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HealthBotz Care Plan Management ApplicationTom Marcin, DataBotz, LLCCopyright © 2011 Allscripts Healthcare Solutions, Inc.
HealthBotz Solution OverviewHigh-level solution description:A web application that enables providers and patients to collaborate in the developmentand management of "care plans" for patients with chronic diseases. The first module willbe focused on diabetes type II care; future modules will address heart disease andpulmonary conditions.Healthcare/business problem addressed:Reducing healthcare costs and improving outcomes for patients with chronic diseases byincreasing patient engagement during the creation and compliance phases of their careplans.The application addresses both challenge categories:█ Applications that improve management of high-cost chronic diseases.█ Innovative approaches to addressing value-based care imperatives.A Connected Community of Health | Copyright © 2011 Allscripts Healthcare Solutions, Inc.
Diabetes Problem & Care█ According to the American Diabetes Association, 25.8 million people in the United States — 8.3% of the population — have diabetes, and it is expected to double by 2038.█ Every 24 hours, approximately 230 people with diabetes have an amputation, 120 suffer from kidney failure, and 55 go blind.█ The annual cost of diabetes in the U.S. exceeds $174 billion, accounting for 14% of healthcare expenditures.█ Interventions to change the trajectory of the disease process are well-researched and include: ‣ Lifestyle modifications, intensive glycemic control, the use of statins for hyperlipidemia, smoking cessation and yearly screening for retinopathy. ‣ ACE inhibitors for hypertension and renal disease, ARBs for microalbuminuria and foot care.█ Self-management blood sugar tools have increased patient understanding of diabetes and provided knowledge necessary to actively participate in the creation of a health plan, resulting in improved HbA1C levels. Sources: CDC, American Diabetes Association, Delaware DHSSA Connected Community of Health | Copyright © 2011 Allscripts Healthcare Solutions, Inc.
Usability & Design—Care plan creation1. Rankings of the top hospitals and physicians, based on positive outcomes, to get more information or second opinions.2. Proprietary Natural Language Processing capabilities integrate unstructured doctors notes and structured data from EMR into a comprehensive care plan.3. HealthBotz creates a foundational care plan based on EMR data.4. Patients and their healthcare professionals collaborate in HealthBotz to define goals to manage the disease.5. The care plan is then uploaded to Allscripts through the API.6. Patients will have a stronger sense of ownership of their care plan, especially after collaborating on its development with their providers.7. HealthBotz gives patients access to their EMR and visit notes. ‣ 78% of patients report that after viewing their doctors visit notes, they were more likely to take their medication. Sources: OpenNotes study in Annals of Internal MedicineA Connected Community of Health | Copyright © 2011 Allscripts Healthcare Solutions, Inc.
Usability & Design—Care plan compliance1. HealthBotz uses simple psychological analysis to determine the recovery phase that a patient is in, and adjusts the care plan suggestions and interactions based on a patients profile.2. HealthBotz leverages social media capabilities to enable the patient to build a community support system to help motivate them to comply with their plan including family, friends, and providers.3. Leverage gamification concepts such as points, badges, leveling-up, and rewards to provide positive reinforcement and motivation.4. For our Diabetes module HealthBotz has already established relationships and integration plans with: ‣ Delaware Health Information Network (DHIN), United States first and most mature HIE. ‣ Anytime Fitness. ‣ Perque Integrated Health system.A Connected Community of Health | Copyright © 2011 Allscripts Healthcare Solutions, Inc.
Usability & Design—Alerts █ Reminders to take your medication and refill your medications. █ Automated pharmacy refill. █ Medical appointment reminders. █ Alerting and messaging throughout the recovery or management period keeps patients motivated. █ Alerting and messaging keeps providers engaged on a more regular basis in between patient visits. █ Alerting and messaging keeps family members informed of a patients progress or more importantly, the lack thereof. █ Alerting and messaging keeps hospital administrators abreast of potential high risk re- admittance cases. █ Alerts notify primary care physicians making them aware of their patients discharge from a hospital while motivating them to establish an appointment.A Connected Community of Health | Copyright © 2011 Allscripts Healthcare Solutions, Inc.
Usability & Design—Health indicatorsTracking health indicators such as weight and glucose improves patient care.60% of US adults track at least one health indicator. Of trackers with 2+chronic conditions like diabetes... ‣ 56% say tracking changed their approach to maintaining their health. ‣ 53% say it led them to ask a doctor new questions. ‣ 45% say it affected a decision about how to treat an illness. ‣ Only 22% use devices to track this data.HealthBotz pulls data from devices & apps, provides a unified dashboard foruser, and pushes data into EHR for health care providers. ‣ Activity & sleep: Jawbone Up, Fitbit, Nike FuelBand, RunKeeper. ‣ Weight: Withings scale, Fitbit Aria. ‣ Glucose: MyGlucoHealth, iGBStar monitors. ‣ Blood pressure: iHealth, Withings cuffs. Sources: Pew Research "Tracking for Health" January 2013A Connected Community of Health | Copyright © 2011 Allscripts Healthcare Solutions, Inc.
Development Stage█ Idea developed and vetted with medical professional team.█ High-resolution simulation created in iRise application development platform.█ Preliminary testing performed with pulling, processing and pushing data from and to the Allscripts EHR platforms.█ Architecture framework established.█ Development environment selected█ Key partner relationships established ‣ Delaware Health Information Network (HIE) ‣ Christiana Care Hospital System (advisors and potential pilot users) ‣ Lexikos, LLC (proprietary natural language processing)A Connected Community of Health | Copyright © 2011 Allscripts Healthcare Solutions, Inc.
High-level ArchitectureKnowledge base ‣ EMR and other patient information translated into graph data model of nodes and labeled edges. ‣ Enables fast link-based algorithms for search and recommendation.Event-driven architecture ‣ Data ingest pipeline pulls medical record data as it becomes available. ‣ Complex event processor matches standing queries and generates notifications to users.Interoperability ‣ Services are provided to third parties via RESTful APIs. ‣ Mapping to RDF-based health ontologies enables interoperability with the Linking Open Data cloud, schema.org, and Semantic Web toolkits.HealthBotz leverages semantic web technology — an early adopter and driver of the web 3.0 — toincrease: ‣ Data access and Patient engagement ‣ Integration of heterogeneous data across the entire health information sphere from biological research based in genetics and genomics to clinical research to clinical practice to social media...to drive more effective and efficient outcomes and better health globally.A Connected Community of Health | Copyright © 2011 Allscripts Healthcare Solutions, Inc.
Integration Description█ Connect to Enterprise or Professional EHR (depending on the customer) from HealthBotz servers and web app using Unity SDK.█ Electronic medical records, including data pertaining to a diabetes care plan, will be pulled from Allscripts into HealthBotz. Supplemental data collected about the patient in HealthBotz will be pushed up into Allscripts for provider access.█ Push data into Allscripts using: ‣ SaveVitals, SaveRX ‣ SaveDocumentImage█ Pull data from Allscripts using: ‣ GetUserAuthentication ‣ GetSchedule, SearchPatients ‣ GetPatient, GetPatientFull, GetPatientActivity ‣ GetPatientCDA, GetPatientSections ‣ GetDocuments, GetDocumentImageA Connected Community of Health | Copyright © 2011 Allscripts Healthcare Solutions, Inc.
Go to Market Plans█ DataBotz plans to leverage its strategic relationship with the DHIN in order to use the DHIN relationship managers to promote DataBotz/DHIN-developed solutions.█ DataBotz will have access to all major hospital systems and over 97%* of ordering physician in the state of Delaware through our DHIN relationship.█ DataBotz will leverage its DHIN relationship to gain access to other state or private HIEs that have been collaborating with the DHIN over the past 5 years.█ DataBotz will also offer and promote its HealthBotz service through the Internet on health related websites such as American Diabetes Association, WebMD, MayoClinc, wellness/ healthy living sites, and other web services such as Patients Like Me.█ Provide user community (GetSatisfaction, etc) for customer questions, problems, requests; help, tutorials and information integrated into the app.█ Additional support needs will be evaluated during our pilot stage and integrated as appropriate.* Provider penetration calculation reflects number of providers who make orders and are enrolled in DHIN (MD’s, DO’s, NP’s, PA’s and ED’s), and does not include healthcare care providers that do not make orders (e.g. Pathologists). Total provider list compiled from multiple sources including the Medical Society of Delaware, University of Delaware, Delaware Blue Cross Blue Shield and the Delaware Division of Professional Regulation.A Connected Community of Health | Copyright © 2011 Allscripts Healthcare Solutions, Inc.
Go to Market Plans30-day free trial for patients and 60-day free trials for providers. Subscriptions will besold in two versions:Consumer/patient version supporting a single family ‣ $2.50/month for individual, $5.00/month per immediate family member (up to 5).Tiered enterprise versions for hospitals, physicians offices, wellness centersincluding monthly and annual contracts. ‣ Cost TBD for practices of up to 5, 10, 25, >25 physicians. ‣ Cost TBD for Hospital systems of up to 250, 500, >500+ beds.Future secondary revenue streams: ‣ Manufacturers Drug/device utilization, compliance, adverse event reporting. ‣ Insurers Diabetes disease management adjunct services. ‣ Providers Diabetes outcomes, performance reporting vs. peers. ‣ Data Consumers Anonymized patient data at $3/patient-month.A Connected Community of Health | Copyright © 2011 Allscripts Healthcare Solutions, Inc.
Video Demonstration█ URL Link: http://youtu.be/uvX0r1Z6f2c█ Our video demonstrates how HealthBotz enables YOU the PATIENT to be the center of your health care. YOU download WE aggregate YOU develop WE analyze YOU collaborate WE alert YOU have fun WE educate YOU change... YOU WIN !A Connected Community of Health | Copyright © 2011 Allscripts Healthcare Solutions, Inc.
Why this solution should be selected!█ 25.8 million people in U.S. have diabetes and the number is projected to double by 2038.█ Successful improvement toward the ADA guidelines in a population of 17,000 has shown healthier lives-400 fewer heart attacks, 300 fewer cases of diabetic eye disease, 130 fewer strokes and 200 fewer deaths.█ Healthbotz supports the client in entering a more productive, patient-centered relationship with his/her provider and care team driving them towards compliance with ADA guidelines and other best practices or informed choices.█ The client is empowered with information for decision making and more likely to negotiate a treatment care plan that will be followed.█ The client receives motivational support and data regularly as opposed to just at the three month follow up with the provider.A Connected Community of Health | Copyright © 2011 Allscripts Healthcare Solutions, Inc.
Why this solution should be selected!█ The provider will receive updates and will have the opportunity to respond to these updates-both the accomplishments and partnering to readjust plan when needed.█ A support team which includes friends and family can virtually support the individual by both encouraging and celebrating their success.█ The client will be in control and invested in the care plan. They will receive frequent data to reflect on, frequent motivation to feel proud of success and move more successfully toward meeting the ADA guidelines and improved health and well-being.█ Health care costs will be reduced and shifted to the primary care offices away from hospitals and emergency room, allowing more access for other critically ill community members.█ Diabetes is just the beginning for HealthBotz... wait until you see what we have planned!A Connected Community of Health | Copyright © 2011 Allscripts Healthcare Solutions, Inc.