Using Wireless Technology and the Internet to Improve Patient Outcomes.

Using Wireless Technology and the Internet to Improve Patient Outcomes

Wireless Technology

ADRIANNA FUSCO:ADRIANNA FUSCO:

What do we mean by Wireless Technology?

• Pagers

• Cell Phones

• Personal Digital Assistants (e.g. Palm Pilots)

• Other wireless devices

• Plus: Our communication software that connects them to the Internet

Treatment Team

ADRIANNA FUSCO:ADRIANNA FUSCO:

Using wireless technology and the Internet, we create a Treatment Team that includes:

• Physicians

• Pharmacists

• Nurses

• Physicians Assistants

• Caregivers

• Case managers

• Call Centers

Benefits

ADRIANNA FUSCO:ADRIANNA FUSCO:

The Benefits of wireless technology to the treatment team:

• An integrated team approach to patient wellness.

• 24/7 access to patients’ medication and treatment schedules.

• Account access can be as restricted or as networked as determined by an organization.

• Choice of devices and number and types of reminders.

• Affordable cost.

• Treatment team has an extended reach and is more effective.

Patient Outcomes

Definition:The process by which a patient’s disease state is assessed at given points in time.

Improving Patient Outcomes

The process or steps a patient or provider takes in order to facilitate improvement within the patient’s disease state.

• From diagnosis to cure

• Asymptotic state

• Symptomatic disease states

Medication and Appointment Reminders

Who Qualifies?40 million patients who currently take medications

for chronic conditions such as:

• Heart Disease• Asthma• Hepatitis C• Depression• Mental Illness• Organ Transplant

• Epilepsy• Women's

Health• ADD• HIV/AIDS• Cancer Care

According to the AMA, less than 60% of patients take their medications properly.

Medication Reminders

What can they include?

• Reminders for specific doses

• Updated medication schedules

• Prescription refills

• Educational messages

• Psychosocial issues—Individualized

• Side effect management

• Reinforcement of pharmacist’s instructions

• Infinite possibilities…

Appointment Reminders

What can they include?

• Case management follow-ups

• Physician appointments

• Nutritional/Holistic/Wellness appointments

• Upcoming diagnostic testing

• Lab work and scheduling

• Infinite possibilities…

MediMOM Demonstrates Results

MediMOM is being evaluated in a clinical trial at the Fenway Community Health Center in Boston, MA.

The objective of the study is to measure the influence of MediMOM on adherence levels of patients following complicated medication regimes. One half of the patients uses pill diaries, an adherence questionnaire and MEM’s caps; the other half uses MediMOM. Preliminary results show that MediMOM improves adherence more than 20%.

This Study has been accepted for presentation at the 8th Retroviruses Conference, to be held in Chicago in February 2001.

Fenway Study Schematic

MediMOM Group Comparison Group

Monitoring Medications with MEMs Caps

Pre-enrollment Monitoring Period

Week 0: Enrollment, Randomize to Study Condition

Week 2: Short-term Outcome Assessment

Week 12: Follow Up Assessment

Adherence Increase in Fenway Study

-5

0

5

10

15

20

MediMOMGroup

ComparisonGroup

Fenway Community Health

Steven A. Safren, William Johnson, Josh Gagne, & Elizabeth Salomon Harvard Medical School / Massachusetts General Hospital

Response Paging and the Internet

Response Paging and the Internet provide

• Confirmation

• Response

Confirmation

The ability to confirm message receipt/compliance with therapy by using standardized responses of an alphanumeric pager or other wireless device.

• Identifies those patients who are at risk for non-compliance and immediately initiate intervention.

Response Paging and the Internet

Response Paging and the Internet provide

• Confirmation

• Response

Response

The ability to send pre-programmed, customized responses to messages that apply to a specific disease state. Patient manager is alerted if the patient is at risk.

• Side effect management

• Adverse reactions

• Initiate intervention or alternate therapy

Percentage of Patients that Drop Out of Treatment in the First 30 Days

0

20

40

60

80

100

WithoutAdherenceProgram

WithAdherenceProgram

Corporate data based on Hepatitis C Treatment Programs.

Average Length of Treatment Durability

0

2

4

6

8

10

12

WithoutAdherenceProgram

WithAdherenceProgram

Corporate data based on Hepatitis C Treatment Programs.

Patient Monitoring

Customized, Advanced and Proactive

Identification of disease-based symptoms for proactive/preventative intervention.

Examples:

• Heart Disease: Blood pressure, diet, exercise, weight maintenance

• Asthma: Peak flow

• Hepatitis C: Side effect management issues

• Diabetes: Glucose readings, symptoms and diet

• Organ Transplant: Identification of adverse reactions, i.e. signs of rejection

At Risk Patients

1. Identify “at risk” patients within a disease

category.

2. Create proactive intervention.

3. Facilitate better patient outcomes.

Overall Benefits

• Better provider/patient communication

• Patient empowerment

• Increased adherence to treatment

• Improved patient outcomes

Valuable Lessons

What lessons have we learned?

Keeping the process simple:

• Utilize existing technology, including the Internet

• Infinite Scalability

• Confidentiality

• Use wireless device(s) patient may already own

• Create and administer program as part of an overall treatment plan

The Future

• Standard of care

• Critical pathways

• Automated healthcare