HIMSS Mobile Health how to Guide
- 1. HIMSS Mobile “How To” Guide HIMSS Physician mHealth Task Force
- 2. HIMSS mHealth ‘How To’ Guide • David Lee Scher, MD, FACP, FACC, FHRS • Alisa Niksch, MD • Megan Ranney, MD, MPH • Lou Diamond, MD • Brian Rothman, MD
- 3. Why Mobile Digital Health Tech Today? The Big Picture • Simple math: more patients via ACA, shortage of physicians and other providers • The need to track patients, inventory, and processes – ACO accountability – ROI=cost savings, not revenue in 2015 • Mobile is a part of everyday life outside of healthcare
- 4. Why Mobile Digital Health Tech Today? The ‘In the Trenches’ Picture • Clinicians are tethered to PCs • EHRs are not intuitive. – Apps can fill void • Communication, patient monitoring & reference tools need to be mobile, safe, and secure • Mobile needed for digital patient education
- 5. •ACOs •Mega-merged organizations •Retail medical care Today’s Healthcare Landscape: New Business Models
- 6. •Bundled payments •Risk/Gain sharing •Readmission penalties Today’s Healthcare Landscape: New Payment Models
- 7. Today’s Healthcare Landscape: New Care Models •Transitional care •Remote patient monitoring •Aging at home •Participatory medicine: Role of the caregiver
- 8. mHealth and Complex Care Models • Complex care implies: – High frequency of chronic disease states, comorbidities – Multiple stakeholders: physicians, healthcare facilities, payers, patients, caregivers, – Disparate communication and record keeping capabilities – Additive human factors: adherence, cost, health literacy, mental health issues
- 9. Why a ‘How To’ Guide? • Legitimate concerns about quality, security, safety of mobile technologies, apps • Up until recently no regulatory guidance • Mobile presents unique challenges • Lack of a central reference guide for adoption of mobile • To understand obstacles to using mHealth to improve healthcare quality and cost from all perspectives
- 10. Purpose of the “How To” Guide • To help address challenges of care in the current healthcare landscape • To increase awareness of available technologies which can: – Improve patient investment in their own health – Improve safety and quality of care – Improve physician workflow efficiency – Improve patient and family satisfaction
- 11. Why an mHealth “How-To” Guide? •To understand obstacles to using mHealth to improve healthcare quality and cost from an individual, institutional, and systemic perspective
- 13. Why an mHealth “How-To” Guide? •For clinicians: How do you know if a tool is what you need? What tools are out there? •For C-suite executives: How do you know if a tool is worth investing in?
- 14. Why an mHealth “How-To” Guide? Clinicians •How do you know if a tool is what you need? – Does it address a clinical problem? – Does it improve your time efficiency or decrease workflow? – Is it something your patients will see as value? – Does it interoperate well with the EHR? – Has it been shown to do what it claims to? – Has it been vetted for security and privacy issues by your IT department?
- 15. Why an mHealth “How-To” Guide? The C-Suite
- 16. Why an mHealth “How-To” Guide? The C-Suite • How do you know if a tool is worth investing in? – Is it something your clinician IT champions want or see value in? – Is it something your IT department has vetted? – Does it add marketing value to the enterprise? – Is it something which can translate to patient satisfaction? – Does it address a clinical or workflow problem? – Is it something potentially valuable as a joint business venture?
- 17. Why an mHealth “How-To” Guide? • mHealth tools must achieve functionality in key areas: – Clear benefit and incentives to the consumer (patient and connected caregivers) – Actionable measures with mechanism for feedback – To assist in bridging health literacy gaps – Integration with other health IT systems
- 18. Leveraging mHealth for New Care Models •ACOs: Real-time mobile analytics, communications •Mega-merged organizations: Inventory management, communications, standardization of UX •Retail Medical Care: Patient education tools
- 19. Leveraging mHealth for Challenges in Care • Discharge process: Scheduling, medication reconciliation • Chronic disease management: Remote patient monitoring, telehealth • Care coordination:: Communications tools, mobile clinical trials • Aging at home: Personal/environmental sensors, social
- 20. Why an mHealth “How-To” Guide? To guide implementation of mHealth initiatives to achieve the Triple Aim* *Institute for Healthcare Improvement
- 21. The National Quality Strategy (NQS): How does mHealth fit in? • NQS: Agency for Healthcare Research and Quality (AHRQ) through HHS • Six priorities based on the triple aim
- 22. The NQS: How does mHealth fit in? • 6 priorities for U.S. healthcare quality: Patient Safety Person and Family- Centered Care Effective Communication and Care Coordination Prevention and treatment of leading causes of mortality Health and Well-Being Affordable Care
- 23. mHealth & the NQS • How can mHealth improve Patient Safety? Patient Safety Person and Family- Centered Care Effective communication and Care Coordination Prevention and treatment of leading causes of mortality Health and Well-Being Affordable Care
- 24. mHealth & the NQS • Priority 1: Patient Safety: – Automated hospital discharge surveys – Can use mHealth to improve satisfaction & safety: • Point of care mobile CPOE, EHR, staff messaging • Mobile EHR accessibility • Text-messaging discharged patients
- 25. mHealth & the NQS • How can mHealth create patient-centric care? How can mHealth streamline communication? Patient Safety Person and Family- Centered Care Effective Communication and Care Coordination Prevention and treatment of leading causes of mortality Health and Well-Being Affordable Care
- 26. mHealth & the NQS • STRATEGIES 2 & 3: Patient-Family-Centered Care & Effective Communication: – Increasing use of “connected care” devices for monitoring of chronic disease • wireless scales for CHF patients – Patient access to data • “OpenNotes” for EHR data – Mobile self-reporting tools • Automated text message data alerts to caregivers • Self-tracking tools for depression, sleep, etc.
- 27. mHealth & the NQS • How can mHealth encourage/sustain healthy lifestyle habits? How can mHealth help manage chronic disease? Patient Safety Person and Family- Centered Care Prevention and treatment of leading causes of mortality Health and Well-Being Affordable Care Effective communication and Care Coordination
- 28. mHealth & the NQS • Strategies 4 & 5: Prevention; and Health & Well-Being – Prevention is presently difficult to achieve – Mobile health can facilitate this with patient engagement tools. • Preventing depression w/SMS messaging high-risk teens presenting to the ER (iDOVE) • SMS message programs for smoking cessation (text2quit) • Apps to reduce relapse after Rx for alcohol abuse (iCHESS) • SMS messaging to create “care teams” (SenseHealth)
- 29. mHealth & the NQS • Will mHealth achieve reduced cost of care? Patient Safety Person and Family- Centered Care Effective communication and Care Coordination Prevention and treatment of leading causes of mortality Health and Well-Being Affordable Care
- 30. mHealth & the NQS • Strategy 6: Affordable Care – Jury still out BUT: • Early studies suggest mHealth and remote patient monitoring initiatives can improve adherence, reduce visits/admissions, and improve satisfaction – Integrated/targeted mHealth programs demonstrate potential for decrease in hospitalization costs
- 31. mHealth Technology’s Role •Technologies are not magic bullet solutions… but tools which can aid in the creation of effective care coordination models
- 32. Case Studies from the HIMSS mHealth Physician Task Force • Remote Patient Monitoring – Evolution with new biosensors, quest for more clinical data and use cases – Barriers to Adoption • How mHealth Can Transform the Delivery of Acute Care • Mobile technology to support care transitions
- 33. HIMSS Resources •The Value of Remote Patient Monitoring (RPM) Physicians’ Perspectives -History of RPM and its evolution -Current case studies -New models of reimbursement and cost of care
- 34. HIMSS Resources Remote Patient Monitoring (RPM) - Security and Other Adoption Barriers - Security and data privacy concerns - Limited business models - Physician adoption barriers, including buy-in for new technologies - Cost of deployment and training - Etc., etc.,…
- 35. HIMSS Resources Mobile Technology Selection to Support Care Transitions – Advantages and obstacles of mHealth as mode of improved communication between caregivers – Introduction of Digital Health Selection Framework – Lays out need for setting criteria for selecting digital health technologies
- 36. HIMSS Resources mHealth: Improving Patients’ Health Before, During, and After an Acute Care Visit -Need for evidence-based mHealth solutions for clinician use and buy-in -Value of text/SMS messaging for behavior change and compliance
- 37. Digital Health Technology Selection Framework
- 38. • A living document • Developed by clinician KOLs in digital health technology • Segmented for administrators and clinicians • Supported by best practices The mHealth ‘How To’ Guide
- 39. THANK YOU
Editor's Notes
- #9: Topic 2: Effective Communication; Prevention & Treatment of Leading Causes of Mortality; Health & Well-being
- #18: Topic 1: Pt Safety & Pt/Family Centered Care
- #25: Topic 1: Pt Safety & Pt/Family Centered Care
- #27: Topic 1: Pt Safety & Pt/Family Centered Care
- #29: Topic 2: Effective Communication; Prevention & Treatment of Leading Causes of Mortality; Health & Well-being
- #31: Topic 3: Affordable Care