himss mhealth "how to" guide

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HIMSS Mobile “How To” Guide HIMSS Physician mHealth Task Force

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Page 1: HIMSS mHealth "How To" Guide

HIMSS Mobile “How To” Guide

HIMSS Physician

mHealth Task Force

Page 2: HIMSS mHealth "How To" Guide

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

Page 3: HIMSS mHealth "How To" Guide

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

Page 4: HIMSS mHealth "How To" Guide

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

Page 5: HIMSS mHealth "How To" Guide

•ACOs

•Mega-merged organizations

•Retail medical care

Today’s Healthcare Landscape:

New Business Models

Page 6: HIMSS mHealth "How To" Guide

•Bundled payments

•Risk/Gain sharing

•Readmission penalties

Today’s Healthcare Landscape:

New Payment Models

Page 7: HIMSS mHealth "How To" Guide

Today’s Healthcare Landscape:

New Care Models

•Transitional care

•Remote patient monitoring

•Aging at home

•Participatory medicine: Role of the

caregiver

Page 8: HIMSS mHealth "How To" Guide

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

Page 9: HIMSS mHealth "How To" Guide

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

Page 10: HIMSS mHealth "How To" Guide

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

Page 11: HIMSS mHealth "How To" Guide

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

Page 12: HIMSS mHealth "How To" Guide
Page 13: HIMSS mHealth "How To" Guide

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?

Page 14: HIMSS mHealth "How To" Guide

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?

Page 15: HIMSS mHealth "How To" Guide

Why an mHealth “How-To” Guide? The C-Suite

Page 16: HIMSS mHealth "How To" Guide

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?

Page 17: HIMSS mHealth "How To" Guide

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

Page 18: HIMSS mHealth "How To" Guide

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

Page 19: HIMSS mHealth "How To" Guide

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

Page 20: HIMSS mHealth "How To" Guide

Why an mHealth “How-To” Guide?

To guide implementation of mHealth initiatives to achieve the Triple Aim*

*Institute for Healthcare Improvement

Page 21: HIMSS mHealth "How To" Guide

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

Page 22: HIMSS mHealth "How To" Guide

The NQS: How does mHealth fit in?

• 6 priorities for U.S. healthcare quality:

Patient SafetyPerson and Family-

Centered Care

Effective

Communication and

Care Coordination

Prevention and

treatment of leading

causes of mortality

Health and Well-Being Affordable Care

Page 23: HIMSS mHealth "How To" Guide

mHealth & the NQS

• How can mHealth improve Patient Safety?

Patient SafetyPerson and Family-

Centered Care

Effective

communication and

Care Coordination

Prevention and

treatment of leading

causes of mortality

Health and Well-Being Affordable Care

Page 24: HIMSS mHealth "How To" Guide

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

Page 25: HIMSS mHealth "How To" Guide

mHealth & the NQS• How can mHealth create patient-centric care? How can

mHealth streamline communication?

Patient SafetyPerson and Family-

Centered Care

Effective

Communication and

Care Coordination

Prevention and

treatment of leading

causes of mortality

Health and Well-Being Affordable Care

Page 26: HIMSS mHealth "How To" Guide

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.

Page 27: HIMSS mHealth "How To" Guide

mHealth & the NQS• How can mHealth encourage/sustain healthy lifestyle

habits? How can mHealth help manage chronic disease?

Patient SafetyPerson and Family-

Centered Care

Prevention and

treatment of leading

causes of mortality

Health and Well-Being Affordable Care

Effective

communication and

Care Coordination

Page 28: HIMSS mHealth "How To" Guide

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)

Page 29: HIMSS mHealth "How To" Guide

mHealth & the NQS

• Will mHealth achieve reduced cost of care?

Patient SafetyPerson and Family-

Centered Care

Effective

communication and

Care Coordination

Prevention and

treatment of leading

causes of mortality

Health and Well-Being Affordable Care

Page 30: HIMSS mHealth "How To" Guide

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

Page 31: HIMSS mHealth "How To" Guide

mHealth Technology’s Role

•Technologies are not magic bullet

solutions… but tools which can

aid in the creation of effective care

coordination models

Page 32: HIMSS mHealth "How To" Guide

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

Page 33: HIMSS mHealth "How To" Guide

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

Page 34: HIMSS mHealth "How To" Guide

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.,…

Page 35: HIMSS mHealth "How To" Guide

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

Page 36: HIMSS mHealth "How To" Guide

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

Page 37: HIMSS mHealth "How To" Guide

Digital Health Technology Selection Framework

Page 38: HIMSS mHealth "How To" Guide

• 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

Page 39: HIMSS mHealth "How To" Guide

THANK YOU