Introduction to mHealth

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Introduction to mHealth for students in Georgetown's healthcare prevention class.

Introduction to mHealth for students in Georgetown's healthcare prevention class.

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  • Take, for instance, a diabetic. Currently a diabetic takes a blood glucose reading and records it by hand. These logs are often illegible and physicians do not have the time to page through them to identify trends. Currently the technology exists to link glucose meter readings to patient records electronically. This link ensures that readings are recorded correctly and allows for physicians to passively monitor a patient’s blood glucose, enabling them to take immediate action when levels fall outside a predetermined range. Furthermore, the system can remind a patient to check their blood sugar and allows the patient to track their progress via an online portal. This application is a prime example of how technology enables effortless patient communication and provider accountability. Pilot studies show that this kind of application is effective; indeed, it is correlated to a reduction of 5 points in blood glucose readings and a 1% reduction in HbA1c readings over a three-month period. Bluetooth Blood Glucose Meter Now Interoperable With Nokia Phones. http://www.medgadget.com/archives/2010/04/bluetooth_blood_glucose_meter_now_interoperable_with_nokia_phones.htmlWatson et al. “Diabetes Connected Health: A Pilot Study of a Patient- and Provider-Shared Glucose Monitoring Web Application” Journal of Diabetes Science and Technology, March 2009, Volume 3, Issue 2: Page 345-352. http://www.connected-health.org/programs/diabetes/research-materials--external-resources/diabetes-connected-health-a-pilot-study-of-a-patient--and-provider-shared-glucose-monitoring-web-application.aspx

Transcript

  • 1. An Introduction to mHealthLearning about the Preventive Health IT Toolbox Jessica Jacobs jess.a.jacobs@gmail.com Georgetown University April 14th 2011
  • 2. What is mHealth? Current Trends ApplicationsOpportunities
  • 3. What is mHealth?: Questions to Consider There is not a consensus on what mHealth is. Questions to Consider: 1) What kind of connection does it have to have?  Broadband? Wifi? Wired Internet? 2) What technology does it include?  Cell phones? PDAs? Devices? Computers? 3) What’s the application?  Clinical Data? Community Health? Personal Health? 4) What’s it part of?  Telehealth? eHealth? http://vimeo.com/17125591
  • 4. What is mHealth?: Broad Definition All the definitions focus on mobile communications and healthcare. Broader definitions seem to be gaining more steam. “The integration of mobile technology, computing devices, and emerging delivery system capabilities into a patient-centered model of care.” – Indian Health Service US Department of Health and Human Services
  • 5. What is mHealth? Current Trends ApplicationsOpportunities
  • 6. Current Trends: Federal Support•HITECH Act to spur the adoption of EHRs, HIEs, and other Health IT.•Provisions in PPACA for telehealth and innovation in healthcare.•Continued Presidential commitment to “the need to increase coverage ofhigh speed wireless networks to 98 percent of all Americans within the nextfive years”: “This isn’t about faster Internet or fewer dropped calls. It’s aboutconnecting every part of America to the digital age. It’s about a ruralcommunity in Iowa or Alabama where farmers and small business owners willbe able to sell their products all over the world. It’s about a firefighter who candownload the design of a burning building onto a handheld device; a studentwho can take classes with a digital textbook; or a patient who can have face-to-face video chats with her doctor.” - President Barack Obama 2011 State of the Union Address
  • 7. Current Trends: Technology Adoption Utilization of Mobile Technology Aged 18-29 Aged 30-49 Aged 50-64 Aged 65 and Over90% 88% 86% 82% 72% 57% 59% 47% 38% 11% 15% 6% Own a Cellphone Send/Receive Text Access Internet on a Cell Messages Phone
  • 8. Current Trends: Technology Adoption SMS Utilization by Insurance Coverage Medicaid 79% Tricare 74%Employer Policy 68%Individual Policy 65% No Insurance 63% VA 45% Medicare 43% Source: Pricewaterhouse Cooper HRI Study, 2010, http://apps4android.org/hhc/New_business_models_delivering_care_anywhere_chart_pack.pdf
  • 9. What is mHealth? Current Trends ApplicationsOpportunities
  • 10. Applications: ContinuumManagement Promotion Surveillance Personal Public Population
  • 11. Applications: Management•Patient-centered personal healthmanagement.•Patient or care-giver driven.•Typically includes a device or smartphoneapplication.•PHR and EHR integration is possible.•Particularly beneficial for conditions wherecontinual tracking is warranted: •Diabetes •Asthma/COPD •CHF •Aging in Place •Medication Adherence 11
  • 12. Applications: Management - Diabetes Link glucose meter readings to patient records electronically. This link ensures that readings are recorded correctly and allows for physicians to passively monitor a patient’s blood glucose. Pilot studies show that this kind of application is effective; indeed, it is correlated to a reduction of 5 points in blood glucose readings and a 1% reduction in HbA1c readings over a three-month period. Watson et al. “Diabetes Connected Health: A Pilot Study of a Patient- and Provider-Shared Glucose Monitoring Web Application” Journal of Diabetes Science and Technology, March 2009, Volume 3, Issue 2: Page 345-352. http://www.connected-health.org/programs/diabetes/research-materials--external-resources/diabetes-connected- health-a-pilot-study-of-a-patient--and-provider-shared-glucose-monitoring-web-application.aspx
  • 13. Applications: Promotion• Educational messages targeted at behavior modification.• Third Party driven (public health depts, governments, insurance companies)• Usually utilizes cell phone messaging because it’s quick, easy, and cheap.• May be one way or two way messaging.• Particularly beneficial for chronic.  Smoking Cessation  Sexual Health  Pregnancy 13
  • 14. Applications: Promotion – text4baby Free national SMS health information service.  One way text messaging. Signup by texting “baby” to 511411. Large public-private partnership.  Healthy Mothers Healthy Babies (HMHB), Voxiva, The Wireless Foundation (CTIA), HHS/OSTP, J&J, etc. 3 messages/week.  Pregnancy through first year of child’s life. 2012 Million Mom Goal Enrollees To Go 16% 84% 14 * As of April 5, 2011, Text4Baby Tuesday Newsletter
  • 15. Applications: Surveillance• Health tracking for timely notification.• Health Worker and/or community driven.• Low cost reporting mechanisms.• Particularly useful in remote areas. • Web and SMS based.• Potentially Useful for: • Disease Outbreaks • Program Evaluation • Contaminations 15
  • 16. Applications: Surveillance - EpiSurveyor Allows people to design forms for data collection on the internet. Data is entered into the forms using either a smart phone application or SMS messaging. Allows for real-time data uploads and analysis. "drastically cut costs while Been used to evaluate: facilitating quality control and improving  anti-malarial bednet distribution and vaccination campaigns in sub-Saharan Africa implementation speed.“  clean water initiatives in Vietnam - The World Bank  drug supplies in several African countries  health delivery systems in Guatemala * 2011 World Bank Report: http://siteresources.worldbank.org/INTLAC/Resources/257803- 1269390034020/EnBreve_166_Web.pdf
  • 17. What is mHealth? Current Trends ApplicationsOpportunities
  • 18. Opportunities Prepare to engage and be engaged with mHealth. Contribute to the growing body of knowledge. Review for efficacy and separate “signal” from “noise.” Innovate to discover applications for new and existing technologies.
  • 19. In Conclusion…  Current trends show that the utilization of mHealth will increase.  Its applications are numerous and widely encompassing:  Management: Connecting mHealth applications with traditional health IT systems will provide a groundbreaking continuum of personal care, particularly for those with chronic conditions, keeping them out of hospitals.  Promotion: Wide scale education and behavior modification will improve the health of the public due to its ability to be anywhere the person is at anytime.  Surveillance: Real-time health tracking and data aggregation leads to actionable information for preventing disease outbreaks and improving population health.Source: http://www.healthcareitnews.com/news/mhealth-apps-forecast-increase-threefold-2012-0
  • 20. I’d now like to welcome any questions…