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ClickMedix Case Studies 2015
ClickMedix is a connected mHealth platform that enables healthcare organizations to serve more patients better, faster, and at lower costs. It has been deployed in 16 countries through over 90 sites addressing different diseases. ClickMedix provides case studies on scaling tele-dermatology, community-based care for low-income populations, and managing diabetic patients collaboratively with multiple specialists. The platform aims to improve access to care through task-shifting to nurses and community health workers while lowering costs.
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ClickMedix Case Studies 2015
- 1. ClickMedix Connected mHealth platformto enable healthcare organizations to serve more patients better, faster, and at lower costs. Ting Shih - Founder & CEO (ting@clickmedix.com) http://clickmedix.com
- 2. ClickMedix has beendeployed in 16 countries, through 90+ sites addressing different diseases 7 1 2 43 3 3 1 2 4 5 1 2 9 2 4 2
- 3. Medical Government Technology Mexico IMSS Corporate ClickMedix Builta Strong Network of Customers and Partners
- 4. 2008: Mobile Applicationfor Tele-Consultation (HIV/AIDS, cervical cancer, pre/post oral surgery) • >$1M USD saved from transportations per year • >90 women treated for cervical cancer (in 3 months) through mid-wives screening for cancer • Thousands of patients with increased access to care per year • Transitioned process and service model to Botswana government
- 5. In the past18 months, ClickMedix enabled Medtronic to screen 70,000+ patients with just 9 health workers. They have also doubled the number of treatments performed in partner hospitals. Service extending to in-hospital and patient counselor follow-up care.
- 6. Health Worker UsingClickMedix to Capture Patient Symptoms Information
- 7. 1,000+ Cases PerWeek
- 8. Most patients complainsof diminished hearing or itching
- 9. Images of CSOM(perforation of the middle-ear causing diminished hearing, and deaf if untreated)
- 10. 1. Serve more patientswhile lowering costs through task-shifting 2. Connect healthcare providers and community caregivers to enable efficient care collaboration 3. Develop revenue model and demonstrate ROI ClickMedix Model to Scale Healthcare Innovations
- 11. Diagnose Treat Follow Up CustomizePatient Symptoms Collection Process to Enable Screen-Triage-Tele-Consult Fitting Provider Workflow
- 12. Screen & Triage Diagnose Treat Follow Up Engage, Educate,and Monitor Task-Shift to Community Nurses / Health Workers to Collect Data via Provider-Designated or Evidence-Based Protocols
- 13. Virtual Specialists rural rural rural urban rural Semi-rural rural urban semi- ruralrural semi-rural Connect HealthcareProviders and Enable Collaboration to Manage Patients Clinics Medical Centers
- 14. What We Learnedand Applied to Achieve Repeatable Outcomes Repeatable Outcomes: • Improve clinic efficiency: < 5 minutes per patient • Increased patient access: < 3 days • Improved quality of care through maximized right-referrals • Improved patient experience • <1 hour of training regardless of health worker education level • Reduced costs of care: eliminate unnecessary procedures, delays, and travel costs Overcame First-World Challenges • Regulation: HIPAA-compliant, bank-level secure, on-device security • Adoption: Customizable workflow, extensible to multiple diseases, easy to use for providers and patients • Scalability: one-click referral to additional patients or other providers and payors • Sustainable payment models: additional patient referrals, private-pay or reimbursement
- 15. Case Study 1:Tele-dermatology • 5 published studies on efficacy from emerging markets • Transitioned to the US through American Academy of Dermatology and implemented in 27 clinics across 6 states (with UCLA, UPenn, Univ of Washington, Harvard, etc.) • 10-20 cases per week per clinic for patients who otherwise wait 6-12 months to see a dermatologist • Hospital system-wide implementation saw ~900 patients in 6 months; 500 from patient backlog resolved in 4 months; captured reimbursement ~900*80 = 72,000 • Commercially replicated into private-pay and reimbursable services
- 16. 200+ health assessments in oneday Deployed to 20+ medical personnel on iPhone, iPad Android Healthcare & education for Grameen America borrowers Launched in NY, September 2013 Case Study 2: Grameen PrimaCare, Community-Based Comprehensive Care for Low-Income Latin Population
- 17. Developing US-Based CommunityHealth Program for Underserved, Low-Income, Uninsured Population $49/month
- 18. Effective Community Engagement,Increases Membership and Financial Sustainability
- 19. Case Study 3:Scaling Multi-Specialists Services to Collaboratively Manage Diabetic Patients Pharmacist Patient Education Nutritionist Nephrologist and Endocrinologist • 25% growth annually • Contracted by Insurers • Collaborate with primary care physicians • 25% growth annually • Contracted by Insurers • Collaborate with primary care physicians • Doubled number of patients seen per day • Task-shifted to care coordinator and medical students for longitudinal patient follow-up • Scaling model to medical schools in Mexico and India
- 20. In 3 Months:Average A1C Drop of 1.66 (from 10.11 to 8.48)
- 21. Chronic Disease ManagementRequires Comprehensive Risk- Assessment and Multiple Specialists Complications
- 22. 1 <7.0 (<53 mmol/mol) SBP < 130 DBP< 80 <100 or <70 with CVD No Symptoms & No Structural Heart Disease At risk; chronic cough, sputum production; normal spirometry No Nephropath y No Retinopathy No Dental Infection No Neuropathy & No PAD 18.5-24.9 No Depressio n PHQ-9 score 0 2 7.0-7.9 (53-63 mmol/mol) SBP 130- 139 DBP < 90 101-130 No Symptoms & +Structural Heart Disease GOLD 1 or 2 & 0-1 exacerbation s/yr & mMRC 0-1 & CAT<10 Albuminuri a 30-299 mg/g Non- Proliferative Mild Mild Gingival Inflammatio n Neuropathy 25-29.9 Minimal Depressio n PHQ-9 score 1-4 3 8.0-8.9 (64-74 mmol/mol) SBP 140- 149 DBP < 90 131-160 Symptomati c & + Structural Heart Disease GOLD 1 or 2 & 0-1 exacerbation s/yr & mMRC ≥2 & CAT≥10 Albuminuri a 300-999 or eGFR 30- 60 Non- Proliferative Moderate Moderate Gingival Inflammatio n +PAD & +/- Neuropathy 30-34.9 Mild Depressio n PHQ-9 score 5-9 4 9.0-9.9 (75-85 mmol/mol) SBP <150 DBP 90-99 161-190 Symptomati c w/ Heart Failure GOLD 3 or 4 & ≥2 exacerbation s/yr & mMRC 0-1 & CAT<10 Albuminuri a 1000-2999 or eGFR 15-29 Non- Proliferative Severe/ Inactive Proliferative Severe Gingival Inflammatio n + Ulcer History 35-39.9 Moderate Depressio n PHQ-9 score 10- 14 5 > 10.0 (≥86 mmol/mol) SBP > 150 -or- DBP > 100 >191 Refractor y Heart Failure GOLD 3 or 4 & ≥2 exacerbation s/yr & mMRC ≥2 & CAT≥10 Albuminuri a >3,000 or eGFR ≤15 Active Proliferative Acute Dental Infection Previous Amputation ≥40 or <18.5 Severe Depressio n PHQ-9 score ≥15 Patient Receives Health Score Card, along with Care Plans and Service Referrals BMI
- 23. 1 <7.0 (<53 mmol/mol) SBP < 130 DBP< 80 <100 or <70 with CVD No Symptoms & No Structural Heart Disease At risk; chronic cough, sputum production; normal spirometry No Nephropath y No Retinopathy No Dental Infection No Neuropathy & No PAD 18.5-24.9 No Depressio n PHQ-9 score 0 2 7.0-7.9 (53-63 mmol/mol) SBP 130- 139 DBP < 90 101-130 No Symptoms & +Structural Heart Disease GOLD 1 or 2 & 0-1 exacerbation s/yr & mMRC 0-1 & CAT<10 Albuminuri a 30-299 mg/g Non- Proliferative Mild Mild Gingival Inflammatio n Neuropathy 25-29.9 Minimal Depressio n PHQ-9 score 1-4 3 8.0-8.9 (64-74 mmol/mol) SBP 140- 149 DBP < 90 131-160 Symptomati c & + Structural Heart Disease GOLD 1 or 2 & 0-1 exacerbation s/yr & mMRC ≥2 & CAT≥10 Albuminuri a 300-999 or eGFR 30- 60 Non- Proliferative Moderate Moderate Gingival Inflammatio n +PAD & +/- Neuropathy 30-34.9 Mild Depressio n PHQ-9 score 5-9 4 9.0-9.9 (75-85 mmol/mol) SBP <150 DBP 90-99 161-190 Symptomati c w/ Heart Failure GOLD 3 or 4 & ≥2 exacerbation s/yr & mMRC 0-1 & CAT<10 Albuminuri a 1000-2999 or eGFR 15-29 Non- Proliferative Severe/ Inactive Proliferative Severe Gingival Inflammatio n + Ulcer History 35-39.9 Moderate Depressio n PHQ-9 score 10- 14 5 > 10.0 (≥86 mmol/mol) SBP > 150 -or- DBP > 100 >191 Refractor y Heart Failure GOLD 3 or 4 & ≥2 exacerbation s/yr & mMRC ≥2 & CAT≥10 Albuminuri a >3,000 or eGFR ≤15 Active Proliferative Acute Dental Infection Previous Amputation ≥40 or <18.5 Severe Depressio n PHQ-9 score ≥15 Patient Receives Health Score Card, along with Care Plans and Service Referrals BMI
- 24. 10,83 1 Case Study 4:Pharmacist-Driven Care Coordination and Referrals Pharmacy-facilitated disease management and expanding to 500 pharmacy stores, affiliated insurer and hospitals
- 25.
- 26. Application to US:CA Senate Bill 493 Authorized Clinical Pharmacists to Manage Patients and Coordinate Care Nurse, pharmacist, or case manager helps patient with assessments Remote specialists responds with diagnosis and treatment advice Advises on medications, educate patients, recommend products and services (MTM Reimbursement potential) Schedules for follow-up visits and reminders ePrescriptionHome monitoring (glucose meter, blood pressure cuff, etc.) OTC and Prescription Drugs
- 27. Community Pharmacist-Facilitated ChronicDisease Management
- 28. Aggregate Proven Solutionsto Improve Care While Lowering Costs for Patients with Diabetes, CHF, COPD, Mental diseases Existing Patients (claims data, etc) Communit y Clinics Home care, patients, and their care givers StratifyScreen Triage 60% 20% 20% Intervene Specialist consultation Case Management Programs Wellness Programs Follow-up periodically Pharmacies
- 29. Pharmacies/ Clinics Easy to Deploy:Chronic Disease Management Application to Community Clinics, Pharmacies, and Patient Homes
- 30. 1. Configure MobileApplications to Enable Patients to Fill Out Self Assessments
- 31. 2. Capture ComprehensiveData for Remote Management by Specialists Via Mobile Devices
- 32. 3. Decision SupportedAssessments to Ensure Best- Practice Protocols are Followed
- 33. 4. Tele-Refer toSpecialists
- 34. 5. Doctor inCall-Center Can Also Help Triage and Tele-Consult
- 35. 6. Contact Patientto Provide Results and Schedule Follow-Ups
- 36. 1 <7.0 (<53 mmol/mol) SBP < 130 DBP< 80 <100 or <70 with CVD No Symptoms & No Structural Heart Disease At risk; chronic cough, sputum production; normal spirometry No Nephropath y No Retinopathy No Dental Infection No Neuropathy & No PAD 18.5-24.9 No Depressio n PHQ-9 score 0 2 7.0-7.9 (53-63 mmol/mol) SBP 130- 139 DBP < 90 101-130 No Symptoms & +Structural Heart Disease GOLD 1 or 2 & 0-1 exacerbation s/yr & mMRC 0-1 & CAT<10 Albuminuri a 30-299 mg/g Non- Proliferative Mild Mild Gingival Inflammatio n Neuropathy 25-29.9 Minimal Depressio n PHQ-9 score 1-4 3 8.0-8.9 (64-74 mmol/mol) SBP 140- 149 DBP < 90 131-160 Symptomati c & + Structural Heart Disease GOLD 1 or 2 & 0-1 exacerbation s/yr & mMRC ≥2 & CAT≥10 Albuminuri a 300-999 or eGFR 30- 60 Non- Proliferative Moderate Moderate Gingival Inflammatio n +PAD & +/- Neuropathy 30-34.9 Mild Depressio n PHQ-9 score 5-9 4 9.0-9.9 (75-85 mmol/mol) SBP <150 DBP 90-99 161-190 Symptomati c w/ Heart Failure GOLD 3 or 4 & ≥2 exacerbation s/yr & mMRC 0-1 & CAT<10 Albuminuri a 1000-2999 or eGFR 15-29 Non- Proliferative Severe/ Inactive Proliferative Severe Gingival Inflammatio n + Ulcer History 35-39.9 Moderate Depressio n PHQ-9 score 10- 14 5 > 10.0 (≥86 mmol/mol) SBP > 150 -or- DBP > 100 >191 Refractor y Heart Failure GOLD 3 or 4 & ≥2 exacerbation s/yr & mMRC ≥2 & CAT≥10 Albuminuri a >3,000 or eGFR ≤15 Active Proliferative Acute Dental Infection Previous Amputation ≥40 or <18.5 Severe Depressio n PHQ-9 score ≥15 7. Patient Receives Health Score Card, along with Care Plans and Service Referrals BMI
- 37. Expected Outcomes forHealth Organizations Improved patient care (outcome metrics for patients) • Decreased time to access doctors and treatment (< 3 days) • Decreased number of unnecessary hospitalizations (up to 55%) • Increased patient education • Increased patient satisfaction • Improved CMS Star Rating and HEDIS Measures (diabetes example) o Increased number of patients with improved Hb1Ac o Increased number of patients with improved blood pressure o Increased number of patients with improved cholesterol (LDL) o Increased patients screened for diabetes retinopathy o Increased patients with neuropathy assessment o Increased patients with foot examination Process Metrics • Increased number of patients screened for health risks • Increased number of patients managed • Decreased time to obtain treatment advice from multiple specialists
- 38. ClickMedix Medical Experts Hub Phar- macies Clinics HomesPhar- macies Clinics Homes Phar- macies Homes Clinics Payors & Third- Party Data Systems Full Scale-Up:Aggregate Population Health Data and Deliver Right Treatments to Improve Health Outcomes
- 39. ClickMedix mHealth Innovations inDisease Management Ting Shih - Founder & CEO @clickmedix ting@clickmedix.com http://clickmedix.com
- 40. Products Features •ClickDiabetes mHealthTraining •Tele-Dermatology Training •Tele-Geriatric Care Certification Training •Tele-Cardiology Training ClickMedix Solution Summary: Ready-to-Use mHealth and mTraining Programs HIPAA-compliant system with all features accessible on mobile phones or web browsers Remote diagnosis with store-and- forward Real-time video consultation Triage protocols Customizable patient forms Patient portal, education & adherence monitoring Electronic health record system ePrescription •Diabetes •Primary Care •Geriatric Care •Maternal & Pediatric Care Multi-media (image, video, slideshow) training materials Self-assessment quizzes Remote consultation with instructors Continuous updates of training materials Online examinations/certifications Click- Health Hospitals & Health Programs Click- Training Click- Specialists •Tele-ENT (ear, nose, throat) •Tele-Dermatology •Tele-Radiology •Tele-Cardiology •Pre/Post Surgery
Editor's Notes
- #3 90 sites include: Governments Hospitals / Clinics Medical Schools NGOs Corporate
- #4 ClickMedix has been able to replicate this model with numerous partners, which gives us a reach of over 600,000 patients.
- #17 To show how this works, here's a case study with Grameen Primacare which was founded by Nobel Laureate Muhammad Yunus. Grameen provides micro finance to thousands of Latina business owners in the US who don't otherwise have healthcare.