The day (for me) is starting with one of my board members presenting on Longitudinal Health for Diabetes Care. Today's highlights include:
Ohana Health - Feasibility study with 15 patients selected by outreach workers using modem connection of glucose uploads to an advanced web-based care management system. Starting 5 patients with blue tooth enabled smart phone for glucose uploads. Patients and physicians responding well to printed graphs and tables of the glucose reading - opportunity for talking point with patients. Patients are able to use the technology as long as they receive some education.
Longitudinal Health is a care delivery system that allow continuous interaction between the care team and the patient using mHealth technology and integrated with other health information technologies. Includes contextually and temporally relevant decision support and use of social support networks for patients and their families, as well as, for health workers and care team members.
Individualized care - pattern recognition application based on algorithm with responses and interactions with the application and care team are additional data points. Over time, the patient relationship is improved by tailoring messages and contact based on the individual responses.
Effective HIT systems move data from EMR to a clinical data repository (CDR), where additional data can be added from the mobile device. In the CDR it is organized and data is sent back to the EMR and messages to the PHR.
Watch for data overload and show value for physicians and other providers.
Chronic disease will be managed by a team, not just a physician.
Need to educate health plans and government on understanding new technology.
New relationships are coming: Health plans and cell phone industry.
As a society need to decide between motivating and medicating.
Telehospice - (WA State and Missouri) Reimbursement is an issue -- Can CMS see value in care of patient in the home? Patient prefer audio/visual, not just telephonic care. Facilitates responding to patients (pain, suffering, etc) in the home - now!
Social networking in palliative and end-of-life care is growing.
Review of a planning template for starting a patient on remote monitoring.
Mobile loop to reach the patient is an enabler. Use of mobile technology requires new workflows, agreed goals, building a story between the patient and physician, creating guideposts and generate wisdom for both the patient and doctor.
Community design - convert thoughts to achievable actions (silence is golden), organize service providers in a geography to create a footprint, and consider the delivery system.
Outcome based measurement is more meaningful when it is noisy (dialogue vs. numbers)
A lot of discussion about the role of social media. :)
Mobile apps are especially beneficial for rural physicians, wilderness medicine, home visits, disaster relief, emergency.
At the end of the day, physicians are really going to care about the outcomes.
Telemedicine drivers identified in Triple Tree mHealth survey.
Home telemedicine - keeping patients with chronic diseases in their home.