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PwC - Apps Formulary for Health Care Organizations
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
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
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
