The HIMSS mHealth Physician Task Force's How-to-Guide will help both clinicians and C-suite executives identify which mobile tools are needed and worth investing in.
2. HIMSS mHealth
‘How To’ Guide
• David Lee Scher, MD, FACP, FACC, FHRS
• Alisa Niksch, MD
• Megan Ranney, MD, MPH
• Brian Rothman, MD
3. 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
6. Today’s Healthcare Landscape:
New Care Models
•Transitional care
•Remote patient monitoring
•Aging at home
•Participatory medicine: Role of the
caregiver
7. 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
8. 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
9. mHealth and Complex
Care Models
• Complex care implies:
– High frequency of chronic disease states,
comorbidities
– Multiple stakeholders: physicians, healthcare
facilities, payors, patients, caregivers,
– Disparate communication and record keeping
capabilities
– Additive human factors: adherence, cost,
health literacy, mental health issues
10. 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
11. 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
12.
13. 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?
14. 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?
16. 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?
17. 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
18. 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
19. 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
20. Why an mHealth
“How-To” Guide?
To guide implementation of mHealth initiatives to achieve
the Triple Aim*
*Institute for Healthcare Improvement
21. 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
22. The NQS: How does
mHealth fit in?
• 6 priorities for U.S. healthcare quality:
Patient Safety
Person and Family-
Centered Care
Effective
communication and
Care Coordination
Prevention and
treatment of leading
causes of mortality
Health and Well-Being Affordable Care
23. mHealth & the NQS
• How can mHealth improve Patient Safety?
Patient Safety
Person and Family-
Centered Care
Effective
communication and
Care Coordination
Prevention and
treatment of leading
causes of mortality
Health and Well-Being Affordable Care
24. 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
discharged
25. mHealth & the NQS
• How can mHealth create patient-centric care? How can
mHealth streamline communication?
Patient Safety
Person and Family-
Centered Care
Effective
Communication and
Care Coordination
Prevention and
treatment of leading
causes of mortality
Health and Well-Being Affordable Care
26. 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.
27. mHealth & the NQS
• How can mHealth encourage/sustain healthy lifestyle
habits? How can mHealth help manage chronic disease?
Patient Safety
Person and Family-
Centered Care
Prevention and
treatment of leading
causes of mortality
Health and Well-Being Affordable Care
Effective
communication and
Care Coordination
28. 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)
29. mHealth & the NQS
• Will mHealth achieve reduced cost of care?
Patient Safety
Person and Family-
Centered Care
Effective
communication and
Care Coordination
Prevention and
treatment of leading
causes of mortality
Health and Well-Being Affordable Care
30. 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
32. 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
33. 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
34. 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.,…
35. 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
36. 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
