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The Patient’s Back-up Brain
                                       A Mobile Health Future

                                   mHealth Initiative June 2009

               Presented by Edward A Stern, RN
                   Clinical Informatics Lead
     George Washington University Medical Faculty Associates


Presented by Edward A, Stern, RN
  ed.stern@nothingbetter.com
About Your Presenter
               • Informatics Nurse for GW Medical Faculty
                 Associates
                         – 500+ Physician teaching practice (plus Residents and
                           Student) with more than 40 clinical specialties in
                           multiple locations, serving the entire Washington DC
                           metro area
                         – Treat an estimated 4,600 patients a day
               • Developed the “Back-up Brain” education series
                 for Clinical professionals
               • Patented consumer “usability” research model
               • Former clinical informatics consultant
Presented by Edward A, Stern, RN
  ed.stern@nothingbetter.com
What is a “Back-up Brain”?
               • Any kind of “device” which:
                         – Helps keeps us in our daily routine
                         – Allows us to reference complex data
                           points
                         – Enables us to “Think, Process and
                           Clear”
                                   • “Stream of consciousness” thinking via;
                                     notes, reminders, etc which pop in get
                                     recorded and cleared for the next..


Presented by Edward A, Stern, RN
  ed.stern@nothingbetter.com
The Mobile Device Market
             • The UN Reports that more than half the
               world population has a mobile phone
                        – Less than a quarter of the world
                          population has Internet access

             • A mobile phone is by it’s very nature
               designed to be a “consumer usable”
               device (so it’s relatively easy to operate)

             • The mobile phone market is available to
               all and tends to level all socio-economic
               groups and age barriers


Presented by Edward A, Stern, RN
  ed.stern@nothingbetter.com
Powerful Consumer Centric
                                    Mobile Market in the US
             • In 2008, 89% of the US population, are mobile phone
               subscribers (>270 million), according to a research study
                        – 15 million more than 2007
             • 1 trillion text messages during 2008 were sent in the US
                        – Triple the number of texts in 2007
                            • 620 billion texts were sent during the second half of 2008
             • Total volume of texting averages 3.5 billion
               per day.
                        – That's 13 messages per person, per day
             • Total wireless revenues in 2008 came to
               $148 billion
                        – $9 billion more than 2007
                                               Source: CTIA President Steve
Presented by Edward A, Stern, RN               Largent, April 2009, Annual Conference
  ed.stern@nothingbetter.com
Playin’ the Patient Averages
               • The mobile phone has changed how the
                 “average human” communicates
                         – 89% of the US population has a cell phone


               • The “average patient” desires to be an active
                 participant in their medical care, but the
                 process is often complex and time consuming
                         – 96% preferred to be offered choices and to be asked
                           their opinions
                                     – J Gen Intern Med. 2005 June; 20(6): 531–535
Presented by Edward A, Stern, RN
  ed.stern@nothingbetter.com
Playin’ the Patient Averages
                 • 54% are actively putting effort into learning more
                   about their personal health”
                 • 64% say they would be interested in using an ”in-
                   home” medical device that could help them know
                   what to do and when
                 • 44% express interest in programs and tools such as
                   health diaries and education
                 • 37% say they are interested in using oniline tools
                   that could help them assess, monitor and manage
                   their health
                 • 68% are interested in home monitoring devices that
                   enable them to check their condition and send
                   results to their doctor
                                            Source: 2009 Survey of Health Care Consumers – Deloitte Center for Health Solutions
Presented by Edward A, Stern, RN
  ed.stern@nothingbetter.com
The Mobile Health Opportunity
                                 “mHealth”


                                                     Patient




                                          Provider


                                                            Mobile
                                                          Technology




Presented by Edward A, Stern, RN
  ed.stern@nothingbetter.com
3 Point Cycle of
                                       Patient Centric mHealth
                                    Reference and
                                       message
                                   solutions for the
                                        patient
                                                        Growth of the
                                                          Patient and
                                                           Provider
                                                         relationship;
                                                          resulting in
                                   Applications to     improved health
                                    remind and
                                     engage the
                                      patient in
                                    personalized
                                        care

Presented by Edward A, Stern, RN
  ed.stern@nothingbetter.com
Solutions must be
                                   patient and market driven
               • 270 million text enabled phones in the US
                         – Simple communicator with a great deal of flexibility
                           and versatility
               • Almost 10 million Blackberry Users +
               • Almost 7 million Windows based phones +
               • Approximately 5.4 Million iPhone devices sold +
                         – Almost 1 billion iPhone applications downloaded
                         – 38% of mobile internet market share (Source: BusinessWeek 5/26/09)
               • Strong presence of market segment for 3rd party
                 vendors                                           + (Source; Comscore via Softpedia May 6, 2009)

Presented by Edward A, Stern, RN
  ed.stern@nothingbetter.com
Where do we start go from here?
               • Determine your patient market segment
                         – Get and classify patient mobile numbers in
                           practices
               • Simply offering help and suggest current 3rd
                 party standalone solutions:
                         – Track your BP, Hgb A1C, blood sugar
                         – Medication reminder apps
                         – Diet diaries/trackers/calculators
                         – Exercise diaries/trackers
Presented by Edward A, Stern, RN
  ed.stern@nothingbetter.com
Quickly moving forward
               • Consider voice options
                         – Televox to mobile phone with patient care
                           updates as simple entry level solutions
               • Text message options
                         – Appointment reminders
                         – Medication reminders
                                   • Pilot program at GW reminding cardiac patients when
                                     to take critical meds
                         – Text to dB options
                                   • Have patients text their Glucose

Presented by Edward A, Stern, RN
  ed.stern@nothingbetter.com
Integrated solutions
               • 3rd party apps directly from phone into MD EMR and patients
                 PHR
                         – Vitals, Medication reminder and use, home testing reference
                           numbers
                         – Appointment scheduling
               • MD and EMRs “to” the mobile device (and PHR)
                         – Consults on medication adjustments based on results sent
                           dynamically from the device
               • Home testing systems using mobile technology direct to the MD
                 (and EMR/PHR)
                         – Hgb A1C, blood sugar, and other home devices
               • Integrated devices
                         – Phone “is” the testing device
               • Emergency care information access
                         – Break the glass solutions on the patient phone for the
                           CCR/EMR/PHR

Presented by Edward A, Stern, RN
  ed.stern@nothingbetter.com
Conclusion The Next Steps
               • Patient population is ready and waiting
               • Industry moves
                         – mHealth Initiative
                         – Move towards HIT (ARRA etc)
               • Start simple and small and move forward




Presented by Edward A, Stern, RN
  ed.stern@nothingbetter.com
Contact
               • Edward A Stern, RN
                         – ed.stern@nothingbetter.com
                         – www.nothingbetter.com


               • This presentation is available on SlideShare
                         – www.slideshare.net/nothingbetter




Presented by Edward A, Stern, RN
  ed.stern@nothingbetter.com

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The Patient’S Back Up Brain

  • 1. The Patient’s Back-up Brain A Mobile Health Future mHealth Initiative June 2009 Presented by Edward A Stern, RN Clinical Informatics Lead George Washington University Medical Faculty Associates Presented by Edward A, Stern, RN ed.stern@nothingbetter.com
  • 2. About Your Presenter • Informatics Nurse for GW Medical Faculty Associates – 500+ Physician teaching practice (plus Residents and Student) with more than 40 clinical specialties in multiple locations, serving the entire Washington DC metro area – Treat an estimated 4,600 patients a day • Developed the “Back-up Brain” education series for Clinical professionals • Patented consumer “usability” research model • Former clinical informatics consultant Presented by Edward A, Stern, RN ed.stern@nothingbetter.com
  • 3. What is a “Back-up Brain”? • Any kind of “device” which: – Helps keeps us in our daily routine – Allows us to reference complex data points – Enables us to “Think, Process and Clear” • “Stream of consciousness” thinking via; notes, reminders, etc which pop in get recorded and cleared for the next.. Presented by Edward A, Stern, RN ed.stern@nothingbetter.com
  • 4. The Mobile Device Market • The UN Reports that more than half the world population has a mobile phone – Less than a quarter of the world population has Internet access • A mobile phone is by it’s very nature designed to be a “consumer usable” device (so it’s relatively easy to operate) • The mobile phone market is available to all and tends to level all socio-economic groups and age barriers Presented by Edward A, Stern, RN ed.stern@nothingbetter.com
  • 5. Powerful Consumer Centric Mobile Market in the US • In 2008, 89% of the US population, are mobile phone subscribers (>270 million), according to a research study – 15 million more than 2007 • 1 trillion text messages during 2008 were sent in the US – Triple the number of texts in 2007 • 620 billion texts were sent during the second half of 2008 • Total volume of texting averages 3.5 billion per day. – That's 13 messages per person, per day • Total wireless revenues in 2008 came to $148 billion – $9 billion more than 2007 Source: CTIA President Steve Presented by Edward A, Stern, RN Largent, April 2009, Annual Conference ed.stern@nothingbetter.com
  • 6. Playin’ the Patient Averages • The mobile phone has changed how the “average human” communicates – 89% of the US population has a cell phone • The “average patient” desires to be an active participant in their medical care, but the process is often complex and time consuming – 96% preferred to be offered choices and to be asked their opinions – J Gen Intern Med. 2005 June; 20(6): 531–535 Presented by Edward A, Stern, RN ed.stern@nothingbetter.com
  • 7. Playin’ the Patient Averages • 54% are actively putting effort into learning more about their personal health” • 64% say they would be interested in using an ”in- home” medical device that could help them know what to do and when • 44% express interest in programs and tools such as health diaries and education • 37% say they are interested in using oniline tools that could help them assess, monitor and manage their health • 68% are interested in home monitoring devices that enable them to check their condition and send results to their doctor Source: 2009 Survey of Health Care Consumers – Deloitte Center for Health Solutions Presented by Edward A, Stern, RN ed.stern@nothingbetter.com
  • 8. The Mobile Health Opportunity “mHealth” Patient Provider Mobile Technology Presented by Edward A, Stern, RN ed.stern@nothingbetter.com
  • 9. 3 Point Cycle of Patient Centric mHealth Reference and message solutions for the patient Growth of the Patient and Provider relationship; resulting in Applications to improved health remind and engage the patient in personalized care Presented by Edward A, Stern, RN ed.stern@nothingbetter.com
  • 10. Solutions must be patient and market driven • 270 million text enabled phones in the US – Simple communicator with a great deal of flexibility and versatility • Almost 10 million Blackberry Users + • Almost 7 million Windows based phones + • Approximately 5.4 Million iPhone devices sold + – Almost 1 billion iPhone applications downloaded – 38% of mobile internet market share (Source: BusinessWeek 5/26/09) • Strong presence of market segment for 3rd party vendors + (Source; Comscore via Softpedia May 6, 2009) Presented by Edward A, Stern, RN ed.stern@nothingbetter.com
  • 11. Where do we start go from here? • Determine your patient market segment – Get and classify patient mobile numbers in practices • Simply offering help and suggest current 3rd party standalone solutions: – Track your BP, Hgb A1C, blood sugar – Medication reminder apps – Diet diaries/trackers/calculators – Exercise diaries/trackers Presented by Edward A, Stern, RN ed.stern@nothingbetter.com
  • 12. Quickly moving forward • Consider voice options – Televox to mobile phone with patient care updates as simple entry level solutions • Text message options – Appointment reminders – Medication reminders • Pilot program at GW reminding cardiac patients when to take critical meds – Text to dB options • Have patients text their Glucose Presented by Edward A, Stern, RN ed.stern@nothingbetter.com
  • 13. Integrated solutions • 3rd party apps directly from phone into MD EMR and patients PHR – Vitals, Medication reminder and use, home testing reference numbers – Appointment scheduling • MD and EMRs “to” the mobile device (and PHR) – Consults on medication adjustments based on results sent dynamically from the device • Home testing systems using mobile technology direct to the MD (and EMR/PHR) – Hgb A1C, blood sugar, and other home devices • Integrated devices – Phone “is” the testing device • Emergency care information access – Break the glass solutions on the patient phone for the CCR/EMR/PHR Presented by Edward A, Stern, RN ed.stern@nothingbetter.com
  • 14. Conclusion The Next Steps • Patient population is ready and waiting • Industry moves – mHealth Initiative – Move towards HIT (ARRA etc) • Start simple and small and move forward Presented by Edward A, Stern, RN ed.stern@nothingbetter.com
  • 15. Contact • Edward A Stern, RN – ed.stern@nothingbetter.com – www.nothingbetter.com • This presentation is available on SlideShare – www.slideshare.net/nothingbetter Presented by Edward A, Stern, RN ed.stern@nothingbetter.com