EMTN Telemedicine Retreat 8/14/2015. What is Telemedicine? What is Virtual Health ?

EMTN Telemedicine Retreat

8/14/2015

What is Telemedicine?

What is Virtual Health ?

3Copyright © 2015 Accenture All rights reserved.

Virtual health is designed to enable the widest range of services for an individual or population needs across a care episode, across time, across the care continuum and across care sites. Technology platforms will be useful to meeting this expectation.

For one patient, many encounters, many clinical

channels and services

Medication compliance & management

Monitor Nutrition and physical

activity

Visits with care team

Virtual supports groups

Caregiver/ family training

Virtual psychosocial

support

Extended care/step-down

care

Home visits and self-management

Health status monitoring

Remote health status monitoring

Remote visits for follow-up

MedicationCompliance

management

Physical activity tracking with devices

Virtual clinical encounters

Virtual psychosocial support for patient and families

Virtual support groups for patients and families

Caregiver and family training

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Why not just traditional telemedicine?

What is a virtual health platform?

A User Story Describes use of the Service and Required Functional

Requirements


Virtual Care Delivery Platform “Modules”Identifying and delivering “modules” of capabilities increase flexibility and speed to market.

Consumer Experience

• Clinician referral services

• Customized portal• Friends and family

access

Video and Collaboration Technologies

Core Functions• Alerting• Scheduling• Analytics• Etc.

Clinical Services and Applications

• Clinical consultations• Biometric monitoring• Secure messaging• Clinical

documentation

Peer and Self-Management Social Platforms

• Curated support groups

• References & information

• Self-tracking

Functional Requirement Use Case Description1 Beneficiary End User Functional Requirements

a End User Registration Use Case 1 Ability to register a member and dependentsi Solicit Registration Use Case 1 Email or notify beneficiary registration material and link

to servicesii Validate End User Registering Use Case 1 Optional: Perform additional identity validation of end

user registering beyond that provided by a TPA and/or self-insured employer

iii Coordinate Identity within Mental Health Services

Both Share end user identity as appropriate with other partners

b End User Access to Mental Health Services

Access and use mental health capabilities

i Manage Profile Use Case 1 Define and update individual demographic, insurance and preference data

ii Document Medications Add, change and remove medications- User enters medications Both End user can change, enter additional, or remove

medications, including medication, dosage, frequency and other information. Would include the ability to document over-the-counter and prescribed medications

- Medications prescribed by provider Both Ability to see and import medications prescribed by a healthcare provider, including medication, dosage, frequency and other information

iii Document Health Activity and/or Device Data

Both End user can enter data collected about their activity or from a monitoring device. The data entry can be manual and/or through a device interface

iv Enter mental health peer and self-support social platform

Both Access and use a social platform for mental health support and services

Functional Requirements Defined in the User StoriesThe following three pages list the functional requirements described in the user stories. Each of these requirements would need to be met by a VHS technology platform to offer the identified services. Functional requirements are also supported with user flows.

Functional Requirement Use Case Descriptionv Find a Provider Both Search a list of Virtual Care Platform-provided providers

for mental health, pharmacy and medication therapy management (MTM) services

vi Schedule Mental Health / TelePsychiatry Visit

Both Schedule a visit for a tele-psychiatrist and/or other Mental Health Service. At the time the visit is scheduled, ensure information is shared with the professional about the beneficiary to support the scheduled visit

vii Initiate TelePsychiatry / Mental Health Visit

Both Initiate a video session for a mental health consultation

viii Schedule TelePharmacy / MTM Visit Both Schedule a visit for a tele-pharmacist and/or MTM service. At the time the visit is scheduled, ensure information is shared with the professional about the beneficiary to support the scheduled visit.

ix Initiate TelePharmacy / MTM Visit Both Initiate a video session for a tele-pharmacist and/or MTM consultation

x Escalate and Schedule TelePsychiatry / Mental Health Visit

Both Notify the end user and appropriate professional Virtual Care Platform support that a social platform monitoring professional has recommended a consult with a healthcare provider outside of the social platform. Ensure documentation to support the recommendation is recorded

xi Record Encounter Notes Both Document and store any virtual visit consult or SOAP notes

xii Create and administer assessments Both Ability to define a variety of assessments that can be taken by beneficiaries including health, disease and engagement assessments

Functional requirements are also described through clinical workflows found in the appendix

Functional Requirements Defined in the User Stories

Functional Requirement Use Case Description2 Virtual Health Platform delegated Administrator and Provider Functional Requirements

a Third-party Administrator (TPA) Setup Use Case 1 Manage member and dependents from TPA

b Virtual Visit Provider Setup Both Manage providers and provider schedules

c Social Platform to Virtual Health Platform Member Data Sharing

Detailed and aggregate data sharing on individual end users

i Organize and Send Member Self-assessment Data

Both From the mental health social platform, share the completion of any assessments taken within the platform

ii Organize and Send Patient Aggregate Use Metrics

Both Share and record individual usage data available on the mental health social platform

d Bill TPA Both Billing for an encounter is sent to a TPA

Functional requirements are also described through clinical workflows found in the appendix

Functional Requirements Defined in the User Stories


Standard Platform Core Technology to Understand “Gaps”

Technical Capability and Ability to Deliver• Unified

communication• Solution

components• Integration• Technology

capabilities• User support• Performance and

alignment with CHI

Ability to Deliver Technology Categories and Capabilities:

• Rules• Unified communications• Scheduling• CRM• Content management• Care management• Resource management• Analytics• Call center• Personal remote devices• Channel to virtual

services• Data management

Data on 360 View of Patient Care:

• Stores• Use in application• Exchange with 3rd

parties• APIs to external systems

Compliance/Security Areas:• Access controls• Audit and accountability• Compliance• Configuration

management• Data encryption• Identification and

authentication

• Incident response• Maintenance• Media protection• Personnel security• Risk assessment• Security assessments• System and

communications protection

Compliance/SecurityRequired security capabilities to ensure the protection and use of patient health information. Compliance with defined regulations.

FunctionalFeatures and functionality required to provide capabilities to meet the needs of a variety of users and clients.

TechnicalRequirements which define how technology is to be used or how it must perform to provide engaging, usable functionality to meet the needs of end users.

DataData requirements to capture, integrate and share across the ecosystem to provide needed capabilities to a variety of clients.

Business, Cap and Partner

Business history, structure, financial strength, and market position to deliver Clients’ capabilities


Core TechnologiesCore technologies must meet a range of requirements to provide the required features and functionality.

• Medication adherence /dispense devices• Remote monitoring• Specialty remote devices

2. Personal & Remote Devices• Rules o Actionable criteria

• Unified Communication o IM, Screen share,

HD video, phoneo Messaging and alerts

• Scheduling• Customer relationship

management (CRM)• Content Management

and Health Tools• Care Management• Resource Management• Analytic • Health Contact Center

1: Engines

• Portals• Smart phone and mobile device applications• Social / information platforms

3. Channel to Virtual Services

• Diverse Data interfaces (Patient provided data, EMR / clinical, history, PBM, LAB results, TPA, etc. )

• Remote device gateway• Data Warehousing (vendor specific)

4. Data Management

Identified services mapped to technology categories required to provide desired functionality

Technologies Required to Meet Service Requirements (1 of 2)

Online scheduling

and wait-time information

Medication therapy

managementVirtual clinical

encounters

Digital (multi-channel) education content

Online risk-centered self-improvement

program

Self-monitoring

applications / devices

Disease-specific

navigator (low

intensity)

Self-care management

support1. Engines Rules X X X XUnified Communication X X X X XScheduling X X X XCRM X X X X Content Management and Health Tools X X X X X Care Management XResource Management X X Analytic X Health Contact Center X X

2. Personal and Remote Devices Medication adherence /dispense X XRemote monitoring X Specialty remote devices

3. Channel to Virtual Services

Portals X X X X X X XSmart phone and mobile device applications X X X X X XSocial / information platforms X X X X

4. Data Management

Diverse Data interfaces X X Remote device gateway X Data Warehousing X X X X X X

Total 6 5 6 5 6 11 10 8

Secure messaging information and support

Risk self-assessment

tools

Virtual group visits /

sessionsOnline social

networks

Multi-disciplinary care team encounters

Personalized care path and engagement

program

Care management

services1. Engines Rules X X XUnified Communication X X X X XScheduling X X X XCRM X X X XContent Management and Health Tools X X X X XCare Management X X XResource Management X X Analytic X X XHealth Contact Center X X X

2. Personal and Remote Devices Medication adherence /dispense XRemote monitoring XSpecialty remote devices X

3. Access to and Provider of Virtual Services

Portals X X X X X Smart phone and mobile device applications X X X X XSocial / information platforms X X

4. Data Management

Diverse Data interfaces X X XRemote device gateway XData Warehousing X X X X X X

8 5 6 3 8 12 15

Identified services mapped to technology categories required to provide desired functionality

Technologies Required to Meet Service Requirements (2 of 2)

Beneficiary

Monitoring Data

Mental health social platform

Guide

HS / EMR Data Repository

Single sign-onData feeds

Legend

Core VHS Engine

Alerts, reminders

Analytics

Other tools

contracted health professionalsClinical pharmacists

Clinical providersMental health providers

Virtual Visit Platform (Tele-psychiatry, mental health, MTM, tele-pharmacy, etc.)

TPAEMR, etc.

(e.g., medication history)

Personal devices

Patient portal

Self-management mobile apps

Identity Validation

T↔V

B↔V

M↔V

U↔V

I↔VD↔V

P↔V

Use Case 1: End user is supported through a online -accessible portal

Use Case 1 led to a high-level, conceptual architecture described in the figure. The red symbols identify system integration points.

A High-level, Conceptual Architecture

Use Case 1

Use Case 2

.

Notatio

nTechnology Solutions Included in the System Integration

U↔V End user to and from VHS technology solution. For example, integration

from an end user-controlled personal health record.

T↔V TPA and/or self-insured employer technology platform and VHS technology

solution. For example, member demographics for eligible members.

I↔V Identity validation service and VHS technology solution. Used to perform

identity validation.

M↔V MDLive virtual visit platform and VHS technology solution.

B↔V Big White Wall (mental health social platform) and VHS technology solution.

P↔V Healthcare provider and VHS technology solution. For example, medication

history from a beneficiary’s primary care physician.

D↔V Device data integrator and VHS technology solution. For example, a device

data collected by Qualcomm’s 2net and integrated with the VHS technology

solution.

Systems to be Integrated to Achieve Virtual ServicesThe table lists the systems to be integrated to achieve the identified services. Each system to system integration was documented based on the technology assumptions. For instance, system integrations were documented between the a IDS platform and MDLive as the best fit to case 1 requirements for video consults.

What’s next ? What’s this IoT?







Copyright © 2015 Accenture All rights reserved.

31

Digital devices permeate every aspect of our lives – at home, in the car, on the road, and in health care.

The Digital Age is Here, Consumers want to be Connected

Mobile health and fitness devices projected to be shipped by 2017.

515M

Want to monitor their health with connected devices that send information to their doctor or people they choose.

56%Of revenue estimated to be generated from health and wellness devices for 2018.

$8B

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Digital Disruption in the Health Landscape

By 2020, an estimated 50 billion devices around the globe will be connected to the Internet.

Source: DHL, Cisco 2015

50 BILLION DEVICES

The connected health segment is projected to grow to $2.4 billion by 2018 at a 36% CAGR between 2013-2018.

Source: Infonetics, Jan 2015

$2.4 BILLION GROWTH

97% of surveyed healthcare organizations agree that IoT will be the most strategic technological initiative their organization will undertake this decade.

Source: Zebra Technologies 2015

97% HEALTH CARE ORGS

Organizations that don’t have a well-defined IoT Virtual Health Strategy in the upcoming years will fall behind as the market matures.

Documents

EMTN Telemedicine Retreat 8/14/2015. What is Telemedicine? What is Virtual Health ?