1. MOBILE TECHNOLOGY DEVELOPMENT Using app development to improve patient outcomes

3. WHY A MOBILE APPOINTMENT APPLICATION IS NEEDED  Patients have multiple physician practice providers Cardiology, Pulmonology, Primary Care  Easily forget their appointments  Difficult to schedule transportation  Forget to refill medications  Cause readmissions

4. HOW THE APP WAS CREATED  Reviewed the barriers to accessing care  Utilized the basic information from our practice setting  Identified the biggest gap in our population Missed / No-Show appointments Medication Adherence  Intersected with inconsistent transportation  Medical home models required availability of appointments

5. FILLING A GAP IN PATIENT KNOWLEDGE  Patients were not aware of their missed appointment  Many challenges related to scheduling rides to /from  Medication management is key to maintaining health  Changes in condition cause changes in providers

6. AIDING IN POSITIVE OUTCOMES  Improve patient engagement Patients involved in their own care process make better decisions  Reduce unnecessary hospitalizations Patients engaged in their primary care and specialty care  Enhance the Medical Home model Reduced missed appointments Increased SDMH appointment slots

7. LEARNING CURVES ALONG THE WAY  Biggest challenges…. Patience with the technology Learning new terminology Integration of multiple mobile devices Design process

8. APPLYING MOBILE TECHNOLOGY  Use of mobile health technology is everywhere  Use of text messaging more normative communication  Preferences to make a quick text than to talk  Current use of phone calls for appointments not working

9. COST EFFECTIVE OPPORTUNITIES  Total costs to start the program was estimated at $10,000  Employee cost average to work program $30,000  Shows a savings if you factor in missed appointments $300 - $1000  Affordable option compared to the unplanned admission $5,000 – $10,000

10. BENEFITS FOR ADVANCED PRACTICE  New method of communicating with patients.  Offers patient choices to engage in their care  Flexibility to work with patients at various times of day / night  Opportunity to input this for other added features.

11. REFERENCES References Crankshaw, T., Corless, I. B., Giddy, J., Nicholas, P. K., Eichbaum, Q., & Butler, L. M. (2010). Exploring the patterns of use and the feasibility of using cellular phones for clinic appointment reminders and adherence messages in an antiretroviral treatment clinic, durban, south africa. AIDS Patient Care & STDs, 24(11), 729-734. doi:10.1089/apc.2010.0146 Lubrano, A. (2014, September 26). Phila. ranks highest among top 10 cities for deep poverty. Philadelphia Inquirer Hancock, L., Bruce, J., & Lynch, S. (2011). Exacerbation history is associated with medication and appointment adherence in MS. Journal of Behavioral Medicine, 34(5), 330-338. doi:10.1007/s10865-011-9316-x Rural Assistance Center. (2015). Economic analysis impact tool. Retrieved from http://www.raconline.org/econtool/ Schmalzried, H., & Liszak, J. (2012). A model program to reduce patient failure to keep scheduled medical appointments. Journal of Community Health, 37(3), 715-718. doi:10.1007/s10900-011-9505-0 Zeber, J. E., Pearson, D., & Smith, D. (2009). Analysis of health appointment no-shows. Primary Health Care, 19(2), 25-29. Retrieved from http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=2010243197&site=ehost-live&scope=site