Mashing Meaningful Use with Insanely Great

Agenda

• Some dots to connect (20 minutes)– Meaningful Use

• Care Receipt for every clinical visit• After Visit Summary for each transaction

– Quantified Self• Personal apps can share• Devices share their observations

• iPhone development brief (20 minutes)• Design session (20 minutes)

Real Lives are Meaningful Use

Panel 1: Meaningful Use of HIT in the Real Lives of Patients & Familiesa. What are consumers’ health information needs in the context of their real lives?b. How do results of ethnographic studies of individuals with chronic health conditions inform our understanding of how HIT can improve their use of health information and connectivity with their providers to improve their health?c. What is the evidence base for patient benefit from their direct use of PHRs and other HIT that interacts with EHRs?d. What is the role of mobile applications in improving health of individuals? Is there a specific role for underserved populations?e. How can we use HIT to make information and knowledge actionable for patients?f. How does HIT enhance collaboration between patients and their providers and change how the patient’s health is managed?

Personal: Key Part of Meaningful Use

Panel 2: Incorporating Patient-Generated Data in Meaningful Use of HITa. What is the role of patient-generated data in improving health of individuals? What is the evidence?b. How can patient-reported data be integrated into EHRs and the clinicians’ workflow to improve care management?c. How can future conceptions of personal health information platforms and information tools facilitate patient-centered care, including transparency, coordinated care, patient activation, while protecting patient privacy?d. What is the role of the patient in ensuring data in EHRs is accurate?e. What are your recommendations for meaningful use criteria for 2013 and 2015 that are achievable by a broad spectrum of providers?

Time: Key Measure of Meaningful Use

Panel 3: Policy Challenges & Infrastructure Requirements to Facilitate Patient/Consumers’ Meaningful Use of HITa. What is required for vendors to be able to export data from EHRs in such a way that consumers and patients can use the data in meaningfully?b. What is the role of providers in making data available to patients in a meaningful way?c. What are the meaningful uses of that data once exported? What evidence of measureable benefits exist?d. What are the privacy and trust issues that might affect this from happening?

Managing Disease is a Dance

Engagement pre-care    Pre-sign up    Facility Registration    ED Care SignupCare DispositionPOS PaymentPost Care ContinuityEngagement post-carePost POS Payment

Diagnose Codes are a trigger

• Care Receipt for Diagnosis:

• Asthma exacerbation (493.92 Asthma unspecified with exacerbation)

• Upper Respiratory Infection (465.9 Acute URI unspecified)

• Medications and measurements (Inhaler, Peak Flow, Exercise)

Recent severity scores

Most current score and trigger for ED VisitMost current score and trigger for ED Visit

Daily medication use

ConditionsConditions PDFPDFAsthma ReportAsthma Report

Current chief complaintAccept new entry from LPCH?Your doctor has published a summary of your last visit. Set new reminders?

Accept new entry from LPCH?Your doctor has published a summary of your last visit. Set new reminders?

OKOKCancelCancel

Reminding Self

Meaningful Use: Asthma• Assignments• Reminders• Logs• Reports• Microsyntax

Quantifying Self

Engagement goes deeper into lifestyle

• Memories• Mindfulness• Friends and Family

QuantifiedSelf.org

iPhone development brief

Building an iPhone app is as easy as posting on a blog

Cloud Computing: Ripple in Time

• Public Cloud (Amazon)– Claims processing– Scientific modeling

• Private Cloud– Consolidating stack– Removing OPEX

• Legacy– Citrix Receiver #1 iPad App

Data Center

Amazon

Cloud Computing: Personal

• Public Cloud– Amazon, Apple,

FaceBook, Twitter• Private Cloud

– Personal matters– Security enabled– Compliance driven

Provider Cloud

MeMe

Me

XCode

• The tool for building apps on the iPhone

• Comes with the iPhone Developer contract

• Bunches of code starters and samples from Apple and others

iPhone IB

• An optional helper application to manage user interface elements into x-code

• Drag and drop library controls into iPhone screens

MockApp

• An tweet-licensed open tool for helping quickly prototype information rich app

• Icons, controls, action sheets, …

GameSalad

• For fun 2D games• Interactive

scripting

• Allergies: Who are the enemies of quality breath

Unity

• For realistic 3D games

• Intense and real• Cameras and point

of view• Physics engine

• Allergies: Overlay air quality on community

Is there an app for your…

Job, Workflow, Diagnoses, Friend, Blood Cells, Medications, Community

Scenario Time

• Let’s assume– Exchange is real-time– Smart phone for all– Push notifications

• 5 minute sketch• 15 minute share

NHIN: HIE

Us