Telemedicine Strategies: Manageing Data and Mobile Devices
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Gain insights into real-world examples of successful telehealth mobile integrations. Join the University of Mississippi Medical center, the Hackensack University Medical Center, and NetMotion Wireless as they discuss telehealth challenges and benefits, including: Device integration and interoperability challenges Data privacy and security concerns Improved patient care outcomes Decreased re-admissions and cost controls
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Telemedicine Strategies: Manageing Data and Mobile Devices
- 1. Managing Data with Integrated, Interoperable Mobile Devices • Thank you for joining us at this FierceLive! Webinar. We will begin momentarily. • The audio will be streamed live over the Internet, so please make sure your computer speakers or headphones are turned on and your volume is turned up. • During the presentations, you can submit your questions in the “Q&A” widget to the right of this screen. The speakers will answer questions at the end of the webinar. Enjoy the presentation! Sponsor:
- 2. The Hospital of Tomorrow Healthcare Information Technology Shafiq Rab, M.D., MPH Vice President, Chief Information Officer Hackensack University Medical Center
- 3. A nonprofit teaching and research hospital located in Bergen County, NJ The largest provider of inpatient and outpatient services in the state. The flagship hospital of the Hackensack University Health Network, one of the largest health networks in the state comprised of 1,140 beds, nearly 10,000 employees and 2,200 credentialed physicians. #1 hospital in New Jersey and one of the top four New York metro area by the U.S. News & World Healthgrades® America’s Best 100 Hospitals in 10 different areas – more than any other hospital in the nation Healthgrades America's 50 Best Hospitals™ for seven years in a row Healthgrades Distinguished Hospital Award for Clinical Excellence™ 11 years in a row Leapfrog Top Hospital 19 Gold Seals of Approval™ by the Joint Commission – more than any other hospital in the country. First hospital in New Jersey and second in the nation to become a Magnet® recognized HackensackUMC is the Hometown Hospital of the New York Giants and the New York Red Bulls www.HackensackUMC.org About Hackensack University Medical Center
- 4. Since Time Immemorial… Information Has Existed Previously only feasible for governments to collect, analyze and control.
- 5. Big Data in Healthcare Improving Medicine At one time physicians made decisions based on nothing more than experience and hunches. the shift to the use of data, best practice alert to predictive modelling and now genotyping has improved medicine
- 6. The Quest for Customer Loyalty is On Convenience is REQUIRED Whenever ACCESS is Guaranteed High Quality is a Given Other Benefits to Distinguish
- 7. The Stage is Set A New Stack of Forces are at Play Economic Drive (90 Million Participate in Exchange) Political Drive (Rising Cost of Healthcare) Transparency Drive ( Quality is a Given) Consumer Drive (Increased Access)
- 8. The Shift Towards Prevention Primary Care Ambulatory Setting Home
- 9. Give Me My Money’s Worth Give the value of healthcare delivered to me as perceived by me Because I am paying for it
- 10. Enabling Information Technology Platform • The key enabler in delivering value based healthcare is IT • It allows access, convenience and the right information to make informed decisions • It also allows Efficient Delivery of Care
- 11. The Transformation A New Stack Supporting Patient Driven Healthcare Predictive - Preventative - Personalized - Participatory Mobility Analytics (Descriptive-Predictive-Prescriptive) Cloud Computing Internet of Things (Always Connected)
- 12. Mobility Becomes the Norm Rank Country or Region Mobile phones Population % of population Last Updated - World Over 6 billion 7,012,000,000[1] 87.00 2011[2][3] 1 China 1,046,510,000 1,341,000,000[4] 75.32 June 2012[5] 2 India 861,660,000 1,220,200,000[6] 70.42 28 Feb 2013[7] 3 United States 327,577,529 310,866,000[8] 103.90 June 2012[9] 4 Brazil 263,040,000 192,379,287[10] 136.70 February 2013[11] 5 Russia 256,117,000 142,905,200[10] 155.50 July 2011[12] 6 Indonesia 236,800,000 237,556,363 109.28 September 2012[10] 7 Pakistan 122,060,799 178,854,781[13] 68.83 Dec 2012[14][15] 8 Japan 121,246,700 127,628,095 95.10 June 2011[16] 9 Germany 107,000,000 81,882,342 130.10 2009[17] 10 Philippines 106,987,098 94,013,200 91.50 October 2011[18] 11 Nigeria 101,271,578 140,000,000 72.30 May 2012[19] 12 Bangladesh 98,470,000 148,090,000 68.00 July 2012[20] 13 Iran 96,165,000 73,973,000 130.00 February 2012[21] 14 Mexico 92,900,000 112,322,757 82.70 Dec. 2011[22] 15 Italy 88,580,000 60,090,400 147.40 Dec. 2008[23] 16 United Kingdom 75,750,000 61,612,300 122.90 Dec. 2008[24] 17 Vietnam 72,300,000 90,549,390 79.00 October 2010[25] 18 France 72,180,000 63,573,842 114.20 Dec. 2008[26] 19 Egypt 92,640,000 82,120,000 112.81 August 2012[27] 20 Thailand 69,000,000 65,001,021 105.00 2010[28]
- 13. The Internet Fuel for the fire Source: Internet World Stats – www.internetworldstats.com/stats.htm 2,405,518,376 Internet users estimated for June 30,2012 Copyright © 2012, Miniwatts Marketing Group
- 14. Getting the Right Information At the Right Time For the Right Person In the Right Format Securely Every Time To Make the Right Informed Decision Complete Information
- 15. Analytics Big Value As Gary Gokins said it is about Big Value Analytics Predictive Analytics Value Creation Decision Making (Strategic & Tactical)
- 16. Big Data in Healthcare Use Case • Wearable Devices Enabling Seniors to live at Home • Ingestible markers (measures and tracks heart rate, respiration, body posture, even sleeping patterns. Physician remotely monitoring will be quickly change dosage or even substitute a new medication) • Understanding the enormous EKG data can help detect a baby’s infection at least a day before it became symptomatic
- 17. The Patient Will See You Now… Diagnostic Devices
- 18. The Patient Will See You Now… The Future
- 19. Thank You Srab@HackensackUMC.org @CIOSHAFIQ551-996-3669 Contact or Follow Dr. Shafiq Rab
- 20. Remote Patient Care Ways to Control Costs, Improve Outcomes, Avoid Readmissions & Modify Patient Behavior
- 21. Why is Telehealth/RPM important? National/ State Challenges Health Care Workforce • Shortage • CME/EBP • Lack of Coordination HospitalViability • Financial crisis • Pay for Performance • Penalties Poor Health Status • High consumers, high cost • Half $ spent on 5% population • Patient disengaged© 2014 University of Mississippi Medical Center
- 23. Bringing the Health Care Team to the Patient It’s health care when where& you need it. 68%Of Mississippi physicians are located in urban/metropolitan areas 60%Of Mississippians live in rural areas 64%Of Mississippians drive at least 40 minutes for specialty care © 2014 University of Mississippi Medical Center
- 24. Telehealth in Mississippi © 2014 University of Mississippi Medical Center
- 25. • 165 telehealth sites of service (non-affiliated) • 34 medical specialties • 8 types of locations • Nearly 100,000 telehealth visits/year • Over ½ million telehealth visits completed • Increase demand in all sectors Community based partnerships = Success UMMC Center for Telehealth (September, 2014) © 2014 University of Mississippi Medical Center
- 26. • Bringing the health care team to the patient • Specialty consults, ancillary services… • Remote Patient Monitoring • Chronic disease management • Care at Home • Avoid Readmissions & ER visits • Personalized Health • Wellness • Wearables • Analytics- Predictive modeling • Population Health- Intelligence Platform/HIN Technology in Healthcare © 2014 University of Mississippi Medical Center
- 27. Tiered Health IT Approach Tier 1 Tier 2 Tier 3 Post Discharge Acute Setting Remote Patient Monitoring Acute or Outpt Setting RPM, Med Adherence and Video Home Visits IVR, RPM IVR, RPM IVR, Med Adherence, RPM, video visits Readmission Prevention Avoid ER Reactive Readmission Prevention Avoid ER Proactive/Reactive Chronic disease mgt, ^ follow- up/monitoring Readmission Prevention Avoid ER Proactive/Reactive Post D/C Service Chronic Disease Mgt Population Health Personalized Health Care © 2014 University of Mississippi Medical Center
- 28. Telehealth Call Center 24/7 Operation with clinical & technical support © 2014 University of Mississippi Medical Center
- 29. The doctor will see you now Saving reducing costs. time and © 2014 University of Mississippi Medical Center
- 30. How It Works in Healthcare HealthCare Need Appointment Scheduled eVisit done in convenient location Treatment Plan provided How it Works © 2014 University of Mississippi Medical Center
- 31. Telehealth & RPM in Coordinated Care
- 32. Quality, Efficiency, Safety • Safety in Transitions of care • Improved outcomes: o early recognition o earlier intervention o minimized complications o decreased LOS • Better Coordination of Care • Improved Patient Management at Home (prevent readmission/ER visits) • Patient Empowerment What does RPM offer? © 2014 University of Mississippi Medical Center Internal & External Application
- 33. Diabetes Project in Mississippi © 2014 University of Mississippi Medical Center
- 34. Target Population Defined INITIAL VISIT (ONSITE) PCP, Pharmacist (MTM), Registered Dietician – self management goals established Retinopathy Screening Technology Equipment Training (Chronic Dz Program Coordinator or PharmD) Referral to UMMC Telehealth Referrals Primary Care Provider Discharge Provider Nurse EHR Reports Self Other Follow-up Pharmacy MTM PCP/Medical Home Established Comprehensive Medication Review Medication Action Plan Diabetes Education Standards of Care Referrals Technology Training & Orientation Documentation & Referrals Target Population Age > 18 years High Risk (HbA1c > 7%) Referrals (PCP, Self, Others) Multiple medications or multiple disease states Recent transition in care Benefit from Specialist/MTM management Follow-up Nutrition Specialist Initial Ophthalmology Initial Endocrinology Technology Monitoring & Education Follow-up Diabetes Education ENROLLMENT (Chronic Dz Program Coordinator or PharmD) Patient Identification, Screening, Consent & Enrollment Required Project Informational Session (Video or Live) Baseline Lab Data Drawn (ordered by initial visit PCP) Clinical Team Weekly Meeting Providers – endo, ophthalmology Chronic Dz Program Coordinator (NSMC) PharmD/Office designee (IFMG) Telehealth RN Dietician
- 35. CDM Project in Mississippi A remote care management (RCM) platform, provides remote access to wellness, education & health care •Daily Health Sessions •Personalized Interventions •Targeted Education •Health Coaching •Behavior Modification •Patient Empowerment
- 36. How can we engage patients?
- 37. Population Health • Predictive Modeling • Risk Stratification to customize care management service • Target high impact patients • Personalized care plans, interventions, and patient education Prevention Well Members Prevention & Disease Management Low Risk Members Disease Management Moderate Risk Members Episodic Case Management High Risk Multiple Disease States Complex Care Inpatient LTC
- 38. • EMR – Health Information Network/Exchange • Pharmacy data • Claims Data • Remote Monitoring devices • “Wearable” data • Patient Reported data The Whole Picture
- 39. Translate to Meaningful & Actionable Data Intervention
- 40. Seldom heard: Mississippi receives A in health care The Clarion-Ledger September 9, 2014 © 2014 University of Mississippi Medical Center
- 41. ? Bridging the gaps in quality healthcare © 2014 University of Mississippi Medical Center
- 42. Steve Fallin Sr. Product Manager NetMotion Wireless
- 43. 43 • • • •
- 45. 45
- 46. Where Are The Mobility Challenges? 46 Visibility Into What’s Really Going On • Troubleshooting in the dark • Always reactive…never ahead of curve Controlling Complex Environments • Multiple applications over multiple networks • Managing business applications on personal devices Productivity of Mobile Workforce & IT Support Team • Application performance not what it should be • Connectivity problems drive high volume of trouble tickets Keeping It Secure AND User Friendly Gartner: Top 10 Strategic Technology Trends 2014 • Mobile Device Diversity & Management • Mobile Apps & Applications • The Internet of Everything • Hybrid Cloud & IT as Service Broker • Cloud/Client Architecture • The Era of Personal Cloud • Software Defined Anything • Web-Scale IT • Smart Machines • 3-D Printing
- 47. 47
- 48. 48 Source: Rsyavy Research, Trends in Enterprise Cellular Network Data Usage, March, 2013
- 49. 49 Before the Mobility pilot we were facing 90•plus trouble tickets a month. At the end of six months, we were down to almost nothing. - Clyde Daisley Systems Engineer Allina Hospitals & Clinics • Clinicians use wireless laptops/tablets • Frequent dropped connections • Frustrated staff were quitting Challenge • Deployed Mobility VPN, Policy Management & Analytics Solution • Patient visits increased 50% • Help Desk tickets dropped from 90+/mo. to virtually nothing • Faster time-to-treatment in emergency room • Lower staff turnover • Hands-off management via policies/notifications/analytics Results
- 50. Questions
- 51. Thank you for joining us! • Thank you for joining us at this FierceLive! Webinar! • This webinar has been recorded and will be available on- demand within 24 hours. You will receive a notice when the recording is up. Sponsor: