Personal Connected Health: From Wearables to EHRs and Workflow

Personal Connected Health Alliance

Personal Connected Health: From Wearables to EHRs to Workflow

John Sharp, MSSASenior Manager, PCHA/HIMSS

9/12/2016



• Division of HIMSS• Originally focused on events

– mHealth Summit• Now expanding to thought leadership,

convening stakeholders, publishing technical guidelines, promoting innovation and developing an evidence base on an international level

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Defining Personal Connected Health

• Personal: unique to a specific person – different for every individual, customized

• Connected: individual’s information flows seamlessly, with their consent, to and from a clinician, caregiver or community

• Health: the state of a person’s physical, social and mental well-being including but not limited to the absence or control of a disease

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State of Personal Connected Health

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Consumer

Apps &

Devices

Mobile phone Cloud Intero

p


CONSUMERISM

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Consumerism and Health

• From Philips Future Health Index

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7

Future of treatment

Connected health devices (apps, wearables, biosensor devices) for patients will form part of treatment plans in the future

33%38%

27%37%

33%42%

USA

UK

Physicians

Consumers

Diabetics


Consumer and Provider

• Seeing the same data – displayed in ways that are usable/actionable for each

• Participatory healthcare• Partnership in care

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Consumerism

• Dana Lewis• Type 1• Do It Yourself

Artificial Pancreas

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WEARABLES AND SENSORS

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Wearable Market

• Fitness bands• Smart watches• Shoe devices and smart shoes• Smart clothing• Ear devices• Headsets• Glasses• Tatoos 9/12/2016


Sensors

• Accelerometer• Gyroscope• Multi-touch

display• GPS• Microphone

Can enable monitoring of multiple actions:• Gait and balance• Fitness• Timed walk• Reaction time• Hand dexterity• Tone audiometry

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Future Applications of Sensors

• Smartphones can be used to identify atrial fibrillation with existing hardware

• uses the phone's own accelerometer and gyroscope to check for atrial fibrillation

• http://www.news-medical.net/

• Wristband detects and alerts for seizures

• http://news.mit.edu

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New Devices

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Smart Inhalers Medical smart tatoosRobotics and exoskeletons

medicalfuturist.com


APPS AND DEVICES

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App and Device Market

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• 78.5 million consumers using home health technologies by 2020


Personal Health Dashboard

9/12/2016 Fitbit


Cloud enabled

• Data moves from the personal health device orapp

• Through secure transmission• To cloud storage• For analysis and visualization• Delivered to consumer and provider

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HEALTHCARE INTERNET OF THINGS

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Healthcare Internet of Things Categories

• Clinical efficiency• Clinical grade biometric

sensors• Consumer/home

monitoring• Infant monitoring

• Fitness wearables• Advanced sports apps• Brain sensors/

neurotechnology• Sleep monitoring

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Internet of Things (IoT)

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Personal Connected Health Alliance9/12/2016


INTEROPERABILITY

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Interoperability and the EHRsPerhaps the most important shortcoming of the

EHR is the absence of social and behavioral factors fundamental to a patient’s treatment response and health outcomes.

In this world of patient portals and electronic tablets, it should be possible to collect from individuals key information about their environment and unique stressors—at home or in the workplace—in the medical record.

• JAMA - August 15, 20169/12/2016


Patient Generated Health Data

• From these sensors, apps and devices, we have data – what do we do with it?– ONC PGHD Fact Sheet

https://www.healthit.gov/sites/default/files/patient_generated_data_factsheet.pdf

– ONC Patient Engagement Playbookhttps://www.healthit.gov/playbook/pe/chapter-4/

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Interoperability

Personal HealthDevices

• Personal Health Devices Interface

Personal Health

Gateway

• Services interface

Health & fitness

Service

• HIS Interface

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EHR

Design Guidelines


Integrating into Workflow

Data from devices, questionnaires Transmission Integration engine

Store in EMR

Algorithm generates alert or

inbox to team member

Take action

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Integrating Patient Generated Health Data

• Workflow options– Alert about significant change in status– Unusual reading which may indicate device

malfunction– Combination of data indicating risk for

readmission– Overall trends sent to inbox as a message

• To whom should each situation be routed?– Medical home team member

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INCENTIVES AND BARRIERS

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Provider Incentives

• Readmission penalties• Diabetes Prevention Programs• Accountable Care Organizations

– pay for value• Chronic Care Management• Comprehensive Primary Care Plus • Care bundles – joint replacement, cardiac

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Barriers to Connected Health

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Behavior Change and Coaching

• Devices and apps alone cannot create real change

• Need strategy and coaching to enable health behavior change

• Example – Diabetes Prevention Programs

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EVIDENCE AND INNOVATION

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Evidence

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propellerhealth.com


Evidence

• Text 2 Move: Diabetes Care – Partners Healthcare– Personalized text messages encouraged physical

activity– Significant lowering of HbA1c levels

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Evidence

• NODE Health – Network of Digital Evidence– From the Sinai App Lab

• Newsletter includes – Initiatives– Publications– Resources

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Innovation – Venture Funding

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2015 – 4.5 Billion


Innovation – Venture Funding

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State of Personal Connected Health

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Consumer

Apps &

Devices

Mobile phone Cloud Intero

p



• December 11-14, 2016• Gaylord National | Washington, DC Area• PCHAconference.org

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Contact Me

• [email protected]• @JohnSharp• Linkedin.com/in/johnsharp• Recent blogs:

http://www.pchaconference.org/blogs

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Health & Medicine

Personal Connected Health: From Wearables to EHRs and Workflow