Extending US Healthcare Capacity with ClickMedix

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As US begins its shift in healthcare payment and delivery models, technology-enabled solutions become ever-more relevant to achieve faster and better outcome-based care, with less resources. This …

As US begins its shift in healthcare payment and delivery models, technology-enabled solutions become ever-more relevant to achieve faster and better outcome-based care, with less resources. This presentation presents a mobile health system in the context of enabling health providers in the US to do more, with less.

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  • 1. Solution for Healthcare Providers: Do more, with less. Mobile Health and Education Delivery System Ting Shih, CEO & Founder ting@clickmedix.com http://clickmedix.com
  • 2. Challenge: Do more, with less $ • 32 Million more Americans would become insurance beneficiaries including1: o Children with pre-existing conditions o By 2014, anyone with preexisting health problems can obtain insurance o Medicaid expands to 133% of poverty level o Annual out-of-pocket medical costs will be capped at $5,950 for individuals and $11,900 for families • Budgets for health providers2 o $10.5B cut from projected Medicare hospital payments over 10 years of inpatient or overnight care through a downward adjustment in annual base payment increases o $4.2B cut from Medicaid disproportionate share payments to hospitals over the next decade Sources 1 New York Times, Washington Post, CBS News, Reuters (http://awesome.good.is/transparency/web/usersubmissions/healthcare/giannini/transparency.jpg) 2 http://capsules.kaiserhealthnews.org/index.php/2013/01/doc-fix-in-senate-fiscal-cliff-plan-cuts-medicare-hospital-payments/Confidential | © ClickMedix, LLC 2013 http://clickmedix.com 2
  • 3. New Healthcare Delivery Model: ACOs • Budgets for health providers forming ACOs based on patient outcomes o Rewards for cost-savings achieved o Penalties for costs exceeding budget 1 Source: Nyew York Times, Washington Post, CBS News, Reuters (http://awesome.good.is/transparency/web/usersubmissions/healthcare/giannini/transparency.jpg) http://www.infographicsarchive.com/health-and-safety/the-aco-prescription-cure-or-disease/#prettyPhoto/1/Confidential | © ClickMedix, LLC 2013 http://clickmedix.com 3
  • 4. Dealing with Budget Cuts: Louisiana State Example • Eliminating 19-35% of operational expenses • Focusing on public-private partnerships in local communities who can help address higher volumes and more complex case • Improving GME programs to incorporate patient-centered quality programs to enrich experience for students and refreshing the program to reflect a 21st century health care market. This includes enhanced relationships with community partners and increased focus on outpatient care. • Right-sizing inpatient operations and administrative functions that will help cover critical services and strengthen medical education programs 1 Source: Nyew York Times, Washington Post, -172737281.htmlConfidential | © ClickMedix, LLC 2013 http://clickmedix.com 4
  • 5. Solution: Mobile Health and Education System As mobile technologies advances, traditional healthcare delivery models can be vastly improved through innovative mobile network powered healthcare services. This proposal illustrates how to deliver highest quality healthcare with less resources to typically hard-to-reach and non- compliant population with chronic diseases of hypertension, diabetes, cancer, heart diseases, and dementia using mobile technologies. The proposed mobile health solution elements have been deployed and successfully demonstrated as viable products by ClickMedix founder in more than 12 countries including the US, China, Taiwan, India, Peru, and Philippines.Confidential | © ClickMedix, LLC 2013 http://clickmedix.com 5
  • 6. Current patient health behavior exacerbates health conditions Diseases such as heart disease, diabetes and hypertension can be prevented, reversed, and controlled with diet, exercise, early screening and continuous monitoring.Confidential | © ClickMedix, LLC 2013 http://clickmedix.com 6
  • 7. Primary objectives 1. Serve more patients, at a fraction of the cost through mobile health (mHealth) and education services 2. Enhance medical capacity in rural areas through two-way tele-consultations and continuous training 3. Improve patient health outcomes through continuous patient management 4. Collaborate on building cost-effective health services via mobile health and education platform for o Chronic diseases (Cardiovascular, diabetes) o Maternal/child health care o Cancer screening servicesConfidential | © ClickMedix, LLC 2013 http://clickmedix.com 7
  • 8. Our solution can: • Facilitate remote medical consultation by doctors and specialists in less than 3 days for patients any where • Increase by 4 times the number of patients a doctor can serve • Enable a single doctor to reach up to 10,000 rural patients when combined with community health workers o Each doctor manages 10 nurses o Each nurse manages 10 health workers o Each health worker serves 100 patients through monthly home- visit care • Provide HIPAA-compliant communication infrastructure for improve healthcare services • Through integration with existing EHRs, help health organizations achieve meaningful useConfidential | © ClickMedix, LLC 2013 http://clickmedix.com 8
  • 9. Addressing healthcare challenges and aligning with healthcare focus areas Increased Penalties for Budget Cuts: insured patients readmission Lack of and senior and delay to Resources and population: digitization of Doctors More, sicker health patients information • Public-private partnership with • Home care visit and • Telemedicine to community-based follow-up care to health workers and reduce readmission extend reach of health organizations rates existing resource • Develop integrated • Use electronic health • Remote training to health information records or integrate increase workforce system to streamline with existing health of skilled workers systems to achieve and monitor service delivery among full digitization of partners health informationConfidential | © ClickMedix, LLC 2013 http://clickmedix.com 9
  • 10. Expected benefits from proposed mHealth solution Benefits • Enable early detection of potentially dire diseases • Minimize time (< 3 days) to access medical experts for targeted disease care • Save on consultation and transportation fees by minimizing clinic visits (up to 25% savings for seniors3) •• Increased revenue from patient retention and telemedicine Increased revenue from patient retention and telemedicine consultations consultations •• Attract more patients by offering specialty care Attract more patients by offering specialty care •• Reduced paper work and administrative costs (up to 25% reduction3)) Reduced paper work and administrative costs (up to 25% reduction3 • Increased medical capacity to treat patients and capture revenue previously on backlog • Improved collaboration among medical experts and referring primary physicians and rural nurses •• Real-time data for expedited healthcare interventions Real-time data for expedited healthcare interventions •• Enhanced health education materials from global base of health Enhanced health education materials from global base of health demographics demographics •• Reduced costs from data collection and analysis Reduced costs from data collection and analysis 3 Source: http://www.alliedhealthworld.com/visuals/smartphone-healthcare.htmlConfidential | © ClickMedix, LLC 2013 http://clickmedix.com 10
  • 11. How It Works: mHealth telemedicine connect patients to doctors anywhere $ Patient Doctors review and case collaborate on case Patient sees Health provider 1.Links appropriate local health (health workers, nurses, doctors and specialists From: primary doctors) provider with 2.Package data securely uses ClickMedix to Hospital Referral health issue with time series, multi- Centers capture appropriate media analysis patient info Treatment Treatment Treatment and Plan Advice follow-up careConfidential | © ClickMedix, LLC 2013 http://clickmedix.com 11
  • 12. How to serve 10,000 more patients at lower costs? By extending the reach of scarce medical experts to provide remote diagnosis/treatment and education to community Urban hospitals and partners, who become medical universities increasingly skilled at caring and engaging end-patients. Community Partners/ Satellite Clinics Hospitals Telemedicine and remote training Mobile phone reach to patientsConfidential | © ClickMedix, LLC 2013 http://clickmedix.com 12
  • 13. Do more with lower-cost health workers equipped with smartphones and diagnostics devices Note: can integrate with other diagnostics devices as identified (blood pressure cuff, blood glucose meter, etc.) Digital stethoscope: records audio sounds and Otoscope for tele-ENT send to remote doctor for diagnosis Fundus scope for tele-diabetes retinopathy screening Tele-radiology application enabling multiple doctors to review images Dermatoscope for tele-skin cancer screeningConfidential | © ClickMedix, LLC 2013 http://clickmedix.com 13
  • 14. Home or on-the-go mHealthcare Kit 14Confidential | © ClickMedix, LLC 2013 http://clickmedix.com 14
  • 15. Health workers or nurses can use smartphones with ClickMedix to capture Health workers or nurses can use smartphones with ClickMedix to capture diagnostics and symptoms information to expedite treatment diagnostics and symptoms information to expedite treatment 1) Measurable improvement in health outcomes 2) Reduction in time to delivery effective treatment 3) Reduction of workforce operational costsConfidential | © ClickMedix, LLC 2013 http://clickmedix.com 15
  • 16. ClickMedix system connects every step and maximizes benefits for patients and providers Assess / Triage Mothers & Patient Children record generation Diagnose / via SMS and Treat Follow- call-centers Up / Point-of-care Prevent Infectious Auto- diagnostics Improve/Train Diseases assessment Auto- to generate Remote reminders Aggregated data to leads diagnosis via expedite funding for telehealth Home-visits intervention development Treatment Shared Chronic administered record with Continuous training Diseases through home- family to build medical visit nurses or members capacity doctors and doctorsConfidential | © ClickMedix, LLC 2013 http://clickmedix.com 16
  • 17. ClickMedix can be configured for select healthcare services or packaged solutions Products Description Customers •Tele-Primary Care • Primary care clinics, rural clinics •Tele-Geriatric Care • Secondary and tertiary hospitals Click- •Tele-Maternal & Pediatric Care • Telehealth centers Health •Home-Visit Care • Home-visit health workers •Electronic health record (EHR) • Nursing homes and device integration • Patients • Primary care clinics, rural clinics •Tele-Dermatology Click- • Secondary and tertiary hospitals •Tele-Wound Care Specialist • Telehealth centers •Tele-Radiology • Patients •Tele-Geriatrics Certification Click- • Medical schools •Tele-Home Care Certification Education • Training institutions •Mobile Telehealth Certification Click- •Epidemiology research • Research organizations Research •Clinical trial research • Pharmaceutical companiesConfidential | © ClickMedix, LLC 2013 http://clickmedix.com 17
  • 18. ClickMedix Programs • Featured Programs o Harvard Massachusetts General Hospital Department of Dermatology: Hansen’s Disease Teledermatology Screening, Trinidad & Tobago o Grameen Health Innovations, NYC: Primary care for low-income women and children, USA o Albert Einstein College of Medicine: Rural Health Teledermatology, Uganda and Guatemala o Global Development Collaborative: Tele-primary care, Peru o University of Illinois at Chicago Medical Center: Teledermatology and Tele- Wound Care, USA o China Hospital: Home-visit maternal care and geriatric care, ChinaConfidential | © ClickMedix, LLC 2013 http://clickmedix.com 18
  • 19. Joins in to create the future of healthcare! • Contact: Ting Shih, CEO & Founder of ClickMedix Email: ting@clickmedix.com Website: http://clickmedix.comConfidential | © ClickMedix, LLC 2013 http://clickmedix.com 19
  • 20. Company Overview http://clickmedix.com
  • 21. ClickMedix • Founded and developed by MIT / Harvard / Carnegie Mellon University graduates and faculty in 2011 after 3 years of pilots in more than 10 countries • Our Mission is to bring faster, lower-cost, and higher-quality health services to all patients regardless of income-level and household environment by connecting patients and frontline health providers to medical experts using mobile technologies. • We are world-class technologists, public health practitioners, development activists, entrepreneurs, and business strategists to bring new sustainable and cost-effective telehealth solutions powered by mobile phones. • Our innovative connected mobile health (mHealth) and education platform connects health service providers, reduces cost of service delivery, and optimally utilizes tiers of existing health system for patient care. A community health-worker or a clinic nurse with a Click-enabled mobile phone is able to act as the primary agent for quality healthcare delivery.Confidential | © ClickMedix, LLC 2013 http://clickmedix.com 21
  • 22. International Deployments Geriatric Maternal and Infectious and Child Chronic Diseases Health DiseasesConfidential | © ClickMedix, LLC 2013 http://clickmedix.com 22
  • 23. Our Customers (International) Clients/ Services Population Partners Reach Clinics / hospitals Click-Health: geriatric care, 420,000 maternal/pediatric care 43 Click-Specialist: dermatology Governments Click-Specialist: dermatology, 100,000 pre/post surgery, cervical cancer 3 Screening Research Institutions Click-Health: 90,000 and medical schools diabetes/nutrition study, TB 3 surveillance, HIV+ staging Click-Education: maternal and pediatric care, tele- geriatrics certificationConfidential | © ClickMedix, LLC 2013 http://clickmedix.com 23
  • 24. Outcomes of using ClickMedix implementations • Government health departments - Government of Botswana saves 500K USD annually on transportation alone - Less crowding in hospitals and increased capacity to see more patients through remote consulting doctors • Non-government health organizations - Saves 2-5 personnel resources from digitizing paper-forms while getting real-time data and auto-generated reports • Health providers - Additional revenue by enabling tele-consultation with remote specialists while providing better treatment to patients • Community health workers - Increased efficiency (e.g. more patients visited) due to time-savings from filing paper reports • Patients - Faster treatment (days instead of months) - Eliminated unnecessary travels (saved on transportation and loss of wage) • Medical schools & research institutions - Enhanced education through access to real-patient cases and consult responses - Enhanced international reach of patients and network of other medical experts - Real-time research data collection and analysisConfidential | © ClickMedix, LLC 2013 http://clickmedix.com 24
  • 25. Lessons Learned • Witnessed rapid improvements in patient health when a remote expert/specialist is involved to provide diagnosis and treatment advice for symptoms unfamiliar to local health practitioners • Medical Expert = health practitioner who specializes in treatment of particular diseases and can quickly recognize associated symptoms • Some patients who otherwise would need to wait for months or even years to see an expert/specialist received effective treatment within 72 hours via remote consultation • 100% patients accepted mobile-phone usage of capturing symptoms information including images when used by health practitioners • Training health practitioners to use mobile phones took an hour or less • In-country health practitioners including health workers liked the “novelty” of using mobile phones for data collection • In-country health practitioners felt empowered to treat their own patients through advice of remote experts/specialists • Cost savings realized through reduction of transportation costs and increased ability to serve more patients without increasing staffConfidential | © ClickMedix, LLC 2013 http://clickmedix.com 25
  • 26. United States United States Client/ Partner Problem Statement Reach (2011) Improvements American Academy • Lack of dermatologists Current: • Reduced triage and treatment time of Dermatology (3:100,000 patients) • 162K population coverage from months to <72 hrs Tele-dermatology for • On average, county clinic • 140 clinic GPs (general • Reduced referral scheduling time from university-affiliated and federally-funded Deployments: US shave 600-1,000 backlog of patients needing physicians) and nurses trained average 6 months to < 3 weeks • Reduced time for medical resident to Clinics (2010) dermatology diagnosis • 30dermatologists trained seek attending approval from days to • Cost of care is prohibitive • 27 clinics < 24 hrs for patients to seek • 10 cities in the US dermatological care Scale up plan: • Cost of hiring dermatologist Increase # of clinics using for government service by at least 100% California state clinics/hospitals are Current: • Reduced backlog from 500 to almost 0 medical center prohibitive to having • 22K population coverage in 3 months Tele-dermatology for US enough dermatologists for • 120 clinic GPs (general • Reduced triage and treatment time city medical hospitals the patient population physicians) and nurses from months to <72 hrs and 7 clinics (2010) trained • Reduced referral scheduling time from • 3dermatologists trained average 6 months to < 3 weeks • 1 hospital, 7 clinics University of Illinois Current: • Deployment in progress Telehealth Center for • 5M population coverage 5000+ state clinics • 5,000 clinic GPs (general teledermatology physicians) and nurses being Consultation (2011) trainedConfidential | © ClickMedix, LLC 2013 http://clickmedix.com 26
  • 27. Africa Africa Client/ Partner Problem Statement KPIs: Reach Improvements (2011) Botswana • Lack of medical doctors • 120K (1 surgeon, 1 population by • • Reduced triage time from months to < 72 hrs Reduced treatment time from months to days Ministry of dermatologist, 5-10 20 rural GPs • Reduced transportation cost to ~500K/year (USD) Health radiologists for the • 6 current GP • Reduced time to seek foreign second opinion from 6-12 •Mobile tele- Deployments: Africa and Caribbean country’s public health system) months to < 24 hrs • Reduced data reporting time from months to minutes • High costs of travel and • Reduced personnel hours spent on reporting and dermatology logistics to treat analysis •Mobile tele-pre/post patients and manage oral surgery health staff •Mobile tele-radiology • Inefficient reporting •Mobile cervical cancer and monitoring screening mechanism (2009-11) Uganda Kisoro • Lack of medical doctors • 10K population (1 primary physician) • Reduced triage time from months to < 72 hrs • Reduced treatment time from months to days Hospital • No Internet availability • Eliminated transportation costs • No electronic record Mobile tele-dermatology system (2011-12) Egypt Ministry • Inconvenient travel by • 10K population • Demonstrated in-person and remote diagnosis patients to seek by 20 rural concordance of > 70% of Health specialist care clinicians (GPs, • Reduced triage time from months to < 72 hrs • Long wait time to see nurses) • Reduced treatment time from months to days Mobile tele-dermatology specialist • 5 current GPs • Reduced time to seek foreign second opinion from 6-12 (2008-2011) • Lack of specialists in months to < 24 hrs remote areas • Reduced data reporting time from months to minutesConfidential | © ClickMedix, LLC 2013 http://clickmedix.com 27
  • 28. Caribbean Caribbean Client/ Partner Problem Statement KPIs: Reach Improvements (2011) Guatemala • Lack of medical • 50K • Reduced treatment time from months to < 72 specialists population by hrs District • High costs of travel 5 rural • Reduced time to seek foreign second opinion Hospital Mobile tele-dermatology Deployments: Africa and Caribbean and logistics to treat patients and clinicians from 6-12 months to < 24 hrs (GPs, nurses) • Reduced data reporting time from months to manage health staff • 1 current GP minutes (2010-11) Guatemala • No trained • 20K • Reduced treatment time from months to < 72 dermatologist population by hrs Mayan Medical general • Reduced time to seek foreign second opinion Aid Clinic physicians from 6-12 months to < 24 hrs and nurses Mobile tele-dermatology (2011-12) Trinidad District • No trained • 10K • Increased detection of Hansen’s Disease dermatologists to population by • Enabled early treatment of identified patients Hospital assist in early general Mobile tele-dermatology screening of highly physicians (2011-12) prevalent Hansen’s and nurses DiseaseConfidential | © ClickMedix, LLC 2013 http://clickmedix.com 28
  • 29. Asia Client/ Partner Problem Statement KPIs: Reach (2011) Improvements St. Luke’s • Lack of dermatologists Rural clinics have significant • 125K population coverage • Reduced triage and treatment time from months to <72 hrs • Medical Center backlog of patients needing • 2 dermatologists • Reduced referral scheduling time from dermatology diagnosis trained average 6 months to < 3 weeks Mobile tele-dermatology • Travel logistics often prevents (2011-12) patients from seeking dermatological care • Costs of hiring dermatologist are prohibitive to having enough dermatologists for the patient population Caloocan City • Low utilization rates of pre-natal services in urban poor • 1,000 pregnant women by 200 CHWs • Improved mothers’ knowledge in maternal care communities • 5 current CHWs • Improved utilization of pre-natal Mobile tele-maternal services in urban-poor communities health • Improved maternal and child (2011-12) outcomes among pregnant women Society for Nutrition, • Lack of general population • 200 population • Real-time population data collection Education & Health knowledge about maternal and coverage for mothers and newborns child care • Early detection of treatment needs for Action (SNEHA) mothers and newborns Mobile tele-maternal and child health (2012)Confidential | © ClickMedix, LLC 2013 http://clickmedix.com 29