mHealth Networking Conference

February 3, 2010

Claudia Tessier RHIA

CEO and President
mHealth Initiative

Copyright 2010 mHealth Initiative Inc., Boston MA. All rights reserved.
 Worldwide mobile subscriber base >4 billion
 Compare that to:
◦ Landline phones: 1.2 billion
◦ TV sets in use: 1.4 billion
◦ Registered automobiles: 850 million
◦ People using PCs: 950 million
◦ Access to internet: 1.3 billion
◦ People with at least 1 credit card: 1.5 billion population
has a mobile phone).
 Devices – thousands including
◦ Apple iPhone
◦ Droid
◦ Blackberry Curve and Storm
◦ HTC Touch HD and HTC Pro
◦ Palm
◦ Samsung
◦ Sony Ericson
 Estimated 5000 mHealth apps available over range
of devices
◦ Over 3700 clinical
◦ Over 1000 consumer
◦ But not all apps available on all phones
mHealth 12 Application Clusters
Before visit
◦ Selecting caregiver
◦ Pre-visit communication
 Text message
 Email Post-visit and between visits
 Photos
◦ Appointment requests,
scheduling, reminders
◦ Appointment agenda
◦ Administrative inquiries
◦ Insurance info
◦ Demographic data
◦ Advance check-in
◦ PHR (CCR)
During visit
◦ Patient education
◦ Financial and administrative
◦ Care communication
◦ Text messages
◦ Email
◦ PHR (CCR)
◦ Medication reminders
◦ Health promotion
◦ Questions (with photos if
applicable)
◦ Patient education
◦ Disease management
◦ Resources
 Appointments
 Medication reminders
 General inquiries
 Administrative questions
 Non-healthcare related communication
 Health promotion
 Patient-initiated communication
◦ Need to reschedule appointment
◦ Need for prescription refill, etc.
Programs like the airlines’ “Remember Me”
provide
◦ A direct path to information about you when calling
from a phone number pre-registered with your
provider.
◦ The system recognizes your phone number,
instantaneously pulls up your information and even
greets you by name.
◦ All of this information is available within a few seconds
at the beginning of the call
 More communication between clinician and
patient leads to
◦ Better quality of care
◦ Greater continuity of care
◦ Greater efficiency
◦ Fewer visits
◦ Lower costs
 Communications must be clear and
customizable (usability)
 Both parties need acknowledgement
 New workflow, parameters and protocols
required
 New reimbursement system must be considered
 New ID systems can help: Photo and
“Remember me”
 Patient ID
 Structured communication
 Security/confidentiality
 Provider workflow issues
Medical reminders are sent to the patient’s
mobile phone, and questions are answered by
simply pressing buttons or using voice response.
The messaging functionality continues to work,
even if out of network range.
Patients have the option of using a GenerationOne-
provided phone or approved mobile devices.

Patients input test results directly into the

mobile phone.

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The patient responses automatically populate
the Dashboard and Patient Health Record.

• Dashboard - Provides real-time monitoring, tracking and

trending by health plan and authorized constituents.

• PHR - Can receive data from EMRs and lab facilities.

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InTouch Clinical

Appointment
Reminders
Your next
appointment with
Dr. Divish is on
04-14-
2009.Please
respond YES or
NO to indicate if
you can attend
 Good afternoon Kelly,
how are you feeling
today? Please let us
Wellness Interaction
know with an “A” for Don't Ask
Great, “B” for OK or
“C” Don’t Ask

Automated Delivery

Reports Patient
Record

© 2010 Life:WIRE Corp PATENT PENDING JANUARY 2010

Jitterbug – phones for seniors
Portable Health Device
www.PortableHealthDevice.com
 Provider directories – and directions
 Urgent care centers
 Formularies
 Guidelines and protocols
 Decision support
 Telemedicine guidelines
 Accessing specific CCR information
 Patient’s comments re Web
 Patient directives
 PHR
For providers and patients
 iTriage
Notes
User follows symptoms
to “Possible Cause”
Geolocation used to
then selects
provide access and
description, tests,
directions to:
symptoms, treatment,
-Hospitals
search web or find a
-Physicians
provider
-Urgent Care
-Centers
Available on other
-Retail Clinics
mobile platforms and
the desktop
Directs consumers to
most appropriate level of
www.itriagehealth.com
care given symptoms

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iSEEK Medical Mobile™
Evidence Based Medicine at the
Point-of-Care for Clinicians

Results
categorized by
topic, source, and
MeSH

Selected Topic
to Drill Down

Scroll down to
view results
◦ The promise of EMRs at your
fingertips anywhere, anytime

 Access patient history in real-time

 Document (capture patient information
capture and generate report) in real-time
 Transmit patient information in real-time
 Navigate patient information in real-time
Real-time, point-of-care
information capture!!!

Is documentation
like this acceptable
anywhere other
than in healthcare?
• Legibility
• Structure
• Meaning
• Completeness

Confidential!
“Handy” – and Mobile!
Handheld
Device?
 Accuracy
 Authentication
 Interoperability
◦ mDevices to HIS and EMR
◦ Medical devices wireless communication
 EMC
 Data integrity
 Interoperability
 From internal system
 From a Website
 From the phone card
 Currently focused on
◦ Diabetes
◦ Asthma
◦ Dermatology
◦ Preventive care in pregnancy
◦ Smoking cessation
◦ Hypertension
◦ Weight control
 Many variations
 Applications
◦ Parents to monitor their children
◦ Patients to monitor and report their health
data
• View data in graphical format,
clearly showing where range
should be

• See a High/Low alert for

readings out of range with
prompts to enter contextual
information

• Medication notepad shows med

changes as flag on graph, to
correlate with readings

• Helps patients begin to associate

readings with lifestyle and other
factors
Blood Sugar Too Low Instructions to Eat Something

Tip after eating and retaking the blood sugar reading

 One Touch
Ultra Series

Ultra Ultra 2 Ultra Mini

Also supports
these blood
glucose
meters

Abbott
Bayer Contour
FreeStyle Lite
 Bluetooth-enabled
Scale

Supports scale measurements for weight loss programs

Tele-Medicine - Products
Temp
BP
ECG
Resp
Pulse

Vital Sign Monitoring

High Risk Pregnancy

Delivery

Remote Cardiac Monitoring

 FDA approval
 Proof of ROI
 Collection of projects/experiences
◦ Aggregation of data
 Teaching, monitoring, coaching…
 New applications in nursing and other
areas
 Teaching patients self-care,
monitoring, expectations
 Need standards
 Preferred communication channels for
lab, pharmacy, etc.
 Colleagues
◦ Specialty-specific communities
◦ Disease-specific experiences
◦ Ask the expert!
 Provider-patient  Asset tracking
applications ◦ Surgical instruments
 Financial data
◦ Medical records
 Demographic data
 Non-clinical data ◦ Equipment
 Appointments  Patient flow
 Self check-in management
 Reminder ◦ Scheduling
 Staff communication ◦ Admissions and
 Internal discharges
 External ◦ Bed management
 Third parties
 Payers
 Labs
 Other providers
 Charge capture
 Providers accessing eligibility info
 Providers sending bills
 Patients accessing coverage and co-pay
information
 Payers in active communication with patients
and providers
 Online real-time adjudication
 For EMS and the ED
◦ Not starting with a “blank sheet”
◦ Advance triage
◦ Substantial cost reductions expected
◦ San Diego experience
 For patients themselves
◦ Emergency self-care
◦ First aid
Thanks to http://www.iphonesavior.com/

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 Reporting of disease outbreaks
◦ Swine flu, for example
 Alerting providers
 Instructing patients
 Bioterrorism
 Surveillance
 Population notifications
 Increasing adoption in developing countries
 Other
 Clinical trials
◦ Automatic, scheduled and ad hoc
information transmission
◦ Rely on instrument rather than patient for
routine data collection
◦ Patient feedback systems
 Patient-led “clinical trials”
 Mobile wearable or implanted sensors that
monitor vital body parameters and
movements and wirelessly transmit data
from the body to provider or elsewhere via
a home base
 Examples
◦ Heart monitor could alert pending heart attack
◦ Auto-inject insulin
◦ Sports activity monitoring: speed, distance,
heart rate, blood pressure
 Big issue: Security
Tele-Medicine - Products
 Develop online resource to record and
access information about mApps
◦ By application cluster
◦ By device
◦ By disease
◦ Information from vendors
◦ Information and feedback from users
 Are there more than 12 clusters?
 www.mobih.org
claudia@mobih.org
617-816-7513