mHealth Community Project.Waegemann
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Project
Participatory Health Enabled Through mHealth
C. Peter Waegemann
Vice President
Copyright 2009 mHealth Initiative Inc Boston MA.
All rights reserved.
mHealth Initiative proposes to
Change and improve healthcare through better communication Facilitate healthcare‟s adjustment to the era of cell phones Orchestrate policies, standards, and systems to facilitate the
delivery of healthcare through mobile technologies. Part of this challenge will be the creation of a consensus between payers and providers for better reimbursement for communication.
Address the expected shortage of family physicians by introducing systems that reduce visits through increased use of electronic communication
Enhance access to healthcare throughout the population Create the playing field for competing systems Educate and stimulate people to manage their healthcare and
wellness Improve public health delivery and surveillance
Proposal: A City- or Regional Model Demonstration Project
Based on Participatory Health Encouraging change in people‟s behavior toward health Simultaneous implementation of
New communication patterns PHR on the phone Disease management through communication Guidelines and protocols through browsers Integrate consumer health applications mDevice documentation trials
Optional: Emergency/Ambulance Services Public Health Surveillance Region-wide Appointment System
Project is designed to
Reduce healthcare cost through better communication and a reduction of visits
Improve the quality of care
Reduce disparities in the delivery of healthcare
Encourage young people to live healthier
Make the healthcare system more convenient and efficient
Address the anticipated shortage of family physicians through a system that will facilitate delivery of care through more communication and fewer visits
Project will enable people/patients/consumers to
Better understand their health Manage their essential health data on their cell phone
or other mobile device (mDevice) Improve health through communication with wellness
and care providers 24x7 as needed Participate in an open and transparent decision
process regarding health, health care, and wellness efforts
Participate in financial decisions related to their health Receive more efficient care (easier appointments,
reduced waiting time, less time lost with inefficient visits)
Project will
Link healthcare and wellness providers with one another and with patients/consumers in an unprecedented way within a community to help improve the health conditions of the population.
It will enable providers to Be better prepared for decision making in care issues through
advance information Access guidelines, protocols, disease-specific information at
the point of care Make EMR documentation more efficient and tolerable
through point-of-care documentation options Provide better care through continuous communication with
patients, other providers, and payers Reduce crisis care (that is emergency care) through greater
connectedness with the patient
The project is designed to demonstrate
Meaningful, practical use of the concept of better communication in healthcare
Before and after measures of healthcare costs as influenced by enhanced communication
Savings in healthcare costs through higher efficiency How patients can be motivated to become active partners in
their wellness/health care How young people can be drawn into managing their
wellness/health How disparities in healthcare delivery can be reduced through
improved communication Better and less costly outcomes from disease management
based on ongoing communication in a participatory healthcare environment
mHealth Initiative Role
mHI will be the enabler of the medical community.
It will create the playing field for patients and providers to participate and for companies to compete in providing services.
The outcome of this project could potentially influence the national strategy on health.
What is the mHealth Community?
People: Patients, consumers, children, adults, and seniors, whether healthy or ill, are encouraged to become active participants in their wellness and health matters, including keeping a personal health record; researching and learning about relevant health topics.
Healthcare providers: From hospitals to clinicians, from occupational therapists to chiropractors, from dentists to podiatrists, from long-term caregivers to child development coaches, from home health nurses to school nurses, all those involved in traditional or alternative medicine
Wellness providers: Health coaches, sports and wellness trainers, massage therapists, nutrition therapists and coaches, activity coaches, and others helping people to live healthier
Public health Pharmacies Health plans and payers
First Challenge
How to get people to participate?
Involvement
New communication
Advertising, PR, other motivations
How to change communication? Patients must be stimulated to communicate on a
regular basis.
Providers must be guided to change workflow and systems in order to make such communication time saving and productive.
A new reimbursement system must include adequate payments for communication and accessing resources to guide care.
Security and confidentiality policies and guidelines must be created.
Change of communication
New pre-visit pattern
Continuous communication between patients and caregivers (email and text)
Professional medial information communities
Device data capture and integration
New communication–based nursing systems
Home care and monitoring systems
Project will improve health communication
First, new continuous communication with text, email and voice will supplement and enhance the traditional visit-based communication system.
Second, active participation of all stakeholders with the patient/consumer at the center will replace the physician and hospital-centric care model.
Third, the use of the Internet and its access through mobile phones will facilitate new ways to access, transmit, and document information and reduce disparities in access to and delivery of healthcare
PHR for people
History of PHR
Failures of existing PHR companies
Smart cards, USB drives, CDs – cell phone
Need to educate people
Community coordination
Integration with provider systems Not limited to hospitals and clinics
PHR on the phone
Learning from industry
Creating multiple homes for data
First covering of a region-wide continuity of care project
Implementing Disease Management
Objective: Collect „before and after‟ data
Showcase specific applications
Resources for the provider
Bring more guidelines to the point of care
Project Goals
Changing healthcare through better communication
Helping healthcare to adjust to the era of cell phones
Orchestrating policies, standards, systems
Creating the playing field for competing systems
Educating people why they should manage their health
Project with 6 Parts
1. Continuous Communication
2. PHR on the Phone
3. Guidelines and Protocols at P-o-C
4. Resources for Patients
5. P-o-C Documentation
6. Communication-based Disease Management
Optional - Desirable
7. Emergency Medicine
8. Public Health Surveillance and Notification
9. Regional Appointment System
Part 1: More digital and voice communication will increase the quality of care, reduce visits, and reduce healthcare costs
Goal: Create a health ecosystem that enables better and more communication among and between all healthcare participants – patients/consumers, healthcare providers, wellness providers, and others.
In order to do accomplish this: Patients must be stimulated to communicate on a regular basis.
Providers must be guided to change workflow and systems in order to make such communication time saving and productive.
A new reimbursement system must include adequate payments for communication and accessing resources to guide care.
Security and confidentiality policies and guidelines must be created.
Potential companies that may participate in Part 1
Those providing
Text messaging management systems
Secure email systems
Cell phone systems for seniors
Home care monitoring systems
Patient support communication systems, such as medication reminders, appointment management systems, patient health advice systems, systems that are capturing medical device data, etc.
Part 2: Continuity of care through cell phone-based PHR will create interoperability, reduce medical errors, and reduce costs
mHealth Initiative seeks to encourage all those living within the demonstration project are to have a copy of their PHR accessible through their cell phone.
Consumer can decide which elements of their health status information are to be shared with whom.
More than three quarters of all personal health records (including Google and Microsoft) are based on the Continuity of Care Record data set. For integration into legacy systems, HL7‟s CCD version of the CCR may be used.
Potential companies that may participate in Part 2
Those providing PHR systems that may be accessed through the mobile phone
As there will be several providers, users in the test project will select the system that fits their needs best.
Part 3: Providing guidelines and protocols as well as other relevant information to the caregiver at the point of care through cell phones’ web browsers
The goal is to enable clinicians to use guidelines and protocols at the point of care
mHealth Initiative will work with the vendor community to encourage them to make such information easily available on mDevices.
It will also work with the clinical community to prepare and encourage them to adopt and use the devices as valuable digital assistants.
Potential companies that may participate in Part 3
Those providing access to
Formularies
Guidelines and protocols
Medication selection systems
Physician support
Nursing support
Other resources
Part 4: Encourage people to use new health resources and create the infrastructure for such consumer health resources
mHI will use advertising and PR campaigns to encourage people to use many of the systems currently available to live healthier and to maintain health.
Potential companies that may participate in Part 4
Numerous systems exist today to guide people in regard to medications, nutrition, activity, and other life style issues.
The project will give maximum exposure of such systems to the project community in order to measure their impact.
Part 5: Use of mDevices at the point of care to access information and document into the EMR
Efforts to implement electronic medical record (EMR) systems are challenged by the burden of documentation.
mDevices enable clinicians at the point of care To access relevant information from various
sources including the provider‟s information system
To document patient information
To transmit patient information
Potential companies that may participate in Part 5
Those providing
Phone-based documentation systems
Integration and documentation systems that are mobile phone-based
Input and integration systems for EMRs
Speech recognition systems
Other documentation systems such as display systems that can display the screen content of a mobile phone onto a wall or other surface
Part 6: Communication-based disease management
For diabetes, asthma, hypertension, and other conditions to demonstrate improved quality of care and reduced emergency visits
mHealth Initiative‟s roles in the implementation of disease management programs will be Coordinating their interoperability and integration Educating providers of the possibilities of communication-
based disease management Educating and guiding patients in regard to their new roles
and their benefits Working with providers to implement systems that can handle
communication-based disease management Working with various vendors on the implementation process Measuring and recording benefits and financial outcomes Comparing various approaches for national implementations
Potential companies that may participate in Part 6
Those providing disease management solutions based on better communication and mobile phone use for Diabetes Asthma Hypertension Heart disease Depression Obesity Pregnancy/OB Other conditions
Part 7 (optional): Making relevant information available in the emergency room to increase the quality of care and reduce costs
Emergency medical services (EMS) should convert from paper-based collections of data to mDevice-based collections that can be sent in advance to the Emergency Department.
Any person within the Participatory Health Project should be assured that she can expect to receive healthcare from professionals who are informed about her allergies, medications, and essential health issues and therefore do not have “to act blindly” as in the past.
Potential companies that may participate in Part 7
Those providing
PDA-based systems to capture emergency data
Voluntary patient identification system (VUHID)
Database systems
Emergency Department information systems
Part 8 (optional): Public health surveillance and notification systems to be included in the mHealth community
This optional part includes, but is not limited to Automating selected reports from providers and patients on
their progress in specific conditions that impact the public health, e.g., flu epidemics, HIV/AIDS, TB.
Tapping into a wealth of information within the Participatory Health community
Establishing targeted disease surveillance within the region Designing and implementing systems that can notify people
in case of health emergencies such as cases of bioterrorism and natural disasters.
Improving access to the total population so that traditionally difficult-to-reach segments are not excluded, thereby better enabling them to be aware of and to have access to public health programs.
Potential companies that may participate in Part 8
Those providing
Linkage to public health departments
Management systems for surveillance
Management systems for notification by mobile phone
Part 9 (optional): On-line appointment systems
The proposal is to create a regional database where a patient can search by health plan, medical specialty, disease specialty, and other criteria for a provider.
It should be possible for patients not only to search but to be able to book appointments online.
Potential companies that may participate in Part 9
Those providing
Online systems and database design.
Status
Development
Acceptance
Time frame
Looking for support
Thank you!
C. Peter Waegemann
Vice President for Development, mHI
p.waegemann@mhealthinitiative.org
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