Steven Heilman - mHealth in everyday practice
2 likes634 views
The document discusses the role of mHealth in improving health outcomes through mobile and wireless technology, highlighting applications such as remote monitoring and telemedicine. It addresses challenges in clinician utilization, patient engagement, and population management, along with barriers to adoption like security and regulatory issues. Key examples include the impact of home monitoring on patient outcomes, particularly in chronic diseases and public health initiatives.
Steven Heilman - mHealth in everyday practice
- 1. mHealth in Everyday Practice Plain Talk September 7, 2012 Steve Heilman M.D., FACEP System Vice President and Chief Medical Information Officer
- 2. Norton Healthcare Integrated Delivery Network of Five Not-for-Profit Hospitals 14 Out-patient Centers 1.4 Million yearly patient encounters $1.5 Billion yearly revenue 12,000 Employees 500 Employed Providers 2,000 Physician Medical Staff 2,000 Licensed Beds 60,000 Admissions/year
- 3. Key Messages for Discussion • mHealth Overview • Clinician Utilization • Patient Engagement • Population Management and Research • Healthcare Reform and mHealth • Adoption Barriers
- 4. What is mHealth? • The use of mobile and wireless devices to improve health outcomes, healthcare services and health research • Applications of mHealth include: – Utilizing devices to collect community and clinical health data – Delivery of healthcare information to clinicians, researchers, and patients – Remote monitoring – Remote provision of care
- 5. Routine Clinician Applications Quick and easy access to cloud based data– drug guides, medical alerts, journal summaries and medical references.
- 6. Routine Clinical Applications Electronic Medical Record (EMR) Access – dedicated native applications to access patient data, refill prescriptions, review and release labs, communicate with staff and patients via secure messaging.
- 7. Routine Clinical Applications Access to Personal Health Record (PHR) information
- 8. Routine Clinical Applications Remote Monitoring Access
- 9. New Applications for Clinicians • Digital Dermatoscopes • Digital Stethoscopes • Ultrasound applications • Medical Imaging Review
- 10. Home Monitoring Applications • Bluetooth devices – scales, glucose monitors, BP, Medication dispensers • Positive Feedback • Patient Education
- 11. New Applications • Microchip patch/ Ingestible event monitors • Cardiac Monitoring
- 12. Population Management/ Research • Telemedicine – enabling the provision of care anywhere. ? mHealth • Physician Specialty Shortages
- 13. Population Management/ Research • Asthmapolis
- 14. Population Management/ Research • Home monitoring can improve outcomes • Columbia University1 – telehealth and data collection from glucometers - greater↓HbA1c compared to control group • Weight and vitals monitoring in CHF patients2,3 - ↓office visits 10% ↓home visits 65%. ↓ six month mortality rate 56.2% 1. Shea S, Weinstock R, Starren J, and etc. A Randomized Trial Comparing Telemedicine Case Management with Usual Care in Older, Ethnically Diverse, Medically Underserved Patients with Diabetes Mellitus. J Am Med Inform Association 13:40-51, 2006. 2. Cleland J, Louis AA, Rigby AS, and etc. Noninvasive Home Telemonitoring for Patients with Heart Failure at High Risk of Recurrent Admission and Death, Journal of the American College of Cardiology 45(10):1654, 2005. 3. Goldberg LR, Piette JD, Wals MN, and etc. Randomized trial of a daily electronic home monitoring system in patients with advanced heart failure the Weight Monitoring in Heart Failure (WHARF) trial. Am Heart J 146:705-712, 2003.
- 15. Population Management/ Research • Africa (Malawi)– Addressing HIV infection with mHealth – Texting HIV test results, treatment instructions – Relay results of treatments back to public health – Prevention messages to high risk groups
- 16. Healthcare Reform and mHealth • Fee for service – Reimbursement based on Volumes ≠ improved adoption efficient tools • Accountable Care Organizations • Value Based Purchasing • Capitated Care • Bundled Payments
- 17. Adoption Barriers • Security • Integration • Licensing Regulations • Bandwidth • Reimbursement • Patient Engagement/Compliance • Physician Acceptance
- 18. Choices to Make
- 19. Questions?