iHT2 Health IT Summit in Austin 2012 – Edward W. Marx, SVP & Chief Information Officer, Texas Health Resources, Keynote Presentation “Leveraging mHealth in the Post Reform Era”
Opening Keynote: "Leveraging mHealth in the Post Reform Era" - Health IT Summit in Austin!
Texas Health Mission
To improve the health of the people in the communities we serve
Texas Health Vision
Texas Health Resources, a faith-based organization joining with physicians, will be the health care system of choice
Innovative Technology Solutions
Innovate, transform, and serve
Mobile Health Definitions
Semelhante a iHT2 Health IT Summit in Austin 2012 – Edward W. Marx, SVP & Chief Information Officer, Texas Health Resources, Keynote Presentation “Leveraging mHealth in the Post Reform Era”
Semelhante a iHT2 Health IT Summit in Austin 2012 – Edward W. Marx, SVP & Chief Information Officer, Texas Health Resources, Keynote Presentation “Leveraging mHealth in the Post Reform Era” (20)
iHT2 Health IT Summit in Austin 2012 – Edward W. Marx, SVP & Chief Information Officer, Texas Health Resources, Keynote Presentation “Leveraging mHealth in the Post Reform Era”
1. Leveraging mHealth
in a Post-Reform Era
Edward Marx
Texas Health Resources
December 2012
ACPE.ORG 1
2. Texas Health Resources
Texas Health Mission
To improve the health of the people in the communities
we serve
Texas Health Vision
Texas Health Resources, a faith-based organization
joining with physicians, will be the health care system
of choice
Innovative Technology Solutions
Innovate, transform, and serve
3. Edward Marx
• Husband to Julie Harding Marx
• Father to Brandon & Talitha Marx
• Passion for God, Family, People, Triathlon & Tango
• Colorado State University (BS, MS)
• Army Combat Engineer Officer/Combat Medic
• Healthcare IT Leadership Career
• Texas Health Services Authority Board Chair
• Worldwide Councils for Cisco, Microsoft and HP
• SMU Engineering School Advisory
• TCU Business School Advisory
• UTD School of Management Advisory
7. mHealth Defined
Term used for the practice of medicine and public
health, supported by mobile devices.
The use of mobile and wireless devices to improve
health outcomes, healthcare services, and health
research.
8. mHealth – “Perfect Storm”
ARRA driven adoption
of EMR exceeded
expectations
EMR/ HIE
adoption
Clinical apps, and
remote care
patient monitoring
Mobility Mobile device
applications adoption
Smartphone and
tablet/ slate
adoption
increasing
8
23. Provider Mobility: EHR
• Current state • Future plans
– 741 subscribers, – Android support
all iOS (Q4, 2012)
– Read-only access to – Dictation (2013)
CareConnect – Image capture (2013)
– eRx in development – Charge capture (2013)
25. Provider Mobility: OB
• Current state
– Realtime, read-only access to tracings of maternal
uterine contractions and fetal heart rate
– 125 subscribers, multiple platforms
29. Provider Mobility: Cardiology
• Current state • Future plans
– Read-only access to – Android support
EKGs (Q4, 2012)
– 500 subscribers, – EKG interpretation
all iOS (2013)
– Expanding access to – Optimize adoption,
EKGs from EMS determine value (2012)
– Integration with
CareConnect, in
development
31. Provider Mobility: ICU
• Current state
– Read-only access to realtime waveforms and vital
signs data; historical view of telemetry alarms
– Not yet licensed at THR
– THP pilot approved by Heart & Vascular Service
Line and ITSC
• Next step
– Pilot at THP
33. Provider Mobility: Stroke
• Current state
– Realtime, bi-directional audio/video interaction
between neurologist and patient
– Specialized telestroke application (Dr. Hinton) in
use at THD, THDN
– Evaluating Epic telehealth capabilities: THP pilot
(Q4, 2012)
39. Patient Mobility: EHR
• Current state • Future plans
– Same functionality as – Acute care setting
Web-based patient
portal
– Available to patients
seen by THPG
CareConnect providers
or hospitalized at THR
– 420 users, iOS and
Android
42. Patient Mobility: Monitoring
• Current state • Future plans
– Real-time and – Add videoconference
asynchronous capability
monitoring of vital – To be considered for
signs; care plans, Care Transition
patient education program (pHealth)
– Nearing completion of – Potential initiative for
AT&T heart failure Campaign 2017
research study
– THAZ disease
management, in
development
44. Patient Mobility: NICU
• Bi-directional audio/video interaction between
– Family and neonate
– Family and care team
• Deployed at THD
• Interest at THFW, THP
• Seeking alternative vendor (AT&T)
45. Patient Mobility
• Future needs and considerations
– Consumer apps
– Wearable devices
– Integration with diagnostic equipment
– Convergence with social media
– Implications for population health management
50. mHealth Challenges
• One size does not fit all
• Vendor support of multiple form factors/devices
• UI that drives adoption – speed & resolution
• Managing devices, power & ruggedness
• Security, HIPAA, FDA
• Integration and interface
• Wireless bandwidth availability
• Potential medical device interference
50
51. mHealth Lessons
• Access to the right data through simplified interfaces
• Ubiquitous connectivity required
• Has to work all the time, be intuitive and fast
• Has to have great user interface
• Start small and build on success
• Must work well over slow, intermittent connections
• Vendors not simply “also have a wireless solution”
• Pick a strong partner willing to go at risk
51
52. mHealth Security Challenges
• Security Challenges…
• Platform Differences
• Mobile Device Management (MDM)
• Data Security Risk is Real
• Not if but when….
• Devices: Personal vs. Corporate-Owned
53. Six Takeaways…
• We are at the proverbial tipping point
• Usability drives adoption
• You need to have a defined, agile strategy
• Start now with something and grow
• The future isn't about mobile; it's about mobility
• Security is about resiliency
The scenes from the left are from Star Trek—the original series (Dr. “Bones” McCoy and his tricorder) and “The Next Generation” (with a more advanced model). The sketch on the right is from Star Wars Episode I – “The Phantom Menace”, the first of the three prequels. In both movies, mobile devices are used at the point of care to perform diagnoses and, in the Star Wars example, deliver drug therapy. In the Star Wars scene, data from a blood sample is collected from the mobile device and transmitted wirelessly to “the cloud” on a starship, where it is analyzed. It is from this analysis that Anakin Skywalker is identified to be the prophesied “chosen one” who will bring balance to the Force. The point is that although these are scenes from science fiction, these capabilities exist with smart phones today.For mobile health--specifically mobile medical apps--to be successful in a patient care setting, six principles must be taken into consideration, according to PricewaterhouseCoopers Managing Director Christopher Wasden, .Wasden said mobile health has matured beyond novelty and eventually will become core to the practice of medicine, he believes that there is still a way to go before it gets there."Mobile health technology is the first--and perhaps the only--technology that physicians have adopted more quickly and aggressively than IT departments can support," he said. "But [patients] stop using apps most often because we find a better one. People abandon the old for the new. This is clearly a market that has a long way to go before we find the secret sauce for success."According to Wasden, the six principles include interoperability, integration, intelligence, outcomes, socialization and engagement."Apps and devices need to be able to talk and share information with one another," Wasden said. "And they need to do more than just spit out data that patients [entered]."To that end, Wasden said, mobile medical apps should be able to come up with recommendations for what patients need to do differently in their lives."Connected health is only valuable if we're comfortable being told we're ugly," he said. Ultimately, Wasden said that successful mobile medical app use is contingent on changing human behavior."As we take digital info and put it in a form factor that we can put in their hands so [doctors] can stand next to patients, it changes the user experience and the practice of medicine," he said.
I went to Wikipedia to find an authoritative answer and to my surprise, this actually made sense:
So even as I was getting more interested in mHealth, it is still hard to define. There are touchpoints everywhere with mobile health. Every day we hear about a new gadget that can be plugged into the iphone, so what is mobile health?
Moving from volume to value
Not going to spend time on gee whiz, you will see some of that laterNot going to spend time on rules and regulations, you have plenty of that
Dr. Anthony Lee
Dr. Cythia Robbins
The RTHS must be assembled from a combination of new and existing applications and systems, technologies, management tools and best practices. The RTHS depends heavily upon the agility and robustness of the underlying IT infrastructure — the real-time infrastructure (RTI) if you will. An RTI is achieved when IT resources are integrated and interoperable, event-driven and service-oriented, and capable of being dynamically configured, optimized and scaled to meet the necessary service levels for an enterprise to effectively perform in the here and now. Some of the technologies that characterize the RTI include:Server, storage and workstation virtualizationRemote hosting, cloud computing and infrastructure utilitiesIT service management toolsLocation- and condition-sensing technologiesWireless and mobile devicesPortals of all typesMiddleware for messaging, alarms and notifications, and device integrationA focus on high availability, disaster recovery and business continuityEndpoint security and data loss prevention measures