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PwC - Apps Formulary for Health Care Organizations

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  • 1. Apps Formulary for Health Care Organizations A Working Model for Discussion @MarkCasselman March 2014 www.pwc.com/ca
  • 2. PwC Making Care Mobile: Shifting Perspectives on the Virtualization of Health Care • Report explores Canadians’ attitudes towards pertinent issues in the health care industry • Provides analysis of what citizens expect decision makers to keep in mind when thinking of the future of health care in Canada Goal of the report • What improvements are citizens looking for in health care? • What channels are citizens using to access health care and information now, and in the future? • What innovations are citizens ready to use that can make health care delivery more efficient? • What are the future possibilities in health care delivery? Key Questions www.pwc.com/ca/virtualcare 2
  • 3. PwC Making Care Mobile Shifting perspectives on the virtualization of health care More than 2,400 Canadians participated in our research to address the central question, “What does the future of health care delivery look like?” 3
  • 4. PwC Virtual assessments via apps are good options in the right situation… 52% of patients indicate that faster access to care is the primary appeal of virtual assessment 1% 8% 15% 20% 21% 36% No answer Not sure None of the above You use an app for an initial assessment You send it to your doctor using an app Doctor takes the photo and communicates with dermatologist 77% of Canadians were comfortable with virtual mole assessment app scenario – although, at this time, most prefer doctor-controlled option. 4
  • 5. PwC Canadians told us they are ready for virtual monitoring for chronic conditions… 79% of Canadians indicate that they are comfortable with virtual monitoring for chronic conditions Most Canadians indicated they would be comfortable having a chronic condition monitored virtually... 36% 43% 10% 5% 4% 2% Yes, definitely Probably Not likely Definitely not Not sure No answer ... and 62% of caregivers indicated that virtual health care would help them to provide care for someone else (e.g. parent/ child) 5
  • 6. PwC … and virtual visits for post-surgical follow-up. 54% of Canadians indicate that virtual visits, home monitoring, and virtual wards are good care delivery options 24% 43% 17% 11% 5% 0 Yes, definitely Probably Not likely Definitely not Not sure No answer The majority of Canadians indicated they would be comfortable having post-surgical follow-up visit done by video conference. 6
  • 7. PwC Q: Are mHealth and vHealth different? Consumer mHealth is exploding in part as a result 7
  • 8. PwC Telemedicine and mobility are coming together facilitating delivery of virtual care anywhere Telemedicine mHealth Virtual Care 8
  • 9. PwC many small pilots 25% By 2020, more than 25% of care will be delivered virtually (with provider and patient in separate places). - Dr. Ed Brown, 2012 9
  • 10. PwC Virtual Health Care: We have been through similar shifts before… Inpatient Care Outpatient Care Virtual Care 1992… More people leave hospital after procedure than remain overnight 202X?… More virtual visits than physical visits Each transition involved people, process, and technology changes. Major shifts in how we organize our care delivery services and assets 10
  • 11. PwC How might this happen; Well here are IDC’s top ten connected health IT predictions for 2014… 1. mHealth + Telehealth + Social Will Be the New Healthcare Delivery Model 2. BYOD Will Come to Health Monitoring, and Smartphones Will Become Biosensors 3. Wearables and Embedded Sensors Will Become Mainstream 4. The mHealth App Formulary: There Will Be a "Prescribed" App for That! 5. Value-Based Healthcare Will Move Care Delivery from the Four Walls of the Traditional Care Setting to the Community 6. Retail Clinics Will Disrupt the U.S. Healthcare System 7. By 2016, 30% of U.S. Healthcare Organizations Will Have Achieved the Repeatable Stage of the IDC Mobile Maturity Model 8. HIE Solutions Will Be Repositioned for Population Health 9. "Little Data" from Connected Health Devices and M2M Connectivity Will Create Opportunities for Big Data and Analytics 10. Select Healthcare Organizations Will Experiment with Google Glass 11
  • 12. PwC We need to construct the Apps Formulary Take 2 Apps and Call Me in the Morning Tech Rx Apps Pharmacy not Apps Store Apps Formulary AliveCor Cardiac Withings Blood Pressure bant Diabetes Pain Squad Pain Mgmt MyIBD Crohn’s Disease UK (Cambridge Healthcare): “Europe’s First Health- App Store” developing certification process for apps it sells. US (Happtique): market-leader in health apps published set of standards to certify apps operability, privacy, security, content reliability 12
  • 13. PwC We need a process and standards for selection, and a taxonomy for regulation of apps Front of Store Over the Counter Prescription Controlled Substance Criteria for evaluation include: • Operability • Privacy & Security • User Data Safeguards • Functional Validation • Clinical Efficacy 13
  • 14. PwC Front of store apps are mHealth ‘vitamins’ that supplement a healthy lifestyle Front of Store Over the Counter Prescription Controlled Substance 14
  • 15. PwC Smoking Cessation: Crush the Crave Crush the Crave • Evidenced based smoking application targeting 19 to 29 year olds • Users develop a customized quit plan, tracks cravings and smoking habits • Targeted SMS for stage in quitting process • Virtual awards for goal attainment Front of Store 15
  • 16. PwC Sleep Cycle Alarm Clock – Helps you wake up rested Front of Store Sleep Cycle Alarm Clock • An intelligent alarm clock that analyzes your sleep- wake cycle and wakes you in the lightest sleep phase • Helps you sleep better and wake up rested 16
  • 17. PwC Fitbit – Helps you achieve your fitness goals Fitbit – Flex 4 • Measures data such as the number of steps and distance walked, stairs climbed, calories burned, activity duration and intensity as well as sleep quality. Front of Store 17
  • 18. PwC Nike+ Fuelband – Set your daily activity goals Nike+ Fuelband • Pedometer tracks steps taken, calories burned, and a proprietary measurement of activity called Nike Fuel • User set daily activity goals. The band's LED display lights up from red to green showing progress throughout the day. Front of Store 18
  • 19. PwC Withings – Pulse Future Innovation… Pulse • First activity tracker to record heart rate with a touch of a button, steps, distance, calories, strides and quality of sleep • Using Bluetooth smart technology, the tracker communicates with the Withings Health Mate app connecting to iOS and Android devices featuring on-device display and alerts Front of Store 19
  • 20. PwC Health services apps to enhance patient experience BC Health Service Locator App Alberta Health Services App Hamilton Health Sciences App Front of Store 20
  • 21. PwC Over the counter apps may be dispensed after an assessment of the patient's needs Front of Store Over the Counter Prescription Controlled Substance 21
  • 22. PwC Mood Watch – Monitor your mood over time Mood Watch • Self-monitoring and care for clients with mood disorders like anxiety, depression, bipolar, borderline, and post-traumatic stress disorders. • Prompts users to track components of their mood such as anxiety, calm, mindfulness and energy • Tracks blood pressure, pulse, sleep, and medications Over the Counter 22
  • 23. PwC PTSD Coach PTSD Coach • The PTSD Coach app can help you learn about and manage symptoms that commonly occur after trauma. • Reliable information on PTSD and treatments that work • Tools for screening and tracking your symptoms • Convenient, easy-to-use skills to help you handle stress symptoms • Direct links to support and help • Downloaded over 100,000 times in 74 countries around the world. Over the Counter 23
  • 24. PwC AlcoDroid Alcohol Tracker AlcoDroid Alcohol Tracker • AlcoDroid is an alcohol consumption tracker, diary, and blood alcohol content calculator. • AlcoDroid helps you get a better handle of what you drink and change your drinking habits. • Set goals and chart your alcohol intake habits daily, weekly or monthly Over the Counter 24
  • 25. PwC W/Me Wristband Future Innovation… W/Me Wristband • Device and platform that monitors the autonomic nervous system including respirations and heart rate to improve wellness • A medical-grade sensor captures electrical impulses • Proprietary algorithm decodes heart rate variability, maps autonomic nervous system activity, which then produces a visual of the user’s mental state at any given moment Over the Counter 25
  • 26. PwC Mobilyze – real-time depression detection Mobilyze • tracks users' behavior patterns and moods to identify states that trigger depression before it happens • support patients with depression in making changes in behavior that will reduce or eliminate depressive symptoms • uses sensors to learn and identify patients’ states at any given moment, allowing intervention in real-time Over the Counter 26
  • 27. PwC recoveryBox recoveryBox • Designed to provide tools needed to help with addiction recovery and accountability • Breaking habits requires knowing why we do what we do, when do we do it and coming up with goals to break unhealthy behaviors • Facilitates tracking of daily life activities by easily breaking them down into your "lights“ • recoveryBox is designed to work with many addictions including drugs, gambling, pornography, and alcohol Over the Counter 27
  • 28. PwC Withings– Blood Pressure Monitor Over the Counter Withings Blood Pressure Monitor • Monitors blood pressure and heart rate • Attaches directly into any iOS device • Allows users to view measurements, graphs and trends over time 28
  • 29. PwC Over the Counter <30 Days • Guides users to break bad habits and adopt a healthier lifestyle in 30 days or less. • Evidence-based and consumer survey derived heart health promotion app <30 Days – Heart & Stroke Foundation 29
  • 30. PwC Zensorium – Tinke Zensorium– Tinke • Measures heart rate, oxygen saturation, respiratory rate, and heart rate variability • Attaches directly into any iOS device • Clients place thumb over Tinke device sensor • Displays readings after 10 seconds • Allows patients to track vital signs over time Over the Counter 30
  • 31. PwC Patient Education Apps Patient Education Apps • Standardized, customizable approach to client/patient education in real-time or asynchronous manner • Promote patient/caregiver/provider communication with visual aids • Teach-out, follow-up, triggered instructions for self-care Over the Counter 31
  • 32. PwC Patient Education Apps Visual Anatomy Orthopedic Patient Education by 3D4Medical.com Muscle System Pro By 3D4Medical.com Knee Pro SpineDecide Muscle Trigger Points HeartDecide Heart Pro III Canadian Cancer Glossary Cancer.net FINR Brain Atlas BabyBump Pregnancy Pro CANRISK Diabetes AHA Pocket 1St Aid CPR Medical French Over the Counter 32
  • 33. PwC GE and Healthline Networks – BodyMaps GE and Healthline Networks – BodyMaps • A education tool for healthcare providers to explain diagnoses and possible treatment options to clients/caregivers • Full color, high-resolution display 3D rotatable images depicting over 1,000 anatomical structures • 200 videos depict how major health conditions, treatments and bodily functions work Over the Counter 33
  • 34. PwC DrawMD DrawMD • Enhance patient/caregiver/provider communication by offering a new paradigm for explaining the complex issues surrounding medical and surgical care • Contains background anatomy images covering a variety of surgical procedures and medical diagnoses • drawMD utilizes the iPad's unique interface to allow anyone to sketch, stamp, or type directly on the detailed anatomic images included in the application • Allows providers to send the drawings discussed thereby helping Help patient/caregivers remember and process the conversation Over the Counter 34
  • 35. PwC WebMD WebMD • Web-based and mobile platform for clients/caregivers that permits fast convenient assess to easy-to-understand health and medical information • Using WebMD, clients can access valuable information about medical conditions, drugs and treatments, first aid as well as a symptom checking tool • Additional WebMD apps include: (1) symptom checker; (2) WebMD baby; (3) WebMD pregnancy; (4) WebMD allergy; (5) WebMD pain control Over the Counter 35
  • 36. PwC Greatcall Greatcall • Phone-based platform that promotes safe independent living through access to urgent care respondents and medication reminders • Urgent Care app combines a medical library and medical symptom checker tool with unlimited access to live, registered nurses who can escalate to a physician • Pressing the button on the 5Star personal emergency response app, connects users to certified response agents. • MedCoach for iPhone, Android, and Jitterbug mobile phones provides daily calls to remind client to take their medications at the correct time of day and when to refill their prescriptions Over the Counter 36
  • 37. PwC GlowCap GlowCap • Medication reminder device • GlowCap devices fits over commonly used prescription bottle • Cap lights up and rings when it is time for next dose • Prompts a phone call for additional reminder • Emails updates to family and doctors • Syncs with pharmacy for automatic prescription refill Over the Counter 37
  • 38. PwC Mango Health Mango Health • Promote medication adherence and safety • Sends reminders when it is time for their next dose • Allows users to enter all of their medications and supplements and provides warnings regarding potential interactions • Gamification: with adherence, users earn points which they then enter for a change to win prizes Over the Counter 38
  • 39. PwC Prescription apps: plan of care written by physician or other health professional Front of Store Over the Counter Prescription Controlled Substance 39
  • 40. PwC Bipolar Disorder Connect Mobile Bipolar Disorder Connect • Bipolar Disorder Connect Mobile is the place to start conversations, talk about treatments, and learn from others • Connect with people who understand what it’s like to live with bipolar disorder • Find answers and caring support as you learn from their experiences • Get real-world tips and advice to help you manage bipolar disorder • Ask questions, start discussions, and comment on what others say Prescribed 40
  • 41. PwC Lawson Supportive Mental Assessment Rehabilitation and Treatment (SMART) Lawson SMART Record • Customized mental health PHR • Created for Lawson Health Research Institute • iPhone’s were provided to mental health patients • Provided patient with a single-coordinator with whom they could connect • Includes: health journals, daily tasks, alerts, personalized tracker, secure messaging with care providers, and appointment reminders Prescribed 41
  • 42. PwC eCBT Mood eCBT Mood • targets depression by using the scientific principles of cognitive behavioral therapy • can be used as a uniform, structured adjunctive support intervention for clinical trials of antidepressants or other therapies for depression • has been used both as an adjunct to traditional psychotherapy (involving a therapist and patient), as well as a stand-alone intervention Prescribed 42
  • 43. PwC Ginger.io Prescribed Ginger.io • Turns smartphone into a diary that writes itself • App asks questions related to medical condition and automatically collects information about movement patterns. 43
  • 44. PwC Medeo – Virtual Visits Prescribed Medeo – Virtual Visits • Medeo lets anyone access health care regardless of their location, mobility or time pressures • Doctor and patient connect from home or office using computer, iPhone or iPad • Date is protected by bank-grade Canadian data centres to secure health information 44
  • 45. PwC Wellx Wellx • EHR • Secure communication with healthcare provider • Providers can broadcast news and send reminders • Healthcare providers and patients can share test results, treatment plans, and other information • Refill prescriptions “Patient messaging improved my practice efficiency and allowed me to have a less crowded schedule” Dr. David Verrilli, Village Family Health Team “It's very easy to use and saves time as opposed to waiting on the phone” Patient Survey Respondent Improve Efficiency Increase Access Prescribed 45
  • 46. PwC Get Real Health – InstantPHR InstantPHR • PHR with EHR capabilities • Secure communication with healthcare provider • Receive lab results • Refill prescriptions • Pre-configured solutions available for readmissions management, chronic disease management, care transitions, and patient engagement Prescribed 46
  • 47. PwC MyChart Prescribed MyChart • Person health record • Online appointment requests • Clinic visit notes • Medication refill requests • Appointment reminders • E-messaging with healthcare provider 47
  • 48. PwC Front of Store Over the Counter Prescription Controlled Substance Controlled apps: require close supervision of management and use 48
  • 49. PwC NeuroSky – Mindwave biosensor Neurosky • EEG solution digitizes analog electrical brainwaves to power the user-interface of games, education and research applications. • brainwave algorithms, developed by NeuroSky researchers and partner universities and research institutions are uncovering new ways to interact with our world Controlled Substance 49
  • 50. PwC Ignition Interlock Devices AliveCor • The interlock records all the times a driver takes the test and their alcohol level. • Each month's results may be sent to driver's probation officer. • After breathalyzer tests driver at the start of the ride, it can monitors them while on road Controlled Substance 50
  • 51. PwC Ignition Interlock Devices AliveCor • The interlock records all the times a driver takes the test and their alcohol level. • Each month's results may be sent to driver's probation officer. • After breathalyzer tests driver at the start of the ride, it can monitors them while on road Controlled Substance 51
  • 52. PwC Buddi – forensic psychology GPS tracker Buddi • most commonly used by local authorities to monitor individuals with dementia • allows individual to be easily found if they get lost after wandering away from their homes • lockable version used to track mental health patients that may pose danger to community or themselves Controlled Substance 52
  • 53. PwC Mobile Cardiac Arrhythmia Diagnostic Service (m-CARDS) m-CARDS • Arrhythmia Diagnostic Service • Alternative to Holter monitoring • Improved access to and timeliness of monitoring services • Can monitor for up to 2 weeks • Auto detect/auto send wireless Event Loop Recorder (ELR) transmits ECG through BlackBerry smartphone • Patients are taught to self connect using video instruction • Information is sent to a diagnostic center where it is interpreted by cardiac technologists Controlled Substance 53
  • 54. PwC SpiroSmart – Mobile Phone Spirometry Future Innovation… SpiroSmart • An affordable, user-friendly mobile phone based platform that analyzes common lung function measures (FEV1, FVC, PEF). • Analyzes lip reverberation to measure pulmonary ailments such as asthma, COPD, and cystic fibrosis • Home spirometry enables early detection and management of pulmonary exacerbations and improves outcomes of chronic lung conditions. Controlled Substance 54
  • 55. PwC MobiSante – MobiUS MobiSante – MobiUS • Accurate and inexpensive smartphone-based ultrasound imaging system • 2011 – FDA cleared • Ultrasound probe transducer plugs directly into a smartphone device • Images can be securely shared using cellular network, WiFi, or direct connectivity to a personal computer • Enables healthcare providers to augment their assessment findings with ultrasound images Controlled Substance 55
  • 56. PwC Welch Allyn – iExaminer iExaminer • Increase utility of fundus exams • 2013 – FDA cleared • The combined system allows clinicians to image the eye while saving the images for later review or to share with patients/ other healthcare providers • Enables telemedicine– allows healthcare providers in remote clinics to share images with ophthalmologists Controlled Substance 56
  • 57. PwC CellScope – Otoscope CellScope – Otoscope • Increase the standard of care by creating a visual history of the middle ear • A special iPhone case which features a protruding probe • Enables physicians to perform ear examinations using iPhone's camera and LED. • Images of the ear canal and the eardrum can be saved, analyzed, and shared Controlled Substance 57
  • 58. PwC Nephosity – MobileCT iPad Radiology Viewer Nephosity – MobileCT ipad • iPad diagnostic imaging tool • 2013 – FDA cleared • Diagnostic viewing of CT, MRI, PET and x-ray images • A pro version, available as an enterprise installation, enables real-time streaming of medical images and collaboration of those images with other users of the same app • The collaboration is fast and scalable to a roomful of users, and synchronizes the screen cursor, object measurements, and user annotations Controlled Substance 58
  • 59. PwC Zephyr – Life Remote Monitoring System Zephyr – Life • Noninvasive, continuous monitoring • Measures heart rate, respiration rate, ECG as well as position change and activity Controlled Substance 59
  • 60. PwC Intel–GE Care Innovations Guide Intel—GE Care Innovations Guide • Home care management client application that facilitates daily biometric data collection and transmission, interactive education delivery, and regular contact with healthcare professionals from a client’s home • An intuitive touch screen interface and support enables capture of daily biometric data through peak flow meters, weight scales, pulse oximeters, glucose meters, blood pressure monitors, and other input devices Controlled Substance 60
  • 61. PwC Intel—GE Care Innovations QuietCare Intel—GE Care Innovations QuietCare • Promote safe independent living with advanced motion sensor technology • Motion sensors are positioned throughout a client’s home in order to track their daily activity • The software analyzes data for potentially urgent situations and major routine changes, then alerts caregivers so they can respond promptly Controlled Substance 61
  • 62. PwC Virtual care and Apps fulfillment is now a new class of service offerings Front of Store Over the Counter Prescription Controlled Substance In this stage of their development, the ‘prescription’ and ‘fulfillment’ of mHealth Apps need not be separated 62
  • 63. This content is for general information purposes only, and should not be used as a substitute for consultation with professional advisors. © 2013 PricewaterhouseCoopers LLP, an Ontario limited liability partnership. All rights reserved. PwC refers to the Canadian member firm, and may sometimes refer to the PwC network. Each member firm is a separate legal entity. Please see www.pwc.com/structure for further details. Will Falk Managing Partner, Healthcare 416.687.8486 william.f.falk@ca.pwc.com @willfalk Mark Casselman Director, mHealth 416.687.8480 mark.casselman@ca.pwc.com @markcasselman