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mHealth Application Clusters


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Presentation by Claudia Tessier at mHealth Initiative's Seminar in San Francisco, September 18, 2009

mHealth Application Clusters

  1. 1. The 12 mHealth Application Clusters mHealth Initiative Seminar San Francisco September 18, 2009 Claudia Tessier RHIA CEO and President Copyright 2009 mHealth Initiative Inc., Boston MA. All rights reserved.
  2. 2. Mobile Phones at the End of the First Decade of the 21st Century Worldwide mobile subscriber base >4 billion Landline phones: 1.2 billion TV sets in use: 1.4 billion Registered automobiles: 850 million People using PCs: 950 million Access to internet: 1.3 billion People with at least 1 credit card: 1.5 billion population has a mobile phone).
  3. 3. 12 Mobile Phone Application Clusters in Healthcare 1 Patient 2 Access to 3 Point-of- Communication Web-based Care 4 Disease Management Resources Documentation 12 Body 5 Education Area Network Programs 11 Pharma/Clinical 6 Professional Communication 10 Public 9 8 Financial Health Ambulance/EMS Applications 7 Administrative Applications
  4. 4. Application Cluster #1 Patient Communication Before visit During visit Selection of caregiver Patient education Pre-visit communication Financial and administrative Text message Care communication Email Post-visit and general Photos Text messages Appointment reminders Email Appointment request and Continuity of care scheduling Medication reminders Agenda Questions (with photos if Insurance info applicable) Update demo data Patient education Advance check-in In the care process PHR (CCR) References Consumer/patient providing information
  5. 5. Text Messaging Appointments Medication reminders General inquiries Administrative questions Non-healthcare related communication Health promotion Patient-initiated communication Need to reschedule appointment Need for prescription refill, etc.
  6. 6. Preferred Communication: The Phone as Identification Programs like the airlines’ “Remember Me” provide A direct path to information about you when calling from a phone number pre-registered with your provider. The system recognizes your phone number, instantaneously pulls up your information and even greets you by name. All of this information is available within a few seconds at the beginning of the call
  7. 7. Benefits of mHealth Patient Communication Systems More communication between clinician and patient leads to Better quality of care Greater continuity of care Greater efficiency Fewer visits Lower costs
  8. 8. Considerations All communication must be clear and customizable (usability) Reason for visit Both parties need acknowledgement This may even be more important for the provider because it will allow them to be better prepared and confirm that tests required for the visit have been done. Requires new workflow, parameters and protocols ID Systems: Photo and “Remember me”
  9. 9. Considerations Requires new reimbursement system Do all communications have equal value? If nine communications are required in one instance and five in another, are they paid the same? How do you measure the amount of work required by the physicians behind the scenes for each communication? Would compensation paradigms that include a frequency component invite abuse? Can the evaluation of the value/compensation be automated or does it need a new bureaucracy? Is this another good reason to move to capitated compensation structures so that providers are free to focus on the optimal way to arrive at best case outcomes?
  10. 10. Considerations Providers must have an auto responder function about emergencies What is the difference between text messaging and telephone messages in terms of impact and liability? Perhaps the terminology should be “emailing or text messaging” since text messages are limited to 160 characters, which may be too limiting. All communication should be logged and saved for a minimum period. Everything that isn’t easily and automatically identifiable as unnecessary (such as appointment reminders) should be saved in an EMR, otherwise time/money is wasted deciding on what’s worthy.
  11. 11. Standards Needed Patient ID Structured communication Security/confidentiality Provider workflow issues
  12. 12. Application Cluster #2: Access to Web-based Resources Formularies Guidelines and protocols Decision support Telemedicine guidelines Accessing specific CCR information Patient’s comments re Web Patient directives PHR For providers and patients
  13. 13. Lexi-Comp References Credit: Renee McLeod
  14. 14. Drug Programs Credit: Renee McLeod
  15. 15. Search PubMed (Pub Search is a free application) Credit: Renee McLeod
  16. 16. Application Cluster #3: Point-of-care, Real-time Documentation The promise of EMRs at your fingertips anywhere, anytime Access patient history in real-time Document (capture patient information capture and generate report) in real-time Transmit patient information in real-time Navigate patient information in real-time
  17. 17. Real-time, point-of-care information capture!!! Is documentation like this acceptable anywhere other than in healthcare? • Legibility • Structure • Meaning • Completeness
  18. 18. Issues Accuracy Authentication Interoperability mDevices to HIS and EMR Medical devices wireless communication EMC Data integrity
  19. 19. Accessing Patient Information Interoperability From internal system From a Website From the phone card
  20. 20. Application Cluster #4: Disease Management Currently focused on Diabetes Asthma Dermatology Preventive care in pregnancy Smoking cessation Hypertension
  21. 21. Diabetes Several companies Applications Parents to monitor their children Patients to monitor and report their health data
  22. 22. Record Blood Sugar Intake Record Instant feedback Follow up
  23. 23. Meal Planning Questions
  24. 24. Disease Management Issues FDA approval Proof of ROI Collection of projects/experiences Aggregation of data
  25. 25. Application Cluster #5: Education Programs Teaching, monitoring, coaching… New applications in nursing and other areas Teaching patients self-care, monitoring, expectations Need standards
  26. 26. Application Cluster #6: Professional Communication Preferred communication channels for lab, pharmacy, etc. Colleagues Specialty-specific communities Disease-specific experiences Ask the expert!
  27. 27. Application Cluster #7: Administrative Applications Provider-patient Asset tracking applications Surgical instruments Financial data Medical records Demographic data Equipment Non-clinical data Appointments Patient flow Self check-in management Reminder Scheduling Admissions/discharges Staff communication Internal Bed management External Third parties Payers Labs Other providers
  28. 28. Application Cluster #8: Financial Applications Charge capture Providers accessing eligibility info Providers sending bills Patients accessing coverage and co-pay information Payers in active communication with patients and providers Online real-time adjudication
  29. 29. Application Cluster #9: Emergency Care Not starting with a “blank sheet” Potential need for record locator system Substantial cost reductions expected San Diego experience
  30. 30. Application Cluster #10 Public Health Reporting of disease outbreaks Swine flu, for example Alerting providers Instructing patients Bioterrorism Surveillance Population notifications Increasing adoption in developing countries Other
  31. 31. Application Cluster #11 Pharma/Clinical Trials Clinical trials Automatic, scheduled and ad hoc information transmission Rely on instrument rather than patient for routine data collection Patient feedback systems
  32. 32. Application Cluster #12: Body-area Networks (BAN) Mobile wearable or implanted sensors that monitor vital body parameters and movements and wirelessly transmit data from the body to provider or elsewhere via a home base Examples Heart monitor could alert pending heart attack Auto-inject insulin for patient whose blood sugar drops Sports activity monitoring: speed, distance, heart rate, blood pressure Fantasy? - Exchange business cards (or patient demographic data) with a handshake? Big issue: Security
  33. 33. mHealth Initiative Plans Develop online resource to record and access information about mApps By application cluster By device By disease Information from vendors Information and feedback from users
  34. 34. Thank you! 617-816-7513