Health IT Module Content for NURS 220Y

MOBILE HEALTH AND TELEHEALTH

DISRUPTIVE INNOVATIONWhat is it’s role in healthcare?

WHAT IS DISRUPTIVE INNOVATION?

Term coined by Clayton Christensen in his book: The Innovator’s Dilemma

“a process by which a product or service takes root initially in simple applications at the bottom of a market and then relentlessly moves up market, eventually displacing established competitors.”

What does that mean in healthcare? http://www.claytonchristensen.com/key-concepts

DISRUPTIVE INNOVATION

Dr. Jason Hwang an internal medicine physician: “The transference of skills from highly trained

but also expensive personnel to more affordable providers, including technology-based care.

The shift away from traditional health care venues like hospitals into clinics and office settings, and, in some cases, into patients’ own homes.”

Townsend, John C. (April 23, 2013) Disruptive Innovation: A Prescription for Better Health Care. Forbes. Retrived August 14, 2013 from http://www.forbes.com/sites/ashoka/2013/04/23/disruptive-innovation-a-prescription-for-better-health-care/

MOBILE HEALTH AND TELEHEALTHEmerging technologies

WHAT IS mHEALTH? Subset of eHealth Practice of medicine or healthcare supported

by a mobile device Phones, tablet, iPad, laptop, other mobile (wireless)

monitoring devices Used to:

Collect data (community/public/home health) Deliver healthcare information (at point of care) Monitor (vitals, labs, activity) Communicate (messaging, email) CDSS Disease surveillance

TELEMEDICINE AND TELEHEALTH

Providing direct care via long distance As simple as a phone consult Video interactions Home monitoring of patients

May use mobile devices

PUBLIC POLICY THAT DRIVES DEVELOPMENT MEANINGFUL USE

improve understanding of their health take a more active role in their health

care.   involvement of their families

Examples:http://www.informationweek.com/healthcare/patient/7-e-health-tools-to-get-patients-engaged/240008652?pgno=1

Do these tools provide “meaningful use” to patients?

http://www.hrsa.gov/healthit/toolbox/HealthITAdoptiontoolbox/MeaningfulUse/intro2meaningfuluseandpatientandfamily.html

REGULATORY ISSUES

FDA- How to regulate a mobile device ? EX: Mobile phone that does a urinalysis What type of medical device is it? How is it regulated for safety, accuracy,

etc? Guidance in development

THE DIGITAL DIVIDE

Digital Natives and Digital Immigrants-Which one are YOU?

PEW INTERNET AND AMERICAN LIFE PROJECT

91% of U.S. adults own a cell phone; 56% of U.S. adults own a smartphone (May 2013 survey)

31% of cell phone owners, and 52% of smartphone owners, have used their phone to look up health or medical information.

19% of smartphone owners have downloaded an app specifically to track or manage health. 

http://pewinternet.org/Commentary/2011/November/Pew-Internet-Health.aspx

WIRELESS CONNECTIVITY

NOTE: Ages are as of 2011

Millennials (18-34)

Gen X (35-46)

Younger Boomers (47-56)

Older Boomers (57-65)

Silent Generation (66-74)

G.I. Generation (75+)

% of American adults in each generation who go online wirelessly(with a cell phone or laptop computer) 82% 71% 55% 46% 33% 9%

PEW

http://www.pewinternet.org/Reports/2010/Generations-2010.aspx

•How well will mobile health technology improve healthcare if the majority of the healthcare consumers do not embrace the technology?

•What can be done to improve access to or use of technology?

HOME USE DEVICES FOR SENIORS

Chronic Disease Management Independent Aging Health and Wellness Smart Homes

http://www.youtube.com/watch?v=NCixWY3eaOc

http://www.csa.us/MedicalDevice.aspx

MOBILE TECHNOLOGY FOR PROVIDERS

Improving care delivery

PATIENT CENTERED CARE What type of app is it?

Reference Diagnostic tool CDSS Networking resource

Cost effective? Free or subscription?

Equipment requirements Hardware or on a mobile platform

Security HIPAA compliant? Where is data stored?

MOBILE TECHNOLOGY FOR PATIENTS

Care centered on patients

WELLNESS AND HEALTH MAINTENANCE

Self monitoring Weight Activity Calories Blood sugars Sleep tracking Stress management Symptoms of chronic

disease Observations of daily

living http://quantifiedself.co

m

Medical reference Health information Health care guidance Community

WHAT ARE CONSUMERS DOING?

Seven in ten (69%) U.S. adults track a health indicator for themselves or a loved one and many say this activity has changed their overall approach to health

Project Health Design personal health records (PHRs) as springboards

for action and improved health decision-making HealthTap (https://www.healthtap.com/)

From web or mobile device Tailored medical advice with the input of doctors who

are site members.

THE NURSE AND MOBILE HEALTH TECHNOLOGY

The future of nursing

NEW TECHNOLOGY REPLACES NURSES? http://www.ted.com/talks/eric_topol_the

_wireless_future_of_medicine.html

Watch this video and discuss in class Does this technology replace the

nurse? Why or why not?

How will the nurses’ role and responsibilities change with this kind of technology?

THE CHANGING ROLE OF THE NURSE

User Educator Innovator Protector Role Model Super User Data Analyst

THE FUTURE OF HEALTHCAREMobile health technology and telehealth

http://vimeo.com/8236700

REFERENCESPOWERPOINT REFERENCES

Department of Health and Human Services (no date) Health IT Adoption Toolbox: Meaningful use: Patient engagement. Retrieved August 14, 2013 from

http://www.hrsa.gov/healthit/toolbox/HealthITAdoptiontoolbox/MeaningfulUse/intro2meaningfuluseandpatientandfamily.html Christensen, C. Information on Disruptive Technology:http://www.claytonchristensen.com/key-concepts/#sthash.JShNbj0o.dpuf   Centers for medicare and Medicaid services (August 2012) Stage 2 Overview Tipsheet. Retrived August 14, 2013 from

https://www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/Downloads/Stage2Overview_Tipsheet.pdf Hansen, Turton, T (December 2010). A Disruptive Innovation in Care Delivery: Nurse Practitioners Fill the Primary Care Gap:http://www.disruptivewomen.net/2010/12/14/a-disruptive-innovation-in-care-delivery-nurse-practitioners-fill-the-primary-care-gap/ Fierce Mobile Healthcare Mobile Health Downloads:a

http://www.fiercemobilehealthcare.com/story/report-14-billion-mobile-health-fitness-app-downloads-2017/2013-06-03#ixzz2byTjXSyD

Fierce Mobile Healthcare, Embedded Health Monitoring:http://www.fiercemobilehealthcare.com/story/market-embedded-health-monitoring-gadgets-hit-170m-devices-2017/2012-08-03#ixzz2byTzZIWnFox, S. (July 1, 2013) Pew Internet: Health. Retreived August 14,2013, from

http://pewinternet.org/Commentary/2011/November/Pew-Internet-Health.aspx Health Tap:https://www.healthtap.com Kellerman, G.R. (December 10, 2012) Mobile Health Tech: From Novel Startups to Global Industry. The Atlantic retrieved August 14.

2103 from http://www.theatlantic.com/health/archive/2012/12/mobile-health-tech-from-novel-startups-to-global-industry/266063/

REFERENCES, CONTMedical technology for the older adult:http://www.csa.us/MedicalDevice.aspx  National Institutes of Health, life time distribution of healthcare costs data:http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1361028/ National Science Foundation video about Smart Home Technology:http://www.youtube.com/watch?v=NCixWY3eaOc Quantified Self: http://quantifiedself.com/Pew Internet Tracking for Health: http://pewinternet.org/Reports/2013/Tracking-for-Health.aspx Topol, E. Ted TALK The Wireless Future of Medicine:http://www.ted.com/talks/eric_topol_the_wireless_future_of_medicine.html Townsend, John C. (April 23, 2013) Disruptive Innovation: A Prescription for Better Health Care. Forbes. Retrived August 14, 2013 from

http://www.forbes.com/sites/ashoka/2013/04/23/disruptive-innovation-a-prescription-for-better-health-care/ Wikipedia entry Digital Native: https://en.wikipedia.org/wiki/Digital_nativeupdated July 30, 2013 Wikipedia entry Disruptive Innovation: http://en.wikipedia.org/wiki/Disruptive_innovation Updated July 23, 2013 Wikipedia entry mHealth: http://en.wikipedia.org/wiki/MHealth Updated August 4,2013 Why mobile technology may well define the future of healthcare. You Tube Video: http://www.youtube.com/watch?v=qkm_7XUDqIY Zickuhr, K. (Dec 16, 2010) Pew Internet Report Generations 2010:http://www.pewinternet.org/Reports/2010/Generations-2010.aspx 

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