Connected Health – What is it? Navneet Kathuria, MD, MPA, MBA Executive Director and Chief Medical Officer Premier Healthcare Carolyn Driscoll, LMSW Research Associate YAI Network PHC is a member of the YAI network.

Premier HealthCare Connected Health Platform Connected HealthCare Tele-medicine Tele-Health e-Medicine Social Media Premier HealthCare Connected Health Platform 11/29/201811/29/2018

Premier HealthCare: Virtual Care Rounds Hospital at Home Virtual Care Visit Residential Services (Over a 100 residential sites housing ~ 700 individuals) Virtual Platform for Patient Management and Referral Premier HealthCare (Five Onsite Clinics) Nurse Visits Treatment Coordinators Social support infrastructure V-consult (automated and standardized workflow templates) V-medical information exchange V-Group Visits Serving the needs of complex patients Providers Dedicated to needs of complex patients Access to comprehensive Health Care 11/29/201811/29/2018

Telemedicine Telemedicine is the use of technology to remotely deliver health services to patients Consultations Health assessments Diagnosis Treatment 11/29/201811/29/2018

Telemedicine was Predicted in 1924! Current Methods: Real-time Techniques Store and Forward Remote Monitoring Current Applications: Two-way video Email Smart phones Wireless tools 11/29/201811/29/2018

Telehealth Telehealth services allow patients to access health education and support through their home computers or wireless devices to help manage their health. It also creates a virtual medical community for providers. Personalized education materials and coaching Online discussions and support groups Provider trainings and continuing medical education 11/29/201811/29/2018

Case Study: At-home Telehealth Program for Veterans VHA’s Care Coordination/Home Telehealth Program supports the care of veterans with chronic conditions in their home Patients are assigned a care coordinator who selects appropriate telehealth technology Care coordinators receive daily vital signs, messaging results, and other disease mgmt data Alerts indicate significant changes and care coordinators intervene Program Outcomes Source: VHA Taking Home Telehealth Services to Scale Nationally: Commonwealth Fund 25% decrease in nursing home bed days of care 20% decrease in hospital readmissions 85% patient satisfaction Annual savings of $1,999 per patient 11/29/201811/29/2018

Case Study: Connecting Patients to Specialists e-Referrals developed by San Francisco General Hospital Structured secure email exchange between primary care doctors and specialists Covers more than 40 specialties and services Others adopting – LA County Dept of Health Services, the Mayo Clinic, UCSF, and UCLA Connecting Patients to Specialists Program Outcomes Source: Connected Health: A Review – Healthy Affairs 2014 50% decrease in wait time for most SF General specialty clinics 20% decrease of in-person specialty visits Improved preparation for specialty visits Stronger collaboration and satisfaction between primary care and specialists 11/29/201811/29/2018

Benefits of Telemedicine/Telehealth Increased access to healthcare services Enhanced access to specialists Improved quality of care Reduced hospitalizations/ER visits Cost-effective method of service delivery Patient and provider satisfaction

e-Medicine e-Medicine refers to health services and information delivered or enhanced through the Internet. 87% of U.S. adults use the Internet Looking for health information is the 3rd most popular online activity Most Popular Searches Specific Diseases 66% Medical Treatments & Procedures 56% Doctors Hospital & other Medical Facilities 36% 11/29/201811/29/2018

Social Media People separated by time and space can create, share, and exchange information and ideas. Tools used in social media Blogs Microblogs (e.g. Twitter) Content Communities (e.g. Youtube) Social Networking Sites (e.g. Facebook) 11/29/201811/29/2018

Surprise! Who’s friending you on Facebook? FACTS: 6 out of 10 internet users aged 50-64 use social networking sites Adoption rates for those 65 and older have tripled over the last 4 years (13% in 2009 to 43% in 2013) Fastest growing groups: Twitter (55-64) up 79% Facebook (45-54) up 46% Google+ (45-54) up 56% 11/29/201811/29/2018

Social Media and HealthCare Case Studies: Dave deBronkart “e-patient Dave” Diagnosed with advanced kidney cancer given 6 months Found successful treatment from online patient support community 38 Year-old woman diagnosed with Spontaneous Coronary Artery Dissection (SCAD) Mother of two young children diagnosed with rare condition offered little guidance Online support group advocated for and got a doctor from the Mayo Clinic to conduct a research study on their behalf 11/29/201811/29/2018

Social Media and Healthcare – What’s Next? The possibilities of using the internet and other technologies as tools in healthcare is limitless! What does research show? Patients are using it and making important decisions What’s needed? More healthcare organizations & doctors becoming a part of it! 11/29/201811/29/2018