Mobile Health Technologies: Future Tools of Healthcare
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A presentation touching on an overview of mobile health tools including apps, social media, patient portals, genomics, and mobile clinical trials.
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Mobile Health Technologies: Future Tools of Healthcare
- 1. Mobile Health Technologies: Future Tools of Healthcare David Lee Scher, MD, FACP, FACC, FHRS Clinical Associate Professor of Medicine the Pennsylvania State College of Medicine Director, DLS Healthcare Consulting, LLC Blog: davidleescher.com @dlschermd
- 2. “The most valuable commodity that I know of is information”. –Gordon Gekko
- 4. What is mHealth? Diverse application of wireless and mobile technologies designed to improve health research, health care services and health outcomes .
- 5. Why is mHealth Good for Patients? • • • • • • • SOMETHING MUST BE DONE to IMPROVE HEALTHCARE Promotes patient engagement (self-management) Provides educational resources Improves doctor-patient relationship Supports caregivers’ mission Creates personalization of healthcare -> ?better outcome Convergence of many technologies -> simplification, convenience
- 6. Barriers to Adoption of mHealth • Nebulous regulatory guidance • Lack of reliability, security/privacy • Lack of mobile strategy by providers (BYOB, M2M integration), payers • Lack of smart phones by older, chronically ill pts • Lack of business models • Lack of proven ROI (except RPM)
- 7. Genomics
- 8. Genomics • Digitization of a person’s genetics: available for <$2000 and sent to your smart phone. • Personalized medicine: – patient susceptibility to specific treatments. – Predict susceptibility to specific diseases. – Pool data => population studies.
- 9. Genomics • Challenges: – Most genetic predispositions require environmental influences. – Associated counseling needed. – Genetics may change over time. – Risks may change over time. – Many diseases not mapped. – Most physicians not prepared to address.
- 10. Benefits of Genomics • Gives patients vision of future-> personalized life, treatment, family planning decisions. • Crowdsourced clinical studies: ?less bias, better compliance (23andME, PatientsLikeMe). • More comprehensive understanding of cancer, other complex diseases. • Faster way to treatments of orphan diseases.
- 11. mHealth and Clinical Trials
- 12. Advantages of Mobile Clinical Trials • • • • Recruitment of patients via social media Instantaneous AE reporting Bidirectional interactions eliminate visits Easier communications among centers/sponsors/reg bodies • Facilitates medication adherence (reminders, pill sensors) • More efficient data collection, reporting, auditing • NO MORE FAXES!
- 13. Medication Adherence and mHealth
- 14. Medication Adherence and mHealth
- 15. Patient Portals: Patients’ Mobile Pathway to Records
- 16. Patient Portals: Intersection of Stakeholders • • • • • Patients & caregivers Providers Payers Healthcare Social Media Pharma/Med Device Companies
- 17. Mobile Medical Applications __________________________ Guidance for Industry and Food and Drug Administration Staff Document issued on: September 25, 2013
- 18. Mobile Medical Application (Mobile Medical App) A “mobile medical app” is a mobile app that meets the definition of device in section 201(h) of the Federal Food, Drug, and Cosmetic Act (FD&C Act)4; and either is intended: • to be used as an accessory to a regulated medical device; or • to transform a mobile platform into a regulated medical device.
- 20. Facts About Health Apps* • 97,000 mHealth applications are listed on 62 full catalog app stores. • 15% are designed for healthcare professionals (CME, RPM, healthcare mgt). • 42% of apps: Paid business model. • Top 10 mHealth apps generate 4 million free and 300,000 paid downloads per day. *Research2guidance, 3/13
- 21. Which Mobile Capabilities Patients Want Their Doctor to Have • 42%: An app to see their test results. • 33%: Remote monitoring devices. • 30%: Access to patient health records via mobile device. • 13%: Didn’t think apps would help improve care at all. Source: 2012 Ruder Finn mHealth Report
- 23. Certification Program David Lee Scher, MD, Chair Cardiologist and Mobile Health Authority Franklin A. Shaffer, EdD, RN, FAAN BLUE RIBBON PANEL Set Standards for App Certification APP CERTIFICATION REVIEW BOARD Head of the Nursing Advisory Council Shuvo Roy, PhD Leading biomedical scientist and researcher Dave deBronkart Implement Program and Oversee Reviewers NURSE REVIEWERS PHYSICIAN REVIEWERS OTHER PROVIDER REVIEWERS Review Apps ePatient Dave Leading Patient Advocate 23
- 24. Problems With mHealth’s Clinical Evidence • Not readily available—some in peer-reviewed literature, but much in blogs, presentations, and other sources. • • Poor accepted by journals: confusion about whether mHealth is a “health” or “IT” intervention. • • Usually small studies • • The evidence base is growing rapidly and it is difficult for individuals to keep up-to-date
- 25. Challenges for mHealth • Ministries of Health, institutions and donors unable to make informed decisions re: commercial and research investments. • Implementers unsure re: best solutions to maximize effectiveness and produce the highest health impact • Researchers have difficulty knowing where to focus their research efforts
- 26. JHU and USAID
- 27. Examples of Mobile Medical Apps
- 35. Ultrasound
- 36. Five Pitfalls of Designing a Medical App • The motivation for the app development is misguided • Lack of clinician involvement • Poor attention to usability • Not knowing the healthcare landscape • Not building to regulatory specifications http://davidleescher.com/2013/01/31/five-pitfalls-ofdesigning-a-medical-app/
- 37. Mobile Strategy Considerations • Who is the customer? – – – – – Provider? Patient? Caregiver? Partnering verticals All of above! • In-house or outsource? • Potential partners: IT (EHRs, portals, analytics, app developers), OPCs, MDM companies, professional societies, advocacy gps.
- 38. The Future of Medical Apps • Final Guidance just release by the FDA • More apps developed by professional medical societies • App formularies for hospitals and payers • Prescribing of apps by providers • Integration of apps into patient portals and EHRs • App development by Pharma/Med Dev companies for disease management
- 39. The Future of Medical Apps • New HIPPA rules will affect apps • Clinical effectiveness studies need done • More apps for the diagnosis and treatment of specific disease states • Movement towards mobile by older people
- 41. Social is Mobile • Five Benefits of online patient communities: – Provide education – Provide emotional support – Pipelines to resources – Provide tools and info to caregivers – Provide forum for patients and providers to interact – Better than in person support groups
- 42. Why Physicians Need to be in Social Media • • • • It’s where the patients are It’s where hospital systems are It’s a venue for humanistic communication It makes for useful interactions with colleagues and vendors • It’s not mandated
- 43. Patient Advocacy in mHealth
- 45. #S4PM: Nothing About Us Without Us
- 47. “If you ask me a question I don’t know, I’m not going to answer” ------Yogi Berra
Editor's Notes
- IMPORTANT TO CHANGEChange wording on my picwe removed the wording under blue ribbon panel as we can talk it throughDavid wants 4 categories of reviews Patient Advocate Reviewers, Nurse Reviewrs, Physician Reviewers and Other Provider Reviewers. Remove the reverse Red Crosses (too busy)Also—the apps that are showing in the bottom square make it look like we have certified Epocrates and others. We think that you can show certified or tablet without giving away promotion to apps that may not be certified.