Connected health no movie

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Patti Brennan's presentation at ConnectedHealth 2012 in Boston, MA,

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  • What we have done through Project HealthDesign is piloted how data about observations of daily living – or ODLs – can be collected, interpreted, and acted upon by patients and clinicians. ODLs can include information about things that are personally meaningful to people and that indicate how they feel – such as mood, pain, appetite, sleeping patterns, energy levels, exercise, etc.
  • The five Round 2 Project HealthDesign teams worked with real patients to use new technologies such as smartphones and iPads to collect observations of daily living and share selected ODL data with clinicians in order to improve care.My project involved [provide one-sentence description of your project]. I’m going to talk more about it in a minute.
  • Out of curiosity, I entered the ODLs that the five Round 2 teams will collect into Wordle.What I see is a mix of qualitative (subjective) and quantitative (objective) data.It also points out how important the grantees attention to analysis, interpretation of the raw data is; as well as the display of the analyzed or trended data.
  • Quote: “easily…and more accurately track environmental and behavioral effects on our health.“Barbara L. Massoudi, Principal Investigator, RTI InternationalAsthma is a common, chronic illness, affecting over 23 million adults in this country. In addition to respiratory symptoms associated with the disease, individuals with asthma are also more likely to experience depression and anxiety. RTI International and Virginia Commonwealth University will design a personal health record application, BreathEasy, building on the latest clinical guidelines for treatment and self-monitoring for patients with asthma and depression. Patients will interact with the application through smartphone mobile devices and biomonitors to capture and report observations of daily living (ODLs) such as use of controller and rescue medications, symptom levels, quality of life and smoking. Clinicians will utilize a Web-based dashboard providing simple analysis and visualization tools that allow them to quickly view their patients’ data, evaluate their health status and communicate any changes in treatment or monitoring. By providing a clearer picture of their health in everyday life, the ODLs will be used by both the patients and their clinicians to make lifestyle and treatment adjustments that will better manage their asthma and depression.
  • Connected health no movie

    1. 1. Listening in the Moment: Project HealthDesign Opens the Window on the Every-day Lives of Patients Patricia Flatley Brennan, RN, PhD University of Wisconsin-Madison Madison, WI USA Support provided by UW Madison, RWJF
    2. 2. Exploring the practical implications ofobservations of daily living
    3. 3. The CARE between the CARE – listening to the every-day experience of peopleJanuary June December
    4. 4. Professionals are experts in clinical carePeople are experts in every-day living
    5. 5. Observation of Daily Living ODLs• Thoughts, feelings, behaviors & actions, and exposures• Cues towards action rather than indicators of pathology• Idiosyncratic, personally meaningful
    6. 6. ProjectHealthDesign Reaching people inevery day life
    7. 7. People LIVE everyday, not just at the hospital or clinic• http://www.projecthealthdesign.org/projects/ round-1-projects/personal-health-application- for-diabetes-self-management
    8. 8. What’s important to Jim1. Negotiating a loan2. Opening his own shop3. Stress4. Exercise5. Medication6. Hypoglycemia Which of these DOESN’T have a SNOMED code?
    9. 9. The Language of Health in every-day Feedback Plan Play Basketball exercise Stress running See how I am H1c doing advice Keep in medicationdecide track Glucose Stay on How to top eat Blood Sugar
    10. 10. The Language of Health in every-day Feedback Plan Play Basketball exercise Stress running See how I am H1c doing advice Keep in medicationdecide track Glucose Stay on How to top eat Blood Sugar
    11. 11. The Language of Health in every-dayPatient Focused Patient Defined Feedback Plan Play Basketball exercise Stress running See how I am H1c doing advice Keep in medication decide track Glucose Stay on How to top eat Blood Sugar
    12. 12. The Language of Health in every-dayPatient Focused Patient DefinedClinical Terms Observation of Feedback Daily Living Plan Play Basketball exercise Stress running See how I am H1c doing advice Keep in medication decide track Glucose Stay on How to top eat Blood Sugar
    13. 13. The Language of Health in every-dayPatient Focused Patient DefinedClinical Terms Observation of exercise Daily Living Plan Play Basketball H1c Stress running decide Blood Blood Glucose advice medication Sugar Keep in track Feedback Stay on Eat right top See how I am doing
    14. 14. HIT can bring the language of every day health into clinical care!• Professional terms: Blood glucose, activity tolerance• Personal terms: open my own shop, go for a run
    15. 15. Project HealthDesign Round 2• Engaged five teams to demonstrate a new vision for improved patient care through integration of patient-generated health data into every day lives and clinical practice• Explored the technical, legal and policy implications of incorporating patient generated data in health care
    16. 16. • dwellSense Elders at risk of cognitive decline• Estrellita High risk infants and their caregivers• Chronology.MD Young adults with Crohn’s Disease• BreatheEasy Adults with Asthma• iN Touch Low-income teens and young adults managing obesity
    17. 17. Observations of Daily Living
    18. 18. BreathEasy: An application for adults with asthma & depression oranxiety“What were developing willenable patients and clinicians tocommunicate more quickly andeasily . . .”
    19. 19. Example 1: Significant improvement after a controller medication was started without an office visit (early 30’s, smoker, no other significant health issues)
    20. 20. Example 2: Different diagnosis suspected, escalated to specialist care, immunotherapy planned (early 50’s with comorbid hypertension, depression, chronic pain, and lupus erythematous)
    21. 21. Challenges: Workflow Integration
    22. 22. BreathEasy ArchitectureHome RTI Clinic Web/App Nurses/ BreathEasy BreathEasy Server Physicians Patient Patient Mobile App DashboardPatient ODLs:• Peak flow rate• Controller Med. Adherence• Rescue Med. Usage Messaging• Asthma Triggers Server• Asthma Symptoms• Activity Level/Types• Depression Level• Anxiety Level• Sleep Patterns• Smoking Habits Challenges: Data Integration •Third party storage •Integration with EHR
    23. 23. What did people do with ODLs?• Recognize when symptoms became problematic• Recognize effects of new medications on symptoms• Increase awareness of triggers• Reminders for daily tasks performance and monitoring• Adhere to doctors’ instructions since s/he “would know”• Know when medication refills were due• Report about health during doctors’ appointments• Gain insights to health behaviors, set goals, and improve health choices
    24. 24. The Patient Experience• ‘I don’t feel so alone’ (patient w/ Crohn’s)• ‘My quality of life has gone way up’. . . ‘my weight is up’ . . . ‘I’m not vomiting every day’• ‘It’s easier to summarize and share between-visit health events and health status’• ‘good intentions to use the app, but not enough energy at the end of the day’ (parents of twin at-risk infants and two pre- school kids)• ‘I charge the study phone before my personal cell’• ‘missed more medication doses than I expected’ (elder at risk)
    25. 25. What did clinicians do with ODLs?• Change a target peak flow rates• Make a new or correct an existing diagnosis• Monitor psychological issues• Understand of the impact of sleep and/or exercise on pain• Track patient weight• Make informed referrals based on increased knowledge of patients symptoms• Better understand patient health status at home• Adjust medication regime
    26. 26. discovery.wisc.edu/lel healthsystems.engr.wisc.eduwww.projecthealthdesign.org

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