mhealth application clustrs.tessier
DESCRIPTION
mHealth Application Clusters presented by Claudia Tessier, President, mHealth InitiativePresented at mHealth Initiative's June 4, 2009 conference in Washington, DC.www.mhealthinitiative.orgTRANSCRIPT
The 12 mHealth Application Clusters
June 4 mHealth Initiative SeminarWashington DC
Claudia Tessier RHIACEO and President
Copyright 2009 mHealth Initiative Inc., Boston MA. All rights reserved.
Total worldwide mobile subscriber base: >4 billion (almost 50% world population)
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).
12 Mobile Phone Function Clusters in Healthcare
- General Technology View -
1 Patient
Communication2 Access to
Web-based
Resources
3 Point-of-
Care
Documentation 4 Disease
Management
5 Education
Programs
6 Professional
Communication
7 Administrative
Applications
8 Financial Applications
9 Ambulance/EMS
10Public
Health
11Pharma/Clinical
12 Body
Area Network
Application Cluster 1Patient Communication
During visit Patient education
Financial and administrative
Care communication
General (inc. post-visit) Text messages
Continuity of care
Medication reminders
Questions (with photos if applicable)
Patient education
In the care process
References
Before Visit Selection of caregiver
Pre-visit communication• Text message
• Photos
Appointment reminders
Appointment request and scheduling
Agenda
Insurance info
Update demo data
Advance check-in
PHR (CCR)
Consumer/patient providing information
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
Preferred Communication
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
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
mHealth Agenda for Communication
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
Considerations
ID Systems: Photo and “Remember me”
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?
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 will often be too limiting.
Message/email Style
Standardize structured text or free text
Occasional need for a more personal touch
Text/emailing creates a superior audit trail to telephone messaging, so assuming that the provider has acted properly, it reduces liability and the likelihood of litigation.
Fail-safe controls are required to ensure a timely response to all communications, otherwise a new avenue of liability would be created.
Need patient agreement and clear guidelines
Guidance where text messaging should be used; what requirements for response and saving it (data base, EMR document).
Considerations
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.
Standards Needed
Patient ID
Structured communication
Security/confidentiality
Provider workflow issues
Application Cluster 2Access to Web-based Resources
FormulariesGuidelines and protocolsDecision supportTelemedicine guidelinesAccessing specific CCR informationPatient’s comments re WebPatient directivesPHRFor providers and patients
Lexi-Comp References
Credit: Renee McLeod
Drug Programs
Credit: Renee McLeod
Search PubMed(Pub Search is a free application)
Credit: Renee McLeod
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
Issues
Authentication
Interoperability
mDevices to HIS and EMR
Medical devices wireless communication
• EMC
• Data integrity
Accessing Patient Information
Interoperability
From internal system
From a Website
From the phone card
Cluster 4: Disease Management
Currently focused on
Diabetes
Asthma
Dermatology
Preventive care in pregnancy
Smoking cessation
Hypertension
Diabetes
Several companies
Applications
Parents to monitor their children
Patients to monitor and report their health data
Instant feedback Follow up
Record Blood Sugar Intake
Record
Meal Planning Questions
Disease Management Issues
FDA approval
Proof of ROI
Collection of projects/experiences
Aggregation of data
Cluster 5: Teaching, Monitoring, and Coaching
New applications in nursing and other areas
Teaching patients self-care, monitoring, expectations
Need standards
Application Cluster #6: Professional Communication
Preferred communication channels for lab, pharmacy etc.
Colleagues
Specialty-specific communities
Disease-specific experiences
Ask the expert!
Application Cluster #7: Administrative Applications
Provider-patient applications
• Financial data• Demographic data• Non-clinical data• Appointments• Self check-in• Reminder
Staff communication• Internal• External
Third parties• Payers• Labs• Other providers
Asset tracking Surgical instruments Medical records Equipment
Patient flow management Scheduling Admissions/discharges Bed management
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
Not starting with a “blank sheet”
Potential need for record locator system
Substantial cost reductions expected
San Diego experience
Application Cluster #9: Emergency Care
Reporting of disease outbreaks
Swine flu, for example
Alerting providers
Instructing patients
Bioterrorism
Surveillance
Population notifications
Other
Application Cluster #10Public Health
Clinical trials
Automatic, scheduled and ad hoc information transmission
Rely on instrument rather than patient for routine data collection
Patient feedback systems
Application Cluster #11 Pharma/Clinical Trials
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
Application Cluster #12 Body-area Networks
mHealth Initiative Plans
Develop online resource to record and access information about mApps
By application cluster
By product
By disease
Information from vendors
Information and feedback from users
Thank you
www.mhealthinitiative.org
617-331-4140