Mobile Health and Remote Monitoring in the Pharmacy

Size: px

Start display at page:

Download "Mobile Health and Remote Monitoring in the Pharmacy"

Cornelia Wilkerson
6 years ago
Views:

1 Mobile Health and Remote Monitoring in the Pharmacy JOEY MAT TINGLY, PHARMD, MBA

Speaker Contact and Disclosure Joey Mattingly, PharmD, MBA Assistant Professor Department of Pharmacy Practice & Science University of Maryland

2 Speaker Contact and Disclosure Joey Mattingly, PharmD, MBA Assistant Professor Department of Pharmacy Practice & Science University of Maryland School of Pharmacy Disclosure: Principal, A & J Consulting, LLC For more information:

3 Learning Objectives After completing this activity, participants should be able to: 1. Compare and contrast mobile apps for patient self-management to apps for health care provider remote monitoring. 2. List and discuss 3 health conditions for which remote monitoring could be used to improve patient outcomes. 3. Discuss logistics of offering a remote monitoring service and strategy for communication between pharmacy, patient, caregiver and other providers.

4 Mobile Health According to the World Health Organization s Global Observatory for Health medical and public health practice supported by mobile devices, such as mobile phones, patient monitoring devices, personal digital assistants (PDAs), and other wireless devices.

5 Mobile Device Functions Voice Short messaging service (SMS) or text message 3G / 4G (3 rd and 4 th generation telecommunications) Global positioning system (GPS) Bluetooth technology mhealth: New horizons for health through mobile technologies. Global Observatory for ehealth series Volume 3. June 7, Available at: accessed August 10, 2015.

6 Mobile Health (mhealth) Examples Treatment compliance Appointment reminders Public health information and promotion Telemedicine Patient monitoring or surveillance Decision support systems Patient records mhealth: New horizons for health through mobile technologies. Global Observatory for ehealth series Volume 3. June 7, Available at: accessed August 10, 2015.

7 mhealth Regulation Food, Drug, and Cosmetic Act (FDCA) Food & Drug Administration has jurisdiction over medical devices FDA Guidance 2015 Focus will be on oversight of mobile apps intended: to be used as an accessory to a regulated medical device to transform a mobile platform into a regulated medical device to provide patient-specific analysis, diagnosis, or treatment FDA intends to exercise enforcement discretion on other apps 21 USC 321(h) Mobile medical applications: guidance for industry and Food and Drug Administration staff. Silver Spring, MD. February 9, 2015.

8 mhealth Regulation FDA Guidance 2015 Apps included in enforcement discretion : Coaching or prompting patients in daily environment Organization and tracking health information Drug interaction or drug allergy tools Videoconferencing portals specific to medical use Body Mass Index (BMI) calculators Electronic health record (EHR) access Mobile medical applications: guidance for industry and Food and Drug Administration staff. Silver Spring, MD. February 9, 2015.

9 Top Health Apps Top Health Apps Based on Pew/CHCF Health Survey Exercise, fitness, pedometer or heart rate monitor Diet, food, calorie counter Weight tracker Period or menstrual cycle Blood pressure WebMD Pregnancy Diabetes Medication management Fox S, Duggan M. Mobile health Pew Research Center. November 8, Available at: Health.aspx, accessed August 10, 2015.

10 mhealth Opportunities Diabetes Chronic disease state management Lifestyle modifications Multiple areas to track Blood glucose Diet Exercise Medication management

11 mhealth Applications (Diabetes) ibg STAR (sanofi-aventis) Glucometer that connects directly to an iphone or ipod Touch App to track: BG readings Carb intake Insulin doses Data is sharable ibgstar. Sanofi Aventis U.S., LLC. Available at: accessed on August 10, 2015.

sharable Data can be backed up to One Touch Reveal Account One Touch Verio Sync Meter.

12 mhealth Applications (Diabetes) One Touch Verio (LifeScan, Inc) Glucometer that wirelessly syncs with iphone, ipad, ipod touch 14, 30, or 90 Summaries of data Data is sharable Data can be backed up to One Touch Reveal Account One Touch Verio Sync Meter. LifeScan. June 30, Available at: accessed on August 10, 2015.

and synced to online account 1,696 ratings (4.5/5 stars) in app store Glucose Buddy.

13 mhealth Applications (Diabetes) Glucose Buddy (SkyHealth LLC) Free iphone app (in-app purchases available) Push notifications Manually enter data Data is sharable and synced to online account 1,696 ratings (4.5/5 stars) in app store Glucose Buddy. SkyHealth LLC. 2011; Available at: accessed on August 10, 2015.

14 mhealth Opportunities Women s Health One of the biggest growth areas of mhealth Includes: Pregnancy and Reproductive health Menstrual cycle tracking Child care related

mhealth Apps (Women s Health) Life+ (Lovetap LLC) Free iphone app (in-app purchases available) Menstrual cycle tracker Symptoms Mood Schedule cycle reminders

15 mhealth Apps (Women s Health) Life+ (Lovetap LLC) Free iphone app (in-app purchases available) Menstrual cycle tracker Symptoms Mood Schedule cycle reminders Predict fertile days 5,196 ratings (5/5 stars) in app store Life+. Lovetap LLC. March 6, Available at: accessed August 11,

16 mhealth Opportunities Heart Health Hypertension, heart rates, education Stroke prevention Broad population Chronic disease Medication management

intake Integrates with several other apps thanks to HealthKit for developers

17 mhealth Apps (Heart Health) Health (Apple Inc) App designed as a part of the last ios software Many heart-related variables Blood pressure Pulse Sodium intake Integrates with several other apps thanks to HealthKit for developers Health. Apple Inc Available at: accessed August 11,

18 mhealth Apps (Heart Health) Heart Rate Monitors: Multiple apps using the iphone s camera to detect heart rate McManus et al. Hearth Rhythm. 2013;10:315-9.

SEARCH-AF Stroke Prevention Study Sydney, Australia 10 Pharmacy sites Screening: Pharmacists trained Intervention <5 minutes Each iecg was read and

19 SEARCH-AF Stroke Prevention Study Sydney, Australia 10 Pharmacy sites Screening: Pharmacists trained Intervention <5 minutes Each iecg was read and interpreted by pharmacist Any potential a fib referred to general practitioner Cost-effective at $4k/QALY Lowres et al. Thrombosis and Haemostasis. 2014;111(6):

20 mhealth Opportunities General Health, Nutrition, and Fitness Most common mhealth app use Health promotion impacts many disease areas Integration with multiple devices or other applications Fox S, Duggan M. Mobile health Pew Research Center. November 8, Available at: Health.aspx, accessed August 10, 2015.

21 mhealth Apps (General Health) Fitbit (Fitbit Inc) Wearable devices mhealth applications Bluetooth syncing Products. Fitbit Inc Available at: accessed August 11,

23 mhealth & Community Pharmacy Pharmacists have demonstrated improved blood pressure control with the use of telemonitoring. Pharmacist coaching and monitoring services (Cholesterol, blood pressure, blood glucose, BMI, waist circumference) have been effective in community pharmacy. Do I need to sell you on how effective community pharmacists can be?!?! Margolis KL et al. Effect of home blood pressure telemonitoring and pharmacist management on blood pressure control: a cluster randomized clinical trial. JAMA. 2013;310: DiDonato KL, May JR, Lindsey CC. Impact of wellness coaching and monitoring services provided in a community pharmacy. JAPhA. 2013;53:14-21.

24 mhealth & Community Pharmacy Implementing mhealth Services PDSA Plan, Do, Study, Act Plan: Pick a service that fits the needs of your patients and works with the strengths of your employees. Do: Start a small pilot and incentivize a few patients to enroll. Study: Measure qualitative and quantitative outcomes. Act: Launch service to a larger group with more structured processes and metrics for success. Phillips MS, Chisholm-Burns MA. Quality Improvement. In: Chisholm-Burns MA, Vaillancourt AM, Shepherd M, eds. Pharmacy Management, Leadership, Marketing, and Finance. 2nd ed. Burlington, MA: Jones & Bartlett Learning; 2014:

25 Challenges and Barriers Privacy Security Licensure Professional liability Yang YT, Silverman RD. Mobile health applications: the patchwork of legal and liability issues to suggest strategies to improve oversight. Health Affairs. 2014;2:222-7.

26 mhealth Now it is YOUR TURN Implementing mhealth Services (Active Case) PDSA Plan, Do, Study, Act on DIABETES Plan: Do: Study: Act: Phillips MS, Chisholm-Burns MA. Quality Improvement. In: Chisholm-Burns MA, Vaillancourt AM, Shepherd M, eds. Pharmacy Management, Leadership, Marketing, and Finance. 2nd ed. Burlington, MA: Jones & Bartlett Learning; 2014:

27 Active Learning Questions 1. List 3 health conditions for which remote monitoring and mhealth could be used to improve patient outcomes?

28 Active Learning Questions 2. What are potential barriers to implementing a mhealth program in your pharmacy?

29 Active Learning Questions 3. What part of the iphone can be used to measure your heart rate? a) Fingerprint scanner b) Headphone jack c) Camera d) Siri

30 Questions?

2015 Annual Convention

2015 Annual Convention Date: Saturday, October 10, 2015 Time: 8:00 am 9:00 am Location: Gaylord National Harbor Resort and Convention Center, Chesapeake 7/8/9 Title: Activity Type: Speaker: Mobile Health