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Mobile Health: Disruptive Innovation for Patient Centered Engagement

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Presentation on theme: "Mobile Health: Disruptive Innovation for Patient Centered Engagement"— Presentation transcript:

1 Mobile Health: Disruptive Innovation for Patient Centered Engagement
NIST 22 May, 2013

2 Diversinet Founded in 1997 as a leader in Mobile Security
Healthcare Focus starting in 2009 Award-winning technology: MobiSecure® and MobiPublisher® Platform with $60 million Technology investment 20 patents & 28 patent applications The Private Securities Litigation Reform Act of 1995 provides a “safe harbor” for forward-looking statements. Certain information included in this document (as well as information included in oral statements or other written statements made or to be made by the company) contains statements that are forward-looking, such as statements relating to anticipated future revenues of the company and success of current product offerings. Such forward-looking information involves important risks and uncertainties that could significantly affect anticipated results in the future and, accordingly, such results may differ materially from those expressed in any forward-looking statements made by or on behalf of the company. For a description of additional risks and uncertainties, please refer to the company’s filings with the Securities and Exchange Commission and with the Canadian Securities Administrators in the EDGAR filing system. The information contained in this presentation and its attachments contains privileged, confidential and protected from disclosure. Please ensure that you do not forward, disseminate, distribute or copy this presentation and its attachments. 2

3 Mobility Will Change Health and Healthcare
There are 5.9 billion mobile subscribers (that's 87% of the world population). Mobile devices allows providers to connect providers and patients. 81% of patients want online access to schedule appointments and fill out forms 78% will go online to access medical histories and share data with their physician 59% of patients will switch to a physician with a greater online presence Source – Intuit Health Care Check-up Survey 2010 ... Powering Care Coordination Through Mobility ... 3

4 mHealth Market Growth and Drivers
PricewaterhouseCoopers and mobile operator industry association GSMA expect global mobile health revenues to hit $23 billion by 2017, with the biggest markets in Europe and the Asia- Pacific region. Revenues from remote patient monitoring services that use mobile networks will rise to $1.9 billion globally by The wireless home health market looks to $4.4 billion by 2013, according to Parks (US market alone)1 The Patient-Provider mHealth apps for Care is expected to grow 270% per year to reach $1.1B by 2017² Multiple mHealth Market Drivers: Cost savings & Improved treatment ⁴ Federal mandates & tax incentives (HITECH, Meaningful Use) ³ Health regulatory/privacy requirements 4 Remote monitoring & med reminders Increased Smartphone use by doctors & users Change: Added the chart, again to make the slide more interesting and provide a visceral feel to how the market will grow. We don’t have a growth chart data for mHealth, only digital IT spending. Hence, why we include this data point and the chart. But Albert can skip over point and just mention the mhealth market before talking about the drivers. Albert doesn't need to drill down on all this info, of course. Just highlight a few things before moving on. 1) mHealth predictions: $1.9B, $4.4B, $4.6B? By: Brian Dolan | Apr 14, 2010 2) mHealth Adoption for Patient Engagement – Chilmark Research May 2012 3) ScienceDaily, May 1, 2008 4) Emrandhipaa.com, Details of Obama’s EMR Stimulus Package 4 4

5 mHealth will be a strategic investment
mHealth extends the ability of the entire healthcare sector to extend their solutions securely through mobility Disease Management Companies Medical Devices Companies Patient Health Record Companies Health Information Exchange Mobility Electronic Medical Record Telehealth Companies Health Plans/ Payers Mobility Activation Healthcare Organizations Empowerment Engagement 5

6 Growing Security Risk for Mobile Health
Frequency of patient data losses at healthcare organizations increased by 32% in 2011 compared to 2010, with 49% of respondents citing lost or stolen computing devices such as laptops, tablets, and smartphones. At the same time, 81% of Healthcare Providers use mobile devices to store or transmit data yet 50% do nothing to protect the data. * Data breaches in U.S. hospitals create a potential economic burden of $6 billion dollars annually – forcing IT departments to focus heavily on preventing security breaches before they occur and bridge the divide between mobility and security* The HIT Policy Committee, which advises HHS, voted Sept. 6 to accept recommendations from its Privacy and Security Tiger Team to require multi-factor authentication in certain cases involving remote access to patient information for Stage 3 of the HITECH Act electronic health record incentive program. The authentication would have to meet NIST Level of Assurance 3 standards. Level 3 includes the use of soft OTP tokenshttp://www.healthcareinfosecurity.com/multi-factor-authentication-gets-boost-a-5095?rf= eh Stage 3 is slated to begin in 2015, and rules are in the early discussion stages at the Department of Health and Human Services. * Second Annual Benchmark Study on Patient Privacy & Data Security Ponemon Institute, December 2011 ... Powering Care Coordination Through Mobility ... 6

7 NIST Diversinet was invited to present at the National Cybersecurity Center of Excellence (NCCoE) on April 17, 2013 to explore Health IT Components that support the Mobile IT Use Case (http://csrc.nist.gov/nccoe/hit/index.html) Use Case Sending an electronic prescription Receiving a lab result Sending a patient lab results and instructions to see a specialist Checking a patient into a hospital under Dr. Smith’s care Sending or receiving consultation information Requesting that a hospital discharge a patient Viewing hospitalized patients’ charts Sending a referral (e.g., clinical information to another physician) Ordering an imaging test Meeting Highlights Attendees: RSA, Microsoft, Intel,  Cisco, Symantec, McAfee, Good technology,  RayTheon, etc.    Other attendees  included - Trustwave, Fiberlink, West Health Institute, MedTec CRADA being established 7

8 A Scalable Model for Mobile Security
Strong Authentication & Encryption for Mobile Applications/Devices Customer Enterprise Server(s) Customer Mobile App mobiPublisher® Server Customer Configured Application Messaging Questionnaires Graphical Results Guest Users/Portal Or Wallet SDK Bilateral 2 Factor Authentication One Time Password SOAP API AES Encrypted Exchange SSL Pipe FIPS 140-2 Pin # for Client Access Content Destroyed After Failed Attempts Content Encrypted Client Bound to Mobile One Time Password mobiSecure is a patented security product that allows clients to secure mobile applications. With provisioning and 2 factor authentication features, it specifically secures data on the device and the transactions with the device. Our security is industry agnostic and is part of the mobiPublisher, which is the first mHealth platform that has been FIPS certification. It has a sophisticated Authentication and Provisioning technology including auto-device detection and over-the-air customization of mobile applications. It also contains a set of native security libraries enable developers to deliver secure applications saving time and money. moiSecure is also a very simple and elegant solution to address Bring Your Own Device (BYOD) challenges, especially for large scale deployments (e.g. consumers). Lastly, it is a strong and light weight to support security for physiologic sensors and other medical devices. mobiPublisher™™ Features: 2-Way OTP – anti-Phishing Double Encryption – Not Dependent Upon SSL Local Use of Device Features and Interfaces Encrypted Content Repository 8

9 Mobile Health Adoption Trends
HITECH Stage 2 Loyalty Offerings ACO Year 1: Quality reporting ACO Year 2: Quality payment Quality Monitoring and Preventive Engagement mPHR and Appointment Scheduling Mobile Health Adoption Trends Rate of Adoption Native EHR 2010 Strategic Initiatives 2011 2012 2013 2014 2015 Affordable Care Act Passed HITECH Stage 1 Messaging and access ... Powering Care Coordination Through Mobility ...

10 mHealth Challenges Rapid Proliferation of Mobile Solutions
No common data model on patient reported outcomes (Describe sleep, mood side effects, etc) Apps are not interoperable Apps are not scalable or have adequate security Provider v. Patient focused apps Innovation competing against interoperability Millions of apps that do not have providers in the provider workflow Eco System based on an open framework Standalone mobile strategy or apps will not achieve the transformational impact. It will take innovation and experimentation using a system based mobile strategy enabled by a secure and flexible enterprise mobile platform

11 mHealth Challenges Evidence shows mHealth adoption is slow as we are evolving our understanding of: How to activate and persistently engage patients on their health and healthcare How social determinants of health, preferences & lifestyle influence health behavior change How to personalize approaches to our patients as unique consumers who respond differently to our attempts to engage, activate and behavior change

12 “Patient engagement is the blockbuster drug of the century”
Problem: Need to engage patients in the white space The red dot represents the average number of minutes (100) a patient spends with a provider per year and the white represents the 525,600 minutes in a year Hon- Market is starting to shift significant focus to understanding how to engage and change patient behaviors. Unless there is a way to measure what and how patients make healthcare decisions, we will not be able to significantly lower our costs. “Patient engagement is the blockbuster drug of the century” Leonard Kish

13 Understanding Patients…

14 Patient Activation= Better Health

15 Engaged Patients LOWERS COST
Disease management programs online and engagement as demonstrated by a Blue Cross Blue Shield: a $9.81 return for every dollar spent. Factoring all results from all of these studies, and it amounts to a $ return for every dollar spent to build and implement patient engagement programs e-s-solution-is-here-it-just-needs-to-take- flight#ixzz2KooO5hbg

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17 Solution to the Cost Problem: Engaged Patients
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18 Recent NQF Commissioned Paper
“An extended set of standardized key data elements, structure, and implementation guidelines to support the broader vision of care coordination and patient-centered care, including the co-management of longitudinal care plans, does not yet exist. “ Seven domains are needed for integrated patient care, proposed by Singer et.al. Coordinated within care team Coordinated across care teams Coordinated between care teams and community resources Continuous familiarity with patient across time Continuous proactive and responsive action between visits Patient-centered - the extent to which providers consider the needs, preferences, values, and capabilities of the patient, family members, and other caregivers Shared responsibility - based on shared responsibility between patient and caregivers for optimizing health Health Information Technology to Support Care Coordination and Care Transitions: Data Needs, Capabilities, Technical and Organizational Barriers, and Approaches to Improvement Lipika Samal, MD, MPH Omar Hasan, MBBS, MS, MPH Arjun K. Venkatesh, MD, MBA Lynn A. Volk, MHS David W. Bates, MD, MSc Brigham and Women’s Hospital, Boston, MA

19 Harmonizing Patient Generated Data
Behavioral characteristics R Score Resilience Eating patterns Medication taking Physical activity Risky drinking Sleep quality Smoking/tobacco use Psychosocial characteristics Patient Characteristics Anxiety and depression Stress Quality of Life Demographics, Preferences, and Social Determinants of Health Health Literacy/numeracy Care Plans with Adherence Monitoring Estabrooks, Paul A, et.al., “Harmonized patient-reported data elements in the electronic health record: supporting meaningful use by primary care action on health behaviors and key psychosocial factors, J Am Med Inform Assoc 2012;19: doi: /amiajnl

20 Framework for Patient Centered Engagement

21 What is mobiHealth Wallet TM ?
MobiPublisher Tools Secure Messaging Surveys Reminders/Alerts Data Integration Workflow Integration Interoperable Mobile Applications Shared Care Plan Adherence Tracker Mood Tracker Preventive Care Secure Data Store Personal Health Records Profile/Preferences Biometrics

22 Enabling Core Technology: mobiPublisherTM
mobiPublisher is an enterprise solution for secure and agile development of mobile applications using a unique “configure once- deploy many” methodology. Applications are interoperable based on the underlying data model, dynamic provisioning and modification, making it easy to apply changes to applications. It has many built-in configurable advanced features. Server-based publisher securely hosts, manages and stores data received from external sources and syncs with mobile devices. The built in content manager provides real-time updates to mobile devices and the configuration manager creates native applications across most mobile OS systems using “Configure Once-Deploy Many” feature mobiPublisher has built in advanced features include secure container, 2-way messaging, autonomous alerts and surveys. It also has “On the Fly” provisioning and modifications of mobile applications. It is secured by mobiSecure® making all its applications HIPAA compliant and meeting stringent US security requirements. 22

23 Enterprise Mobile Platform
Target Outcomes: Reduced Readmission, Improved Adherence & Compliance, etc Mobile Application Solutions Medication Mgmt Compliance Increased Sales of Rx’s Chronic Care Mgmt Diabetes Asthma COPD Cardiac CHF CABG Rehabilitation Wellness Obesity Fitness MobiSecure Platform INTERFACES: EHR HIE Medical Devices CONTENT: Care Pathways, Care Plans, Patient Education Care Coordination Engine Mobile App Platform with content management (Customers configure our template based care and set alerts and reminders based on the care plan) Secure Publisher & messenger Secure - Write Once Deliver Across All Mobile Platforms MobiSecure SDK 23 23

24 Key Customers and Partners
US ARMY Mihealth mCare Wounded Warriors Ontario, Canada San Antonio, Texas Mobile case management to support 10K wounded warriors and extended care givers, with BYOD over 280 devices. Secure messages, appointment reminders, questionnaires, mood tracking. Decision made to expand to over 10K+ users. Secure patient to clinic communication and PHR, using portal & mobile devices. Connecting PHR, EMR, Lab Results, Providers, Patients. Controlled PHI sharing for dependents empowering caregivers. Being the first to receive FDA clearance for its device-agnostic mobile patient monitoring applications, mobiSecure® SDK will power ultra secure messaging, HIPPA compliant, with FIPS military grade security for all consumer smartphones, tablets, and mobile devices.

25 HCOs, ACOs, PCMHs, & Payers Health Information Exchanges
Value Proposition Patients and Families HCOs, ACOs, PCMHs, & Payers Health Information Exchanges Population Health

26 Our Story of an Empowered Patient: Carl
Why does this matter? We believe that for patients like Carl who are mobile and want to better manage his health, a mobiHealth Wallet gives him the tool to not only control his medical record and how he shares his data (with new physicians) but also to securely communicate and engage with his primary care team and care givers. Because of the adherence capability and its ability to track and report how Carl is doing with his shared target health goals, we can provide a 360 degree view of the patients rather than the traditional episodic views during the visits with his doctors.

27 Patients receive care in multiple settings

28 Carl Downloads Data and Establishes Profile

29 Carl’s Profile Personalizes his Care Plan

30 Tracking Adherence to Care Plan Goals

31 Wallet supports consumer mediated exchange

32 Providers are able to view Carl’s Record

33 Primary Care Provider is Notified of ED Visit

34 Care Plan is Easily Customized & Updated

35 Carl is Engaged and Improving His Health

36 Summary Mobile Health is still emerging
A sustainable business model for mobile health Adoption has been limited due to Reimbursement Emerging understanding of patients and how they make decisions about health and healthcare Workflow: Provider-Patient Engagement Data Silos ROI Future: mHealth will disrupt current healthcare model

37 Thank you Hon Pak, MD, FAAD, CEO Susan Hull, MSN, RN Chief Health Informatics Officer David Annan Chief Technology Office X232


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