Mobile Device Connectivity

Part 3: Mobile Device Connectivity Benefits

JOHN R. ZALESKI, PHD, CPHIMS
Case Study 2 VICE PRESIDENT OF CLINICAL APPLICATIONS & CTO
Supporting Technologies JZALESKI@NUVON.COM
C: +1 484 319 7345
Summary
O: +1 215 966 6142

MOBILE HEALTHCARE NEED
(PWC HRI STUDY, 2010 HEALTHCARE UNWIRED)

– SURVEY OF 1000 PHYSICIANS, 2000 CONSUMERS
– MORE THAN 30% OF PHYSICIANS: MAKE DECISIONS ON
INCOMPLETE INFORMATION
– 40% OF PHYSICIANS: COULD ELIMINATE FROM 11%30%
OF OFFICE VISITS THROUGH USE OF MOBILE HEALTH
TECHNOLOGIES
– PATIENT COMPLIANCE: 88% OF PHYSICIANS WOULD LIKE
PATIENTS TO BE ABLE TO MONITOR THEIR HEALTH (WEIGHT,
BLOOD SUGAR)

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Sunday, May 29, 2011

MOBILE HEALTHCARE TECHNOLOGY IMPEDIMENTS
(PWC HRI STUDY, 2010 HEALTHCARE UNWIRED)

– INTEGRATION: >60% OF PHYSICIANS IN SURVEY USE
PERSONAL DEVICES FOR MOBILE HEALTH SOLUTIONS THAT
ARE NOT CONNECTED TO THEIR PRACTICE OR HOSPITAL
SYSTEMS (E.G.: EMAIL)
– SECURITY: >30% OF PCPS AND >40% OF SPECIALISTS
SURVEYED CONCERNED ABOUT PRIVACY & SECURITY
– BANDWIDTH: CONCERN OVER EXISTING HEALTH ENTERPRISE
NETWORKS TO SUPPORT ADDED BANDWIDTH

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ARE THE BENEFITS REAL?
• CLEVELAND CLINIC & MICROSOFT:
– DECEMBER 2008 PILOT PROJECT, 250 PARTICIPANTS (26% DIABETES, 6% HF, 68% HYPERTENSION)
• ADVAMED (M.E. STACHURA, MD & E.V. KHASANSHINA, MD, PHD):
- OCTOBER 2007, SURVEY INCLUSIVE OF 426 PATIENTS WITH DM, CHF, COPD
• CCF, ADVAMED, PWC HRI REPORTS:
Condition Activity Effect

Diabetes monitoring (PA, Post-discharge 71% increase in days
OH) monitoring using WiFi between visits; 42% drop
transmitter of vital signs in overall cost/patient
CHF (Trans-European) Home Care Management 35% drop in LoS; 10%
of patients with reduction in office visits;
implanted cardiac 65% drop in home health
defibrillators visits
COPD (CANADA) Remote monitoring of Reduced hospital
respiratory illness admissions by 50%
“Cleveland Clinic/Microsoft Pilot Promising; Home Health Services May Benefit Chronic Disease Management” 3/1/2010
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WIDESPREAD REMOTE MONITORING CAN CUT
CHRONIC CARE COSTS BY ~$200B1
“Savings largely attributable
Condition Estimated 25-Yr Cost to better management…
Saving because widespread
Congestive Heart Failure $102.5B implementation … means key
vital signs can be transmitted
(CHF)
to a caregiver or data center
Diabetes $54.4B in real-time and trigger
instant alerts when readings
Chronic Obstructive $24.1B
change in a medically
Pulmonary Disease (COPD) different way.”
Chronic Skin Ulcers $16B --Robert Litan, Page 2.

Patients with chronic illness account for ~80% of
increases in Medicare costs
-Lisa Remington, 2008 MegaTrends Predictions and Forecasts Across the Healthcare Delivery System (Jan/Feb 2008)

1Tim Rowan reporting on AT&T Study, and conducted by Brookings Institution
economist Robert Litan. Study presented by Better Health Care Together
Coalition.

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ATTRACTIVENESS, USEFULNESS OF WIFI
TECHNOLOGIES TO CLINICIANS

EMR Access 83% PCPs 88% Specialists

Prescribing Meds 86% PCPs 82% Specialists

InPatient Monitoring 69% PCPs 75% Specialists

Referral Initiation/Track 65% PCPs 62% Specialists

Patient Communication 61% PCPs 59% Specialists

Remote Monitoring 65% PCPs 54% Specialists

56% Indicated mobile health access would expedite
decision making
Source: PwC HRI Physician Survey, 2010 6

Standards Based WiFi Technology Spectrum
(From Home Healthcare Horizons)
Source: JT Adams, L. Schmitt, J. Zaleski. “Simple,
Interoperable, Wireless Connectivity Solutions for Home
Healthcare.” Home Healthcare Horizons, 2010. Page 41

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Standards Based WiFi Technology Spectrum
(Example: Zigbee Mesh Networking)

Source:
ZigBee Wireless Sensor Applications for Health, Wellness and Fitness . March
2009, Page 9. http://www.zigbee.org
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Summing Up

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MORE CONTINUOUSLY AVAILABLE INFORMATION
UNDERGIRDS BETTER CARE
• EVOLUTION FROM EPISODIC TO CONTINUOUS MONITORING
– PROMOTES MORE HOLISTIC VIEW
– TRENDS BECOME VISIBLE OVER LONG TERM
– EXPOSURE OF INDIVIDUALLY UNINTERESTING EVENTS, ONCE INTEGRATED,
PROMOTE EARLIER DETECTION OF UNDERLYING PROBLEMS

• PATIENT CARE DEVICE DATA ARE KEY TO CONTINUOUS TRENDING
– FROM ICU FLOW SHEETS TO PHR, EVIDENCE EXISTS TO DEMONSTRATE
BENEFITS
– A KEY ENABLER TO THE OVERALL PROCESS OF CLINICAL DECISION MAKING

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TO SUPPORT CLINICAL DECISION MAKING, PATIENT
CARE DEVICE INTEGRATION SHOULD…

• BE SEAMLESS: OPERATE ACROSS ENTERPRISE ENVIRONMENT, THROUGH
ANY NETWORK TOPOLOGY, AND PROVIDE SECURE REMOTE ACCESS TO DATA
FROM COLLECTION TO DELIVERY
• BE SCALABLE: TRUE PLUG-AND-PLAY WITHOUT NEED FOR TOPOLOGY
CHANGES, AND WITH AUTO-DISCOVERY OF NEW DEVICES UPON
ATTACHMENT
• BE RELIABLE: S/W AND H/W SHOULD SUPPORT AUTOMATIC FAILOVER AND
BE SELF-HEALING
• BE FLEXIBLE: BECOME A STANDARD TOOL OF CLINICIAN AND PATIENT BY
INTEGRATING WITH WORKFLOW TO ENHANCE STANDARDS OF CARE, NOT
JUST SUPPORT THEM

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Summary
• Medical device connectivity is essential adjunct
for real-time intervention and clinical guidance
• Clinical decision support systems will need to
leverage medical device technology and focus on
real-time access to data is essential, including
waveform data
• Future electronic medical record development
should take real-time considerations into account
in terms of interventional guidance.
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“As to diseases, make a habit of
two things—to health, or at least
to do no harm.”
Hippocrates in Epidemics, Bk I, Sect. XI

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Mobile Device Connectivity

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