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Clinicians' Challenge 2014 - MyKidneys

Finalist for the Clinicians Challenge 2014. Presented by Dr Allister Williams, Head of Dept Medicine, Taranaki DHB, at HINZ 2014, 11 November 2014, 4pm, Plenary Room

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Clinicians' Challenge 2014 - MyKidneys

  1. 1. Background 1. The opportunity 2. The ingredients 3. Current interfaces Health Information NZ CLINICIANS’ CHALLENGE 2014 MBChB 1993, MRCP UK 2005, FRACP 2012 Consultant Physician and Nephrologist Head of Dept Medicine, Taranaki DHB, NZ “REALITY” 1. Platforms 2. Patient impact 3. Financial impact Dr Allister Williams MyKidneys app 1. Screenshots 2. Patient ownership 3. The advantages Conclusion 1. Proven benefits 2. Potential to expand 3. Acknowledgements Writing software applications since 1985! (Commodore 64 with Dos and GwBasic)
  2. 2. Background 1. The opportunity 2. The ingredients 3. Current interfaces “REALITY” 1. Platforms 2. Patient impact 3. Financial impact MyKidneys app 1. Screenshots 2. Patient ownership 3. The advantages Conclusion 1. Proven benefits 2. Potential to expand 3. Acknowledgements MyKidneys Smartphone App Patient centred management of Chronic Kidney Disease (CKD) Health Information NZ CLINICIANS’ CHALLENGE 2014 Dr Allister Williams MBChB 1993, MRCP UK 2005, FRACP 2012 Consultant Physician and Nephrologist Head of Dept Medicine, Taranaki DHB, NZ
  3. 3. Background 1. The opportunity 2. The ingredients 3. Current interfaces “REALITY” 1. Platforms 2. Patient impact 3. Financial impact MyKidneys app 1. Screenshots 2. Patient ownership 3. The advantages Conclusion 1. Proven benefits 2. Potential to expand 3. Acknowledgements OPPORTUNITY Patients with renal failure to take ownership of their chronic kidney disease Clinician to expand our current use of IT in the renal services of Taranaki HINZ to invest in a software tool that can change the way we manage Chronic diseases in NZ MyKidneys Smartphone App Patient centred management of Chronic Kidney Disease (CKD) Health Information NZ CLINICIANS’ CHALLENGE 2014
  4. 4. Background 1. The opportunity 2. The ingredients 3. Current interfaces “REALITY” 1. Platforms 2. Patient impact 3. Financial impact MyKidneys app 1. Screenshots 2. Patient ownership 3. The advantages Conclusion 1. Proven benefits 2. Potential to expand 3. Acknowledgements
  5. 5. Background 1. The opportunity 2. The ingredients 3. Current interfaces “REALITY” 1. Platforms 2. Patient impact 3. Financial impact MyKidneys app 1. Screenshots 2. Patient ownership 3. The advantages Conclusion 1. Proven benefits 2. Potential to expand 3. Acknowledgements “REALITY” Current web-base application
  6. 6. Background 1. The opportunity 2. The ingredients 3. Current interfaces “REALITY” 1. Platforms 2. Patient impact 3. Financial impact MyKidneys app 1. Screenshots 2. Patient ownership 3. The advantages Conclusion 1. Proven benefits 2. Potential to expand 3. Acknowledgements MyKidneys Proposed application “REALITY” Current web-base application
  7. 7. Background 1. The opportunity 2. The ingredients 3. Current interfaces (Developed by A Williams since being a renal registrar in 2004)) REALITY “REALITY” 1. Platforms 2. Patient impact 3. Financial impact MyKidneys app 1. Screenshots 2. Patient ownership 3. The advantages Conclusion 1. Proven benefits 2. Potential to expand 3. Acknowledgements Patient name and NHI Clinical decision making tool for secondary care providers “live” since 2011, web-based since 5 May 2014
  8. 8. Background 1. The opportunity 2. The ingredients 3. Current interfaces “REALITY” 1. Platforms 2. Patient impact 3. Financial impact MyKidneys app 1. Screenshots 2. Patient ownership 3. The advantages Conclusion 1. Proven benefits 2. Potential to expand 3. Acknowledgements Active surveillance Virtual consults 30% reduction in patients on dialysis Less patients starting dialysis unplanned: “crash landing” Advance management of bone health and anaemia Better planning for service provision
  9. 9. 10% reduction in cost ($200 000 saving) 2.50 2.00 1.50 1.00 0.50 Background 1. The opportunity 2. The ingredients 3. Current interfaces “REALITY” 1. Platforms 2. Patient impact 3. Financial impact MyKidneys app 1. Screenshots 2. Patient ownership 3. The advantages Conclusion 1. Proven benefits 2. Potential to expand 3. Acknowledgements 1.51 1.62 1.74 2.06 2.02 2.09 2.09 1.98 2.22 2.10 2.01 0.00 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 Million dollars Actual Actual
  10. 10. Background 1. The opportunity 2. The ingredients 3. Current interfaces “REALITY” 1. Platforms 2. Patient impact 3. Financial impact MyKidneys app 1. Screenshots 2. Patient ownership 3. The advantages Conclusion 1. Proven benefits 2. Potential to expand 3. Acknowledgements Moving from this “Hospital-centered care” Passive patient involvement REALITY … and add this “Patient-centered care” Patient: active participant MyKidneys
  11. 11. Patient and doctor interfaces in primary and secondary care Background 1. The opportunity 2. The ingredients 3. Current interfaces Patient Doctor “REALITY” 1. Platforms 2. Patient impact 3. Financial impact MyKidneys app 1. Screenshots 2. Patient ownership 3. The advantages Conclusion 1. Proven benefits 2. Potential to expand 3. Acknowledgements Primary Care Secondary Care Awareness Screening Shared care REALITY Ownership MyKidneys Information Technology
  12. 12. MyKidneys – the smartphone app Background 1. The opportunity 2. The ingredients 3. Current interfaces “REALITY” 1. Platforms 2. Patient impact 3. Financial impact MyKidneys app 1. Screenshots 2. Patient ownership 3. The advantages Conclusion 1. Proven benefits 2. Potential to expand 3. Acknowledgements
  13. 13. Background 1. The opportunity 2. The ingredients 3. Current interfaces “REALITY” 1. Platforms 2. Patient impact 3. Financial impact MyKidneys – for managing my health MyKidneys app 1. Screenshots 2. Patient ownership 3. The advantages Conclusion 1. Proven benefits 2. Potential to expand 3. Acknowledgements Diabetes My HbA1c (Aim 40-60) Your average blood sugar levels for the past 3 months 57 Blood pressure My BP (Aim for 130/80) High blood pressure can harm your kidneys and blood vessels Urine proteinuria My Urine PCR (Normal <50) Kidneys leaking proteins is a Sign of scarring or inflammation Cholesterol level My TC:HDL ratio (Aim < 5) High cholesterol causes more Heart attacks and strokes 130 80 144 5.2 MyKidneys the smartphone app MyHealth Chronic diseases Color coded Quantifiable markers Big buttons Patients with disabilities MyHealth
  14. 14. Background 1. The opportunity 2. The ingredients 3. Current interfaces “REALITY” 1. Platforms 2. Patient impact 3. Financial impact MyKidneys – for managing my health Diabetes - trends My HbA1c (Aim 40-60) Your average blood sugar levels for the past 3 months MyKidneys app 1. Screenshots 2. Patient ownership 3. The advantages Conclusion 1. Proven benefits 2. Potential to expand 3. Acknowledgements MyKidneys the smartphone app MyHealth Chronic diseases Color coded Quantifiable markers Trends over time MyTrends
  15. 15. Background 1. The opportunity 2. The ingredients 3. Current interfaces “REALITY” 1. Platforms 2. Patient impact 3. Financial impact MyKidneys – for managing my health General information There should be no/very little protein in your urine. A level up to 50 is still considered to be normal. Levels above this normally indicates your kidneys had been scarred or are currently inflamed. What’s my level? You urine protein creatinine ratio (U PCR) is 144, which is high. This can be controlled with drugs like ACE inhibitors. Diet got little impact on this level. What shall I do? If you haven’t been seen by a kidney specialist, your GP should refer you to one. Contact your GP MyKidneys app 1. Screenshots 2. Patient ownership 3. The advantages Conclusion 1. Proven benefits 2. Potential to expand 3. Acknowledgements MyKidneys the smartphone app Factual information Patient specific advise Guide management Urine proteinuria
  16. 16. Background 1. The opportunity 2. The ingredients 3. Current interfaces MyHealth MyKidneys “REALITY” 1. Platforms 2. Patient impact 3. Financial impact MyKidneys – for managing my health MyKidneys app 1. Screenshots 2. Patient ownership 3. The advantages Conclusion 1. Proven benefits 2. Potential to expand 3. Acknowledgements 2 Kidney Function My eGFR : (normal >60) eGFR is an estimate of your kidney function as percentage 12 Anaemia My Haemoglobin (Aim 105-120) Haemoglobin carriers oxygen to All parts of your body. 112 Bone health My PTH level (Aim 14-28) Parathyroid hormone (PTH) keep your bones healthy 21 My dialysis Haemodialysis since 2012 Dialysis cleans your blood From waste products HD MyKidneys the smartphone app Disease specific markers Chronic Kidney disease MyKidneys
  17. 17. Background 1. The opportunity 2. The ingredients 3. Current interfaces “REALITY” 1. Platforms 2. Patient impact 3. Financial impact MyKidneys – for managing my health MyKidneys app 1. Screenshots 2. Patient ownership 3. The advantages Conclusion 1. Proven benefits 2. Potential to expand 3. Acknowledgements 2 Urine proteinuria My Urine PCR (Normal <50) Kidneys leaking proteins is a Sign of scarring or inflammation 144 Kidney Function My eGFR : (normal >60) eGFR is an estimate of your kidney function as percentage 12 Urine proteinuria My Urine PCR (Normal <50) Kidneys leaking proteins is a Sign of scarring or inflammation 144 With the Smart phone app Integrated in one package MyHealth MyKidneys MyAlarms MyAlarms Patient advice If you haven’t been seen by a kidney specialist, your GP should refer you to one. Contact your GP
  18. 18. MyKidneys completes the cycle of the patient-doctor interface Background 1. The opportunity 2. The ingredients 3. Current interfaces Patient Doctor Awareness Screening “REALITY” 1. Platforms 2. Patient impact 3. Financial impact Shared care MyKidneys app 1. Screenshots 2. Patient ownership 3. The advantages REALITY Conclusion 1. Proven benefits 2. Potential to expand 3. Acknowledgements Ownership MyKidneys Information Technology Primary Care Secondary Care Adding patients to our workforce
  19. 19. In summary Background 1. The opportunity 2. The ingredients 3. Current interfaces Health Information NZ CLINICIANS’ CHALLENGE 2014 “REALITY” 1. Platforms 2. Patient impact 3. Financial impact MyKidneys app 1. Screenshots 2. Patient ownership 3. The advantages Conclusion 1. Proven benefits 2. Potential to expand 3. Acknowledgements MyKidneys - Mobile arm of our current product Hard work already done “REALITY” Proven patient and service benefits
  20. 20. Background 1. The opportunity 2. The ingredients 3. Current interfaces Health Information NZ CLINICIANS’ CHALLENGE 2014 “REALITY” 1. Platforms 2. Patient impact 3. Financial impact Potential to expand MyKidneys app 1. Screenshots 2. Patient ownership 3. The advantages Conclusion 1. Proven benefits 2. Potential to expand 3. Acknowledgements MyKidneys - Mobile arm of our current product Hard work already done “REALITY” Proven patient and service benefits MyKidneys NZ Management of CKD country wide MyHealth NZ Management of other chronic diseases In summary
  21. 21. Background 1. The opportunity 2. The ingredients 3. Current interfaces Health Information NZ CLINICIANS’ CHALLENGE 2014 “REALITY” 1. Platforms 2. Patient impact 3. Financial impact MyKidneys app 1. Screenshots 2. Patient ownership 3. The advantages Conclusion 1. Proven benefits 2. Potential to expand 3. Acknowledgements Family Taranaki DHB and ICT services team Health Information NZ - supporting my career as programmer and now clinician - support in making the web-based application “REALITY ” a reality! - grant and subsequent support MyKidneys : patient-centred smartphone app for CKD in NZ Acknowledgements
  22. 22. Background 1. The opportunity 2. The ingredients 3. Current interfaces “REALITY” 1. Platforms 2. Patient impact 3. Financial impact MyKidneys app 1. Screenshots 2. Patient ownership 3. The advantages Conclusion 1. Proven benefits 2. Potential to expand 3. Acknowledgements Family Taranaki DHB and ICT services team Health Inofrmation NZ Health Information NZ CLINICIANS’ CHALLENGE 2014 Thanks for listening by Dr Allister Williams MBChB 1993, MRCP UK 2005, FRACP 2012 Consultant Physician and Nephrologist Head of Dept Medicine, Taranaki DHB, NZ Acknowledgements

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  • rebeccagrainger007

    Jun. 19, 2015

Finalist for the Clinicians Challenge 2014. Presented by Dr Allister Williams, Head of Dept Medicine, Taranaki DHB, at HINZ 2014, 11 November 2014, 4pm, Plenary Room

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