ClickMedix is a connected mHealth platform that enables healthcare organizations to serve more patients better, faster, and at lower costs. It has been deployed in 16 countries through over 90 sites addressing different diseases. ClickMedix provides case studies on scaling tele-dermatology, community-based care for low-income populations, and managing diabetic patients collaboratively with multiple specialists. The platform aims to improve access to care through task-shifting to nurses and community health workers while lowering costs.
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ClickMedix Connects Healthcare for Better Patient Outcomes
1. ClickMedix
Connected mHealth platform to enable healthcare
organizations to serve more patients better, faster,
and at lower costs.
Ting Shih - Founder & CEO
(ting@clickmedix.com)
http://clickmedix.com
2. ClickMedix has been deployed in 16 countries, through
90+ sites addressing different diseases
7
1
2
43
3
3
1
2
4
5 1
2
9
2 4
2
4. 2008: Mobile Application for Tele-Consultation (HIV/AIDS,
cervical cancer, pre/post oral surgery)
• >$1M USD saved from transportations per year
• >90 women treated for cervical cancer (in 3 months) through mid-wives screening for
cancer
• Thousands of patients with increased access to care per year
• Transitioned process and service model to Botswana government
5. In the past 18 months, ClickMedix enabled
Medtronic to screen 70,000+ patients with
just 9 health workers. They have also
doubled the number of treatments
performed in partner hospitals. Service
extending to in-hospital and patient
counselor follow-up care.
9. Images of CSOM (perforation of the middle-ear
causing diminished hearing, and deaf if untreated)
10. 1. Serve more
patients while
lowering costs
through task-shifting
2. Connect
healthcare providers
and community
caregivers to enable
efficient care
collaboration
3. Develop revenue
model and
demonstrate ROI
ClickMedix Model to Scale Healthcare
Innovations
14. What We Learned and Applied to Achieve
Repeatable Outcomes
Repeatable Outcomes:
• Improve clinic efficiency: < 5 minutes per patient
• Increased patient access: < 3 days
• Improved quality of care through maximized right-referrals
• Improved patient experience
• <1 hour of training regardless of health worker education level
• Reduced costs of care: eliminate unnecessary procedures, delays, and travel costs
Overcame First-World Challenges
• Regulation: HIPAA-compliant, bank-level secure, on-device security
• Adoption: Customizable workflow, extensible to multiple diseases, easy to use for
providers and patients
• Scalability: one-click referral to additional patients or other providers and payors
• Sustainable payment models: additional patient referrals, private-pay or
reimbursement
15. Case Study 1: Tele-dermatology
• 5 published studies on efficacy from emerging markets
• Transitioned to the US through American Academy of
Dermatology and implemented in 27 clinics across 6
states (with UCLA, UPenn, Univ of Washington,
Harvard, etc.)
• 10-20 cases per week per clinic for patients who
otherwise wait 6-12 months to see a dermatologist
• Hospital system-wide implementation saw ~900
patients in 6 months; 500 from patient backlog resolved
in 4 months; captured reimbursement ~900*80 =
72,000
• Commercially replicated into private-pay and
reimbursable services
16. 200+ health
assessments
in one day
Deployed to
20+ medical
personnel on
iPhone, iPad
Android
Healthcare &
education for
Grameen
America
borrowers
Launched in
NY,
September
2013
Case Study 2: Grameen PrimaCare, Community-Based
Comprehensive Care for Low-Income Latin Population
19. Case Study 3: Scaling Multi-Specialists Services to Collaboratively
Manage Diabetic Patients
Pharmacist Patient Education
Nutritionist
Nephrologist and Endocrinologist
• 25% growth annually
• Contracted by Insurers
• Collaborate with primary care physicians
• 25% growth annually
• Contracted by Insurers
• Collaborate with primary care physicians
• Doubled number of patients seen per day
• Task-shifted to care coordinator and medical
students for longitudinal patient follow-up
• Scaling model to medical schools in Mexico and
India
20. In 3 Months: Average A1C Drop of 1.66
(from 10.11 to 8.48)
22. 1
<7.0
(<53
mmol/mol)
SBP < 130
DBP < 80
<100 or <70
with CVD
No
Symptoms
& No
Structural
Heart
Disease
At risk;
chronic
cough,
sputum
production;
normal
spirometry
No
Nephropath
y
No
Retinopathy
No Dental
Infection
No
Neuropathy
&
No PAD
18.5-24.9
No
Depressio
n
PHQ-9
score 0
2 7.0-7.9
(53-63
mmol/mol)
SBP 130-
139
DBP < 90
101-130
No
Symptoms
&
+Structural
Heart
Disease
GOLD 1 or 2
& 0-1
exacerbation
s/yr &
mMRC 0-1 &
CAT<10
Albuminuri
a
30-299 mg/g
Non-
Proliferative
Mild
Mild
Gingival
Inflammatio
n
Neuropathy 25-29.9
Minimal
Depressio
n
PHQ-9
score 1-4
3
8.0-8.9
(64-74
mmol/mol)
SBP 140-
149
DBP < 90
131-160
Symptomati
c
&
+ Structural
Heart
Disease
GOLD 1 or 2
& 0-1
exacerbation
s/yr &
mMRC ≥2 &
CAT≥10
Albuminuri
a
300-999
or
eGFR 30-
60
Non-
Proliferative
Moderate
Moderate
Gingival
Inflammatio
n
+PAD
&
+/-
Neuropathy
30-34.9
Mild
Depressio
n
PHQ-9
score 5-9
4
9.0-9.9
(75-85
mmol/mol)
SBP <150
DBP 90-99
161-190
Symptomati
c
w/
Heart
Failure
GOLD 3 or 4
& ≥2
exacerbation
s/yr &
mMRC 0-1 &
CAT<10
Albuminuri
a
1000-2999
or
eGFR 15-29
Non-
Proliferative
Severe/
Inactive
Proliferative
Severe
Gingival
Inflammatio
n
+ Ulcer
History
35-39.9
Moderate
Depressio
n
PHQ-9
score 10-
14
5 > 10.0
(≥86
mmol/mol)
SBP > 150
-or-
DBP > 100
>191
Refractor
y Heart
Failure
GOLD 3 or 4
& ≥2
exacerbation
s/yr &
mMRC ≥2 &
CAT≥10
Albuminuri
a
>3,000
or
eGFR ≤15
Active
Proliferative
Acute
Dental
Infection
Previous
Amputation
≥40 or
<18.5
Severe
Depressio
n
PHQ-9
score ≥15
Patient Receives Health Score Card, along with Care
Plans and Service Referrals
BMI
23. 1
<7.0
(<53
mmol/mol)
SBP < 130
DBP < 80
<100 or <70
with CVD
No
Symptoms
& No
Structural
Heart
Disease
At risk;
chronic
cough,
sputum
production;
normal
spirometry
No
Nephropath
y
No
Retinopathy
No Dental
Infection
No
Neuropathy
&
No PAD
18.5-24.9
No
Depressio
n
PHQ-9
score 0
2 7.0-7.9
(53-63
mmol/mol)
SBP 130-
139
DBP < 90
101-130
No
Symptoms
&
+Structural
Heart
Disease
GOLD 1 or 2
& 0-1
exacerbation
s/yr &
mMRC 0-1 &
CAT<10
Albuminuri
a
30-299 mg/g
Non-
Proliferative
Mild
Mild
Gingival
Inflammatio
n
Neuropathy 25-29.9
Minimal
Depressio
n
PHQ-9
score 1-4
3
8.0-8.9
(64-74
mmol/mol)
SBP 140-
149
DBP < 90
131-160
Symptomati
c
&
+ Structural
Heart
Disease
GOLD 1 or 2
& 0-1
exacerbation
s/yr &
mMRC ≥2 &
CAT≥10
Albuminuri
a
300-999
or
eGFR 30-
60
Non-
Proliferative
Moderate
Moderate
Gingival
Inflammatio
n
+PAD
&
+/-
Neuropathy
30-34.9
Mild
Depressio
n
PHQ-9
score 5-9
4
9.0-9.9
(75-85
mmol/mol)
SBP <150
DBP 90-99
161-190
Symptomati
c
w/
Heart
Failure
GOLD 3 or 4
& ≥2
exacerbation
s/yr &
mMRC 0-1 &
CAT<10
Albuminuri
a
1000-2999
or
eGFR 15-29
Non-
Proliferative
Severe/
Inactive
Proliferative
Severe
Gingival
Inflammatio
n
+ Ulcer
History
35-39.9
Moderate
Depressio
n
PHQ-9
score 10-
14
5 > 10.0
(≥86
mmol/mol)
SBP > 150
-or-
DBP > 100
>191
Refractor
y Heart
Failure
GOLD 3 or 4
& ≥2
exacerbation
s/yr &
mMRC ≥2 &
CAT≥10
Albuminuri
a
>3,000
or
eGFR ≤15
Active
Proliferative
Acute
Dental
Infection
Previous
Amputation
≥40 or
<18.5
Severe
Depressio
n
PHQ-9
score ≥15
Patient Receives Health Score Card, along with Care
Plans and Service Referrals
BMI
24. 10,83
1
Case Study 4: Pharmacist-Driven Care Coordination
and Referrals
Pharmacy-facilitated disease management and expanding
to 500 pharmacy stores, affiliated insurer and hospitals
26. Application to US: CA Senate Bill 493 Authorized Clinical
Pharmacists to Manage Patients and Coordinate Care
Nurse,
pharmacist, or
case manager
helps patient
with
assessments
Remote
specialists
responds with
diagnosis and
treatment
advice
Advises on medications,
educate patients, recommend
products and services (MTM
Reimbursement potential)
Schedules for
follow-up visits
and reminders
ePrescriptionHome monitoring
(glucose meter,
blood pressure
cuff, etc.)
OTC and
Prescription Drugs
28. Aggregate Proven Solutions to Improve Care While Lowering Costs
for Patients with Diabetes, CHF, COPD, Mental diseases
Existing
Patients
(claims
data, etc)
Communit
y Clinics
Home care,
patients,
and their
care givers
StratifyScreen Triage
60%
20%
20%
Intervene
Specialist
consultation
Case Management
Programs
Wellness Programs
Follow-up periodically
Pharmacies
36. 1
<7.0
(<53
mmol/mol)
SBP < 130
DBP < 80
<100 or <70
with CVD
No
Symptoms
& No
Structural
Heart
Disease
At risk;
chronic
cough,
sputum
production;
normal
spirometry
No
Nephropath
y
No
Retinopathy
No Dental
Infection
No
Neuropathy
&
No PAD
18.5-24.9
No
Depressio
n
PHQ-9
score 0
2 7.0-7.9
(53-63
mmol/mol)
SBP 130-
139
DBP < 90
101-130
No
Symptoms
&
+Structural
Heart
Disease
GOLD 1 or 2
& 0-1
exacerbation
s/yr &
mMRC 0-1 &
CAT<10
Albuminuri
a
30-299 mg/g
Non-
Proliferative
Mild
Mild
Gingival
Inflammatio
n
Neuropathy 25-29.9
Minimal
Depressio
n
PHQ-9
score 1-4
3
8.0-8.9
(64-74
mmol/mol)
SBP 140-
149
DBP < 90
131-160
Symptomati
c
&
+ Structural
Heart
Disease
GOLD 1 or 2
& 0-1
exacerbation
s/yr &
mMRC ≥2 &
CAT≥10
Albuminuri
a
300-999
or
eGFR 30-
60
Non-
Proliferative
Moderate
Moderate
Gingival
Inflammatio
n
+PAD
&
+/-
Neuropathy
30-34.9
Mild
Depressio
n
PHQ-9
score 5-9
4
9.0-9.9
(75-85
mmol/mol)
SBP <150
DBP 90-99
161-190
Symptomati
c
w/
Heart
Failure
GOLD 3 or 4
& ≥2
exacerbation
s/yr &
mMRC 0-1 &
CAT<10
Albuminuri
a
1000-2999
or
eGFR 15-29
Non-
Proliferative
Severe/
Inactive
Proliferative
Severe
Gingival
Inflammatio
n
+ Ulcer
History
35-39.9
Moderate
Depressio
n
PHQ-9
score 10-
14
5 > 10.0
(≥86
mmol/mol)
SBP > 150
-or-
DBP > 100
>191
Refractor
y Heart
Failure
GOLD 3 or 4
& ≥2
exacerbation
s/yr &
mMRC ≥2 &
CAT≥10
Albuminuri
a
>3,000
or
eGFR ≤15
Active
Proliferative
Acute
Dental
Infection
Previous
Amputation
≥40 or
<18.5
Severe
Depressio
n
PHQ-9
score ≥15
7. Patient Receives Health Score Card, along with Care
Plans and Service Referrals
BMI
37. Expected Outcomes for Health Organizations
Improved patient care (outcome metrics for patients)
• Decreased time to access doctors and treatment (< 3 days)
• Decreased number of unnecessary hospitalizations (up to 55%)
• Increased patient education
• Increased patient satisfaction
• Improved CMS Star Rating and HEDIS Measures (diabetes example)
o Increased number of patients with improved Hb1Ac
o Increased number of patients with improved blood pressure
o Increased number of patients with improved cholesterol (LDL)
o Increased patients screened for diabetes retinopathy
o Increased patients with neuropathy assessment
o Increased patients with foot examination
Process Metrics
• Increased number of patients screened for health risks
• Increased number of patients managed
• Decreased time to obtain treatment advice from multiple specialists
39. ClickMedix
mHealth Innovations in Disease Management
Ting Shih - Founder & CEO
@clickmedix
ting@clickmedix.com
http://clickmedix.com
40. Products Features
•ClickDiabetes mHealth Training
•Tele-Dermatology Training
•Tele-Geriatric Care Certification
Training
•Tele-Cardiology Training
ClickMedix Solution Summary: Ready-to-Use mHealth and
mTraining Programs
HIPAA-compliant system with all features
accessible on mobile phones or web
browsers
Remote diagnosis with store-and-
forward
Real-time video consultation
Triage protocols
Customizable patient forms
Patient portal, education & adherence
monitoring
Electronic health record system
ePrescription
•Diabetes
•Primary Care
•Geriatric Care
•Maternal & Pediatric Care
Multi-media (image, video, slideshow)
training materials
Self-assessment quizzes
Remote consultation with instructors
Continuous updates of training
materials
Online examinations/certifications
Click-
Health
Hospitals &
Health
Programs
Click-
Training
Click-
Specialists
•Tele-ENT (ear, nose, throat)
•Tele-Dermatology
•Tele-Radiology
•Tele-Cardiology
•Pre/Post Surgery
ClickMedix has been able to replicate this model with numerous partners, which gives us a reach of over 600,000 patients.
To show how this works, here's a case study with Grameen Primacare which was founded by Nobel Laureate Muhammad Yunus. Grameen provides micro finance to thousands of Latina business owners in the US who don't otherwise have healthcare.