Personal Connected Health: Patient Generated Data Use Cases
Download as PPTX, PDF0 likes288 views
The presentation discusses the use cases for patient-generated health data (PGHD) and remote patient monitoring, highlighting advancements in technology and the importance of data interoperability for healthcare providers and patients. It emphasizes various health conditions like atrial fibrillation, heart failure, and diabetes while mentioning partnerships and studies that leverage wearables for better patient management. The document also addresses challenges such as data accuracy, privacy, and the need for standardized practices in telehealth monitoring.
Personal Connected Health: Patient Generated Data Use Cases
- 1. THE PRESENTATION TITLE GOES HERE 1 Personal Connected Health: Patient Generated Data Use Cases 1 John Sharp Director, Thought Advisory, HIMSS
- 2. THE PRESENTATION TITLE GOES HERE “ An examination of the current state and projection of the future state of PGHD reveals the opportunities, challenges, and calls to action for the main health care stakeholders, as well as supporting stakeholders. 2 ONC PGHD Report, 2017
- 3. PGHD Adoption Curve – ONC 2017 3
- 4. 4
- 5. The Rise of the Data-Driven Physician – Stanford Medicine 2020 5
- 6. Remote Patient Monitoring Why Now? 6 • Better technology including miniaturization of sensors • Pervasive wireless networks including home networks • Smart phones enabled with Bluetooth • Growth of wearables -consumerization • Incentives – CPT codes for reimbursement, value-based care, financial penalties • Regulatory changes – FDA approvals
- 7. 7 Who Sees the Data? • Providers need data in a format that they can interpret and act on • Within the EMR context • Outside the EMR – within a ACO or Chronic Disease Management system • Patients – See the data in ways that they can interpret and take action • Usually through and app or small dashboard on the device • Device/app companies • Only to provide technical support
- 8. 8 Use Cases - Remote Patient Monitoring • Atrial Fibrillation • Cardiac Rehab • Heart Failure • Hypertension • Diabetes • Mental Health
- 9. Atrial Fibrillation Apple Heart Study The Apple Watch and corresponding Heart Study app uses photoplethysmography to intermittently measure blood flow activity and detect subtle changes that might indicate an irregular heartbeat. • 419,297 people self-enrolled in the study • A pulse notification was received by 2,161 participants (0.52 %) • While the watch and corresponding app "offers promise," its accuracy is still far short of more traditional and currently used monitoring techniques. • No interoperability – those who got notifications were instructed to contact the study doctor. 9
- 10. Apple Watch Study - Implications 10 • Recruitment of people using wearables shows potential for large sample sizes • Concerns about false positives • May be more effective focusing on those with heart disease • Lack of interoperability – particularly moving data to the EMR for effective disease management • Future application to diagnostics and symptom identification through wearables New Apple Studies • Women’s Health Studies • Heart and Movement Study • Hearing Study
- 11. Home-Based Cardiac Rehabilitation Program 11 • Compliance with cardiac rehab is poor • Requires weeks of outpatient rehab appointments • Often means a caregiver transporting the patient daily • Drop-out is high
- 12. 12 Kaiser – Samsung partnership • Samsung smartwatch that pairs via Bluetooth with an Apple or Android smartphone • The watch sends reminders to the patient to exercise, collects patient activity data and continuously displays the patient heart rate during exercise • uploaded via the smartphone into the patient's chart (via FHIR?) Home-Based Cardiac Rehabilitation Program
- 13. Incentives – CMS will not pay for readmission within 30 days The hope is that more intensive monitoring in the community can identify decompensation early, support adherence to lifestyle and medication, and prompt intervention Now included in guidelines by the European Society of Cardiology and the American College of Cardiology, with caution about limited evidence The potential is great. “RM will find an important place for those living with HF and the professionals advising them.” 13 Heart Failure
- 14. THE PRESENTATION TITLE GOES HERE Cardiac Failure Review 2019;5(2):86–92.
- 15. THE PRESENTATION TITLE GOES HERE 15 Hypertension Front. Cardiovasc. Med., 13 June 2019
- 16. • People living with the Type 1 rarely have to seek professional assistance • Their blood glucose concentrations can easily be incorporated into data platforms that can be accessed by patients, their carers and their healthcare professionals at any point in time and from anywhere there is internet access to the cloud-based server. • For those requiring insulin, there are now patches that monitor blood glucose every few minutes, and wirelessly communicate with an insulin pump to help ensure stable blood glucose control. 16 Diabetes
- 17. 17 Diabetes – Closed loop
- 18. 18 Diabetes – closed loop
- 19. Standards should include consideration of: • data safety and privacy (data storage, use and sharing policies must be made transparent to users of the app) • effectiveness • user experience/adherence • data integration (via APIs using open standards) Towards a consensus around standards for smartphone apps and digital mental health, World Psychiatry. 2019 Feb; 18(1): 97–98. 19 Mental Health
- 20. 1. What seems obvious to an engineer (or informatics manager) may not be obvious to a patient. 2. What seems quick and easy may strike the patient as burdensome. 3. Questionnaires developed for research may not be appropriate for clinical practice. 4. Many words used by doctors and researchers can be replaced by something simpler 5. Don’t ask questions for clinical care unless you are prepared to act 6. A subgroup of users can cause a great deal of additional work 7. Watch patients use your tool and ask about their experiences. 8. Patient trust is hard to gain and easy to lose 20 Interfaces for collecting data from patients: 10 golden rules – JAMIA Jan. 2020
- 21. • There are now several use cases for collection of PGHD via remote monitoring and apps • Initial evidence of clinical improvement is mixed • Implementation of remote monitoring needs more standardization to scale • Reimbursement is now available through CMS which will incentivize RPM • Data transfer can be via Bluetooth to a mobile platform or direct to cloud • Data integration is enabled via APIs 21 Summary
- 22. Your health is not a number. Be careful when evaluating your health. Your habits are more than numbers to be hacked. 22 “ Chris Dancy, The World’s Most Connected Person Don’t Unplug
- 23. THE PRESENTATION TITLE GOES HERE 23 Questions
- 24. THE PRESENTATION TITLE GOES HERE 24 Contact me Linkedin.com/in/johnsharp @JohnSharp john.sharp@himss.org PCHAlliance.org