Mobile Device Connectivity
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The document discusses the benefits of mobile device connectivity for healthcare. It notes that over 30% of physicians make decisions with incomplete information, and mobile technologies could eliminate 11-30% of office visits. Remote monitoring is shown to reduce costs and hospital admissions for conditions like diabetes, congestive heart failure, and COPD. Widespread use of remote monitoring for chronic conditions could save over $200 billion in healthcare costs over 25 years. Standards-based WiFi technologies can effectively support remote patient monitoring.
Mobile Device Connectivity
- 1. 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
- 2. 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) 2 Sunday, May 29, 2011
- 3. 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 3 Sunday, May 29, 2011
- 4. 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 4 Sunday, May 29, 2011
- 5. 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. 5 Sunday, May 29, 2011
- 6. 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 Sunday, May 29, 2011
- 7. 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 7 Sunday, May 29, 2011
- 8. 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 8 Sunday, May 29, 2011
- 9. Summing Up 9 Sunday, May 29, 2011
- 10. 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 10 Sunday, May 29, 2011
- 11. 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 11 Sunday, May 29, 2011
- 12. 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. 12 Sunday, May 29, 2011
- 13. “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 13 Sunday, May 29, 2011
- 14. Further Reading 14 Sunday, May 29, 2011
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- 16. Book I John Zaleski, Ph.D. Integrating Device Data into the Electronic Medical Record A Developer’s Guide to Design and a Practitioner’s Guide to Application ISBN 978-3-89578-323-4 A19100-L531- B977-X-7600 Approx. 300 pages Approx. 100 illustrations Contents: THE MEDICAL DEVICE INTEGRATION LANDSCAPE DEVICE NETWORKING AND COMMUNICATION MECHANISMS FOR INTERFACING AND INTEGRATING DEVICE DATA REAL-TIME AND NON-REAL-TIME DATA MANAGEMENT COMPUTER-BASED PATIENT RECORD CORRECTLY ASSOCIATING DEVICE DATA WITH PATIENTS BALANCING DATA QUANTITY WITH QUALITY: TECHNIQUES FOR DATA ANALYSIS AND REDUCTION HOW TO DISPLAY DATA IN A FLOWSHEET INTERFACE SOFTWARE AS A MEDICAL DEVICE THE FUTURE OF MEDICAL DEVICE INTEGRATION, INCLUDING DEVICE COMMAND & CONTROL EXAMPLE METHODS AND SOFTWARE 16 Sunday, May 29, 2011
- 17. Thank you for your attention! JOHN R. ZALESKI, PHD, CPHIMS VICE PRESIDENT OF CLINICAL APPLICATIONS & CTO JZALESKI@NUVON.COM C: +1 484 319 7345 O: +1 215 966 6142 17 Sunday, May 29, 2011