Mobile Technology and Clinical Telemedicine a System Perspective. Dr Rob Williams Ontario Telemedicine Network April 28, 2012

Transcription

1 Mobile Technology and Clinical Telemedicine a System Perspective Dr Rob Williams Ontario Telemedicine Network April 28, 2012

2 Overview About OTN Mobile devices supporting OTN s clinical services Considerations for the successful use of apps running on mobile devices in clinical care 2

3 OTN: Available Everywhere One of the world s largest & most active TM networks. Programs & services delivered collaboratively at more than 1,400 sites using 2,600 telemedicine systems. Page 3

4 OTN Virtual Channels 1. Healthcare Office 2. Acute Care 3. Learning 4. Home and Community

5 2011 Clinical Utilization Clinical Events Annual growth rate 170,875 39% Consultants 1,622 Physician Consultants 1,180

6 Patient Location 2011 Community 51% Hospital 31% Primary Care 14% Other 4%

7 OTN s Telemedicine Operating System Real time video-conferencing using room based equipment and dedicated network. Web-cast events (a/synchronous) using PC/laptop and internet. Store forward (dermatology, retinal imaging) expanding to e- Referral. Portal for referral management and scheduling, directory, event calendar, call management. Telehomecare including home sensor devices. Real-time video using PC/laptop and Internet. Social networks for communities of clinical practice. Security and identity management. 7

8 Global Drivers for mhealth Widespread use of smart phones and tablets with devices (camera, video, sensors, GPS). Inexpensive broadband and pervasive global connectivity. Providers and patients want anytime, anywhere, easy access to the virtual health care system. Wide spread availability of health related applications that operate on mobile devices.

9 Drivers for mhealth at OTN 1. Access to all OTN applications available on our Telemedicine OS using a mobile device. 2. Support the use of health applications running on mobile devices that contribute to the government s Health Care Transformation goals: Enhance access to health services; Enhance communication between providers and patients; and More timely and personalized sharing of health information. 9

10 Health Applications Highly creative uses, often with wireless sensors Monitoring vital signs, blood sugar Counting calories and energy expenditure Tracking the mood or side effects of treatment Tracking medication consumption Screening skin lesions and the retina Tracking falls at home and location of Alzheimer patient Eliciting a persons ethical and decision making desires

11 Health Applications Generate a large amount of data which needs to be analyzed and synthesized into meaningful information for the patient and provider.

12 OTN s Medical Devices and Mobile Apps Service Lead clinical reviews and assessments. Effectiveness and suitability for the clinical application. Compliance with privacy and best practices. Ease of use and workflow integration. Technical interoperability. Cost effectiveness. Implementation and support of approved medical devices, remote sensing devices and mobile health applications. 12

13 Review Considerations Customer friendly Simple to use Comprehensive one stop shopping Integrates everything with a few clicks Sensor generated data automatically uploaded Remembers data between uses Interactive and fun to use Predictive coaching

14 Review Considerations Meaningful clinical benefit to HCP s, patient s and funders. Cost to the HCP s, patients and funder. Alignment with HCP s normal workflow and patient s daily personal routine. Interoperability with other parts of the virtual health care system. 14

15 Implementation Barriers for HCP s Information overload. Need for evidence based effectiveness on improving quality of care. Medico-legal, privacy and security concerns. Integrating information with the EHR. Remuneration (FFS payment poorly aligns). Disrupting usual workflow and business processes. Need for after hours availability. 15

16 Implementation Barriers for Patients Lack of access to mobile technology and inadequate skills to use technology and apps. Fear of reduced personal hands on care from HCP and reduced quality of care. Cognitive or physical inability to use mobile apps. Cost

17 Opportunities for Success Engage stakeholders early to ensure user friendliness. Ensure affordability, integration, scalability and valueadd/fit with health care practices. Ensure data collection, analysis and reporting is succinct and app meaningfully assists with decision making. Develop training/support for users and allow customization/personalization of user interface. Promote and market best practices and evaluation. 17

18 Summary How mobile devices will support OTN s suite of telemedicine services. OTN s role in supporting OTN s role in supporting the use of apps in clinical care.

19 Follow

20 Trends in Health Care (extra slide) More accessible and timely communication between patients and providers. Care that is more personalized and individualized. Individuals own and manage their personal health information. Improved ability to digitize an individual s physiology, anatomy and biology. Improved computing of health data with convergence of data sources (EHR, DI, data from sensors and apps). Social networking facilitating communities for patients, providers and both combined. 20