODIC TO CONTINUOUS MONITORING – PROMOTES MORE HOLISTIC VIEW – TRENDS BECOME VISIBLE OVER LONG TERM – EXPOSURE OF INDIVIDUALLY UNINTERESTING EVENTS, ONCE INTEGRATED, PROMOTE EARLIER DETECTION OF UNDERLYING PROBLEMS • PATIENT CARE DEVICE DATA ARE KEY TO CONTINUOUS TRENDING – FROM ICU FLOW SHEETS TO PHR, EVIDENCE EXISTS TO DEMONSTRATE BENEFITS – A KEY ENABLER TO THE OVERALL PROCESS OF CLINICAL DECISION MAKING 10Sunday, May 29, 2011
  • TO SUPPORT CLINICAL DECISION MAKING, PATIENT CARE DEVICE INTEGRATION SHOULD… • BE SEAMLESS: OPERATE ACROSS ENTERPRISE ENVIRONMENT, THROUGH ANY NETWORK TOPOLOGY, AND PROVIDE SECURE REMOTE ACCESS TO DATA FROM COLLECTION TO DELIVERY • BE SCALABLE: TRUE PLUG-AND-PLAY WITHOUT NEED FOR TOPOLOGY CHANGES, AND WITH AUTO-DISCOVERY OF NEW DEVICES UPON ATTACHMENT • BE RELIABLE: S/W AND H/W SHOULD SUPPORT AUTOMATIC FAILOVER AND BE SELF-HEALING • BE FLEXIBLE: BECOME A STANDARD TOOL OF CLINICIAN AND PATIENT BY INTEGRATING WITH WORKFLOW TO ENHANCE STANDARDS OF CARE, NOT JUST SUPPORT THEM 11Sunday, May 29, 2011
  • Summary • Medical device connectivity is essential adjunct for real-time intervention and clinical guidance • Clinical decision support systems will need to leverage medical device technology and focus on real-time access to data is essential, including waveform data • Future electronic medical record development should take real-time considerations into account in terms of interventional guidance. 12Sunday, May 29, 2011
  • “As to diseases, make a habit of two things—to health, or at least to do no harm.” Hippocrates in Epidemics, Bk I, Sect. XI 13Sunday, May 29, 2011
  • Further Reading 14Sunday, May 29, 2011
  • 15Sunday, May 29, 2011
  • Book I John Zaleski, Ph.D. Integrating Device Data into the Electronic Medical Record A Developer’s Guide to Design and a Practitioner’s Guide to Application ISBN 978-3-89578-323-4 A19100-L531- B977-X-7600 Approx. 300 pages Approx. 100 illustrations Contents: THE MEDICAL DEVICE INTEGRATION LANDSCAPE DEVICE NETWORKING AND COMMUNICATION MECHANISMS FOR INTERFACING AND INTEGRATING DEVICE DATA REAL-TIME AND NON-REAL-TIME DATA MANAGEMENT COMPUTER-BASED PATIENT RECORD CORRECTLY ASSOCIATING DEVICE DATA WITH PATIENTS BALANCING DATA QUANTITY WITH QUALITY: TECHNIQUES FOR DATA ANALYSIS AND REDUCTION HOW TO DISPLAY DATA IN A FLOWSHEET INTERFACE SOFTWARE AS A MEDICAL DEVICE THE FUTURE OF MEDICAL DEVICE INTEGRATION, INCLUDING DEVICE COMMAND & CONTROL EXAMPLE METHODS AND SOFTWARE 16Sunday, May 29, 2011
  • Thank you for your attention! JOHN R. ZALESKI, PHD, CPHIMS VICE PRESIDENT OF CLINICAL APPLICATIONS & CTO JZALESKI@NUVON.COM C: +1 484 319 7345 O: +1 215 966 6142 17Sunday, May 29, 2011