LIS 4785 Introduction to Health Informatics Instructor: Dr. Sanghee Oh Telehealth LIS 4785 Introduction to Health Informatics Fall 2015, Week 10-2 Instructor: Dr. Sanghee Oh

TeleHealth

Telehealth https://www.youtube.com/watch?v=luClBI57BPM#t=15

What is telehealth? Telehealth is simply using digital information and communication technologies, such as computers and mobile devices, to manage your health and well-being. Telehealth is the _______________________________ technologies to support _____________ 1) _____________ 2) _____________ 3) _____________.  Technologies include videoconferencing, the internet, store-and-forward imaging, streaming media, and terrestrial and wireless communications.

_____________ vs. _____________ _____________: The use of electronic information and telecommunications technologies to support long-distance 1) clinical health care, 2) patient and professional health-related education, 3) public health and health administration.  A broader scope of remote healthcare services The use of medical information exchanged from one site to another via electronic communications to improve patients’ health status Limited to remote transmission or exchange of clinical information only

_____________ vs. _____________ _____________: The use of electronic information and telecommunications technologies to support long-distance 1) clinical health care, 2) patient and professional health-related education, 3) public health and health administration.  A broader scope of remote healthcare services The delivery of healthcare services via mobile communication devices, such as cell phones, smartphones, and tablets

Telehealth services _____________ Email and online communication with health care providers Video or online doctor visits Remote monitoring of vital signs, such as blood pressure, or symptoms Online health information and self-management tools Personal health records systems Online support groups

e-Visits Enable Virtual Urgent Care https://www.youtube.com/watch?v=5w-jbDGbabA

_____________ A doctor's appointment you do online instead of in person How to do e-visits You type in your question or problem, usually through a progression of questions.  Your message is sent to your health care provider, who reviews it and sends a response.  You may receive a prescription for medication, a recommendation for a follow-up appointment or other advice.  Your messages are secure — meaning no one else can see or read them.  Visits can also take place in real time via a video conference.

E-visits Trends Care delivered via e-visits is growing at a rapid pace. A 400% Increase, $5 Billion Saved,  between 2012 and 2014 The main factors contributing to the proliferation of eVisits   Improvements in technology and telecommunications infrastructure Pressure to reduce health care costs while improving the quality of care in the value-based care model

Benefits of E-visits E-visits can be a powerful engagement tool, providing convenience and access when patients need it most. E-visits can save doctors’ and patients’ time compared with office visits. E-visits can be especially helpful for people in rural areas or those who don't have easy access to transportation.

E-visits Basic Guidelines By the American Academy of Family Physicians E-visits are available only to established patients Patients must initiate the e-visits process All communication must occur over a HIPAA-compliant online connection Physicians must appropriately document the e-visits in the patient’s medical/health record. There must be a defined period of time within which responses to an e-visits request are complete. http://www.aafp.org/about/policies/all/e-visits.html

_____________ Use of telehealth Doctors can also take advantage of technology to provide better care to their patients. One example is virtual consultations that allow primary care doctors to get input from specialists when they have questions about a particular diagnosis or treatment. The primary care doctor sends test results, X-rays or other images to the specialist to review. The specialist can respond electronically or request a face-to-face meeting if needed. In some cases, the specialist may even "see" the patient via video.

Benefits of Telehealth _____________ Access to consultative services Each consultation is inherently educational Access to continuing medical education Reduces sense of isolation Supports recruitment

Benefits of Telehealth _____________ Timely access to locally unavailable services Improved triage when patient transfer required Improved quality of care Reduced readmission for same diagnosis Improved chronic disease management Spared burden and cost of unnecessary travel

Benefits of Telehealth _____________ > 85% of patients remain in local community Care in the community (lower cost) environment Enhanced healthcare and local economic development Lower cost of care Improve outcomes “Green” technology

Challenges of TeleHealth _____________ Malpractice Insurance Coverage Remote Prescribing Reimbursement

Personal health apps Personal health records management A multitude of apps have been created to help consumers better organize their medical information, in one secure place. These digital tools allow you to store health records, upload information from devices, such as a blood glucose monitor or blood pressure cuff, and share information with your health care providers. Some even offer personalized reminders and recommendations.

_____________ Devices such as blood pressure monitors can be connected to the Internet or to video equipment that allows real-time, face-to-face interaction with health care providers. Home health monitoring can be particularly useful for people with chronic diseases, such as heart disease, as well as those who live in rural or remote areas. The benefits are greater convenience, fewer office visits, and easier access to medical care and advice.

_____________ These devices can assess sounds, images, body motion, and vital signs such as blood pressure, body temperature, heart rate and pulse, body weight, and blood oxygenation. Devices can also monitor sleep patterns and physical activity. These devices are connected through networks to a clinic or monitoring center.

_____________ A smart home is equipped with sensors and automated devices designed for remote monitoring, early detection of problems or emergencies, and promotion of safety and quality of life. Smart homes and wearable monitoring devices offer the potential of enabling older adults to live independently, if they prefer, rather than in assisted living facilities.

What is mHealth? mHealth is the __________________________of health information via _____________.

The mHealth market Infographic: The Rising Popularity of Mobile Health & mHealth Apps http://hitconsultant.net/2013/08/21/infographic-the-rising-popularity-of-mobile-health-mhealth-apps/ What is infographic? Information graphics or infographics are graphic visual representations of information, data or knowledge intended to present complex information quickly and clearly

Apple's HealthKit

Apple's HealthKit Apple's HealthKit is similar to S Health and Google Fit, but the company's partnerships with Epic Systems and Mayo Clinic take it one step further. Mayo Clinic will provide health information and content to users, and users can send data to Mayo physicians and establish communication. With Epic, the platform has the capability to provide a completely comprehensive picture of patient health by incorporating user-facing mHealth app data right into the electronic health record.

Patients and mHealth The use of mHealth and fitness apps in 2013 far exceeded the use of the overall app industry A number of recent studies found texting interventions were beneficial and helped improve health outcomes.  Remote patient monitoring devices present another way to collect biometrics without requiring patients to come to the hospital, and the market of such clinical-facing devices is poised to surpass the consumer-facing mHealth market.

Wearable Intelligence in Healthcare

Physicians and mHealth The number of clinicians using mHealth is on the rise. The majority of physicians — 48 percent — used mHealth to determine medication interactions, followed by 27 percent for diagnosis tools and 19 percent to access EHRs (MedData group) Physicians are finding ways to incorporate mHealth into patient care. More than one-third have reported recommended an app to patients within the last year, and 47 percent have used their own devices to show patients (Manhattan Research survey) 

mHealth and Regulation The rise of mHealth has sparked concern over data security and privacy. Nearly 40 percent of commercially available free mHealth apps and 30 percent of paid apps sent user data to third parties and did not disclose this happenstance in the privacy policy or within the app. (Mobiquity, a mobile engagement provider) Researchers project clinical mHealth devices will start proliferating in the industry partly because certain devices have moved passed regulatory processes and are now actually in the marketplace where physicians can use them.  The FDA certainly can't regulate every single new mHealth app that pops up on the market. 

Barriers to mHealth The use of mHealth varies significantly with age, gender and socioeconomic status. Even though a large number of Americans have downloaded mHealth apps, not many stay engaged. About two-thirds of consumers who have downloaded an mHealth app have stopped using it (MIT Technology Review report) Only 28 percent of smartphone users and 18 percent of tablet users report being "very satisfied" with the quality of available mHealth apps (Booz & Company report) The problem is the apps currently on the market aren't offering what consumers want (McKinsey&Company report)

mHealth and Wearables A wearable can be a device like a watch or even a garment like a shirt that tracks biometrics. The market for biosensing wearables has three main drivers: 1) wearables' ability to directly send information to smartphones and apps, 2) falling sensor prices and 3) healthcare's renowned focus on preventative medicine instead of reactionary medicine. The most popular biosensing wearables are those measuring movement, sleep and heart rate, but new biosensing niches are entering the market, such as devices measuring glucose levels, respiration, blood pressure and other indicators of a user's health. The biosensing wearable market shares a main hurdle with the overall mHealth market: poorly sustained user engagement.