HIMSS Physician mHealth Task Force mHealth Summit 2015

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