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mHealth & the Provider Experience
     Harnessing mHealth to improve the patient relationship



                                                 Luca M. Sergio

                                            LMSergio@gmail.com
                                               Twitter: @LMSergio
                                          Mobile: +1-201-744-3364
Luca Sergio
•   CEO of ophthalmic marketing
    communications firm, Ethis
    Communications

•   Industry experience: technology
    commercialization and strategy

•   Ophthalmology, dentistry, infection control

•   Healthcare IT

•   Catalyst behind 1st mHealth app and
    miniPACS cloud system in eyecare:
    EyeRoute® Synergy (Topcon Medical
    Systems)

•   mHealth advocate

                                                  [mHealth & the Provider] : [April 2013]
Objectives for this evening

• Understanding of mHealth
• How it applies to the provider and the patient
• Deeper dive on some of the technology
• Trends
• Key needs
• An overview of what’s coming



                                             [mHealth & the Provider] : [April 2013]
what is mHealth?
Mobile healthcare (mHealth) is “the biggest technology breakthrough of our time
 [being used] to address our greatest national challenge”, said US Health and
                 Human Services Secretary, Kathleen Sebelius

  mHealth is defined as the provision of healthcare or health-related information
   through the use of mobile devices (typically mobile phones, but also other
 specialized medical mobile devices, like wireless monitors). Mobile applications
  and services can include, among other things, remote patient monitors, video
conferencing, online consultations, personal healthcare devices, wireless access
                      to patient records and prescriptions.




                                                      [mHealth & the Provider] : [April 2013]
what is mHealth?

                     $11.5 billion in
   $23 billion
                       pervasive                $6.6 billion in
 global market
                       mHealth                    devices
    by 2017
                        services



         http://www.emdt.co.uk/article/jvosinterview




                                         [mHealth & the Provider] : [April 2013]
who is mHealth? data exchanged between
all




                          [mHealth & the Provider] : [April 2013]
what makes up mHealth?




                    [mHealth & the Provider] : [April 2013]
example - ophthalmology




                    [mHealth & the Provider] : [April 2013]
example - ophthalmology




                    [mHealth & the Provider] : [April 2013]
example - cardiology




                       [mHealth & the Provider] : [April 2013]
example – enterprise Health IT –
apps, interoperability, BI/analytics




                        [mHealth & the Provider] : [April 2013]
example - diabetes




                     [mHealth & the Provider] : [April 2013]
example – vital signs monitoring




                      [mHealth & the Provider] : [April 2013]
example – infection control




                      [mHealth & the Provider] : [April 2013]
example – secure communications




                    [mHealth & the Provider] : [April 2013]
example – new patient scheduling




                     [mHealth & the Provider] : [April 2013]
example – patient education




                      [mHealth & the Provider] : [April 2013]
example – remote pediatric care




                      [mHealth & the Provider] : [April 2013]
example – mobileRx of healthapps




                     [mHealth & the Provider] : [April 2013]
example – infection control




                      [mHealth & the Provider] : [April 2013]
what should mHealth drive?
               Alignment with Meaningful Use
               Stage 2 behavioral
               requirements
               mHealth 2.0 is all about driving
               behavioral change (patient &
               provider) via mobility of
               systems
               mHealth 1.0 was an app for an
               app's sake


                          [mHealth & the Provider] : [April 2013]
key mHealth macro opportunities
Chronic disease (chronic heart failure, chronic obstructive
 pulmonary disorder, diabetes) - 75% of US healthcare
                       spending
                   Behavioral change
        Intelligent systems to handle data deluge




                                       [mHealth & the Provider] : [April 2013]
mHealth trends
         Cell phone subscribers constitute largest distribution
         system for healthcare info
         Anytime, anywhere, any device
         Initial enthusiasm focused on apps and fitness
         sensors, focus now shifting to mobile enabled
         services that drive meaningful change
         Focus on quality of care, patient retention, and
         patient communication
         Recent VA & NHS studies evidence cost reductions
         via mHealth
         Continued lack of interconnection between data silos
         & consequent emergence of meta-systems to access
         disparate data silos

                                     [mHealth & the Provider] : [April 2013]
mHealth trends
 While buzz is about mHealth & Health 2.0 systems, the
real change agent will be the data ... But they must be
actionable, with low latency, and within feedback loop
Meanwhile, MDs suffer from a data deluge
Newer IT players displacing older, legacy systems
MD & consumer adoption of mobile devices plus patient
expectations of "now" creating pressure for new data
dialogue and new clinical insights
Greater patient involvement will revolutionize care
Aging at home must be a priority
Reimbursement models emerging in US with alignment to
quality of care


                                                      [mHealth & the Provider] : [April 2013]
key provider needs


                                          Focused on
                                        closing specific
Instantaneous       Mobilized,
                                          compliance
view of patient   eased workflow
                                           loops with
                                             patient




                                   [mHealth & the Provider] : [April 2013]
key patient needs


    Self care
                                         Easily closing
information, but
                   24/7 access to       compliance loop
  connected to
                     providers            for MD care
valued partner:
                                          instructions
      MD




                                    [mHealth & the Provider] : [April 2013]
problems to avoid


                Wasting time to
   Adding
                 learn a non-              Non HIPAA
complexity to
                    intuitive              compliance
  workflow
                   interface




                                  [mHealth & the Provider] : [April 2013]
barriers to broad adoption


                                          Lack of
               Reimbursement         interoperability
 Regulatory
                 / business            with existing
 uncertainty
                   models               Health IT
                                         systems




                               [mHealth & the Provider] : [April 2013]
FDA/EU, Congress, & certification

FDA & EU                                    US Congress                                      Certification
• FDA guidance document not finalized       • 3 days of recent hearings                      • Question: “Is this app medically valid?”
  (7/21/2011) – perhaps by 2013?            • House Committee on Energy &                    • “Is it useful, standardized and accurate?”
• Debate on device / app classification       Commerce                                       • Happtique Health App Certification
  continues                                 • Inconclusive                                     Program (a CCHIT for mHealth)
• EU debating as well – most apps Class 1   • Raised awareness and scrutiny
• Hindering innovation?                     • Focus on patient benefits, regulation, and
• Issues:                                     spurring innovation
  • Re-representing data                    • Rep. Mike Honda (D-CA) “Healthcare
  • Clinical Decision Support                 Innovation & Marketplace Technologies
  • Controlling a device                      Act” (HR 6626) to be introduced again to
                                              2013 Congress:
  • Creation of alarms
                                              • “FDA Office of Wireless Health”
  • Quality systems requirements
                                              • Innovation fund
                                              • Reducing barriers to entry
                                              • Financing to MDs for adoption




                                                                                           [mHealth & the Provider] : [April 2013]
what does the future hold?
           1.Sensors, smartphone sleds & attachments
           2.Apps, Cloud Systems, and Interfaces with broader Health IT
           3.Big Data, Predictive Analytics, Modeling Tools, & Business
            Intelligence Dashboards
           4.Clinical Decision Support systems
           5.Remote Patient Monitoring / Patient Centered Home / Telemedicine
           6.Communications / Healthcare Social Media / Collaboration tools
           7.Middleware for national patient IDs
           8.Patient Communication & Self-Service - Patient Portals, Databases,
            Apps, & Kiosks
           9.Explicit services linked to a Mayo Clinic-type org / Hub & Spoke
           10.Quantified Self / Fitness devices
           11. Platform as a service: enabling workflow & data across multiple
            devices


                                                  [mHealth & the Provider] : [April 2013]
a vision of a connected future –
from Kaiser Permanente…




                       [mHealth & the Provider] : [ April 2013]
mHealth influencers & resources
             www.MobiHealthNews.com
             www.Happtique.com
             www.mhealthsight.com
             www.HealthcareMobile.com
             Dr. Eric Topol, @EricTopol
             Dr. Ruchi Dass, @drruchibhatt
             Dr. David Lee Sherer, @dlschermd
             Paul Sonnier, @Paul_Sonnier
             Wireless Health group on LinkedIn
             Luca Sergio, @LMSergio

                             [mHealth & the Provider] : [April 2013]
For more conversation…
    Please reach out to me at any time



                                     Luca M. Sergio

                                 LMSergio@gmail.com
                                    Twitter: @LMSergio
                               Mobile: +1-201-744-3364

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mHealth & the Medical Provider

  • 1. mHealth & the Provider Experience Harnessing mHealth to improve the patient relationship Luca M. Sergio LMSergio@gmail.com Twitter: @LMSergio Mobile: +1-201-744-3364
  • 2. Luca Sergio • CEO of ophthalmic marketing communications firm, Ethis Communications • Industry experience: technology commercialization and strategy • Ophthalmology, dentistry, infection control • Healthcare IT • Catalyst behind 1st mHealth app and miniPACS cloud system in eyecare: EyeRoute® Synergy (Topcon Medical Systems) • mHealth advocate [mHealth & the Provider] : [April 2013]
  • 3. Objectives for this evening • Understanding of mHealth • How it applies to the provider and the patient • Deeper dive on some of the technology • Trends • Key needs • An overview of what’s coming [mHealth & the Provider] : [April 2013]
  • 4. what is mHealth? Mobile healthcare (mHealth) is “the biggest technology breakthrough of our time [being used] to address our greatest national challenge”, said US Health and Human Services Secretary, Kathleen Sebelius mHealth is defined as the provision of healthcare or health-related information through the use of mobile devices (typically mobile phones, but also other specialized medical mobile devices, like wireless monitors). Mobile applications and services can include, among other things, remote patient monitors, video conferencing, online consultations, personal healthcare devices, wireless access to patient records and prescriptions. [mHealth & the Provider] : [April 2013]
  • 5. what is mHealth? $11.5 billion in $23 billion pervasive $6.6 billion in global market mHealth devices by 2017 services http://www.emdt.co.uk/article/jvosinterview [mHealth & the Provider] : [April 2013]
  • 6. who is mHealth? data exchanged between all [mHealth & the Provider] : [April 2013]
  • 7. what makes up mHealth? [mHealth & the Provider] : [April 2013]
  • 8. example - ophthalmology [mHealth & the Provider] : [April 2013]
  • 9. example - ophthalmology [mHealth & the Provider] : [April 2013]
  • 10. example - cardiology [mHealth & the Provider] : [April 2013]
  • 11. example – enterprise Health IT – apps, interoperability, BI/analytics [mHealth & the Provider] : [April 2013]
  • 12. example - diabetes [mHealth & the Provider] : [April 2013]
  • 13. example – vital signs monitoring [mHealth & the Provider] : [April 2013]
  • 14. example – infection control [mHealth & the Provider] : [April 2013]
  • 15. example – secure communications [mHealth & the Provider] : [April 2013]
  • 16. example – new patient scheduling [mHealth & the Provider] : [April 2013]
  • 17. example – patient education [mHealth & the Provider] : [April 2013]
  • 18. example – remote pediatric care [mHealth & the Provider] : [April 2013]
  • 19. example – mobileRx of healthapps [mHealth & the Provider] : [April 2013]
  • 20. example – infection control [mHealth & the Provider] : [April 2013]
  • 21. what should mHealth drive? Alignment with Meaningful Use Stage 2 behavioral requirements mHealth 2.0 is all about driving behavioral change (patient & provider) via mobility of systems mHealth 1.0 was an app for an app's sake [mHealth & the Provider] : [April 2013]
  • 22. key mHealth macro opportunities Chronic disease (chronic heart failure, chronic obstructive pulmonary disorder, diabetes) - 75% of US healthcare spending Behavioral change Intelligent systems to handle data deluge [mHealth & the Provider] : [April 2013]
  • 23. mHealth trends Cell phone subscribers constitute largest distribution system for healthcare info Anytime, anywhere, any device Initial enthusiasm focused on apps and fitness sensors, focus now shifting to mobile enabled services that drive meaningful change Focus on quality of care, patient retention, and patient communication Recent VA & NHS studies evidence cost reductions via mHealth Continued lack of interconnection between data silos & consequent emergence of meta-systems to access disparate data silos [mHealth & the Provider] : [April 2013]
  • 24. mHealth trends While buzz is about mHealth & Health 2.0 systems, the real change agent will be the data ... But they must be actionable, with low latency, and within feedback loop Meanwhile, MDs suffer from a data deluge Newer IT players displacing older, legacy systems MD & consumer adoption of mobile devices plus patient expectations of "now" creating pressure for new data dialogue and new clinical insights Greater patient involvement will revolutionize care Aging at home must be a priority Reimbursement models emerging in US with alignment to quality of care [mHealth & the Provider] : [April 2013]
  • 25. key provider needs Focused on closing specific Instantaneous Mobilized, compliance view of patient eased workflow loops with patient [mHealth & the Provider] : [April 2013]
  • 26. key patient needs Self care Easily closing information, but 24/7 access to compliance loop connected to providers for MD care valued partner: instructions MD [mHealth & the Provider] : [April 2013]
  • 27. problems to avoid Wasting time to Adding learn a non- Non HIPAA complexity to intuitive compliance workflow interface [mHealth & the Provider] : [April 2013]
  • 28. barriers to broad adoption Lack of Reimbursement interoperability Regulatory / business with existing uncertainty models Health IT systems [mHealth & the Provider] : [April 2013]
  • 29. FDA/EU, Congress, & certification FDA & EU US Congress Certification • FDA guidance document not finalized • 3 days of recent hearings • Question: “Is this app medically valid?” (7/21/2011) – perhaps by 2013? • House Committee on Energy & • “Is it useful, standardized and accurate?” • Debate on device / app classification Commerce • Happtique Health App Certification continues • Inconclusive Program (a CCHIT for mHealth) • EU debating as well – most apps Class 1 • Raised awareness and scrutiny • Hindering innovation? • Focus on patient benefits, regulation, and • Issues: spurring innovation • Re-representing data • Rep. Mike Honda (D-CA) “Healthcare • Clinical Decision Support Innovation & Marketplace Technologies • Controlling a device Act” (HR 6626) to be introduced again to 2013 Congress: • Creation of alarms • “FDA Office of Wireless Health” • Quality systems requirements • Innovation fund • Reducing barriers to entry • Financing to MDs for adoption [mHealth & the Provider] : [April 2013]
  • 30. what does the future hold? 1.Sensors, smartphone sleds & attachments 2.Apps, Cloud Systems, and Interfaces with broader Health IT 3.Big Data, Predictive Analytics, Modeling Tools, & Business Intelligence Dashboards 4.Clinical Decision Support systems 5.Remote Patient Monitoring / Patient Centered Home / Telemedicine 6.Communications / Healthcare Social Media / Collaboration tools 7.Middleware for national patient IDs 8.Patient Communication & Self-Service - Patient Portals, Databases, Apps, & Kiosks 9.Explicit services linked to a Mayo Clinic-type org / Hub & Spoke 10.Quantified Self / Fitness devices 11. Platform as a service: enabling workflow & data across multiple devices [mHealth & the Provider] : [April 2013]
  • 31. a vision of a connected future – from Kaiser Permanente… [mHealth & the Provider] : [ April 2013]
  • 32. mHealth influencers & resources www.MobiHealthNews.com www.Happtique.com www.mhealthsight.com www.HealthcareMobile.com Dr. Eric Topol, @EricTopol Dr. Ruchi Dass, @drruchibhatt Dr. David Lee Sherer, @dlschermd Paul Sonnier, @Paul_Sonnier Wireless Health group on LinkedIn Luca Sergio, @LMSergio [mHealth & the Provider] : [April 2013]
  • 33. For more conversation… Please reach out to me at any time Luca M. Sergio LMSergio@gmail.com Twitter: @LMSergio Mobile: +1-201-744-3364