OPEN MINDS 2012 Planning & Innovation Institute

Transcription

1 Panel: Trish Cavestany, MSN, RN, CCM Director, Clinical Products and Services, Robert Bosch Healthcare Systems Steve Daviss, MD Chair, Dept Psychiatry, Baltimore Washington Medical Center Chair, Committee on Electronic Health Records, APA Co-chair, Behavioral Health Work Group, CCHIT Gerald Hurowitz, MD Assistant Professor of Clinical Psychiatry, Columbia University College of Physicians & Surgeons Moderator: Laura Morgan, Senior Consultant, OPEN MINDS OPEN MINDS 2012 Planning & Innovation Institute June 6, 2012/1:00 2:30 pm

2 1. Overview of latest developments in technologies for remote monitoring in support of community-based care 2. Implications for behavioral health care providers OPEN MINDS All rights reserved. 2

3 Telehealth Telecare & Assistive Technology ehealth Smart home Technology Techassisted cognitive retraining Companion robots Remote monitoring systems Remote vital sign sensors Wearable wireless devices mhealth Smartphone applications Text message alerts Telemedicine Real-time consultation Remote audio/video therapy OPEN MINDS All rights reserved. Today s focus 3

4 Consumer monitoring technologies Home health technologies designed to collect and transmit clinical and patient data through electronic information processing technologies Data input can involve both active patient and clinician interaction and passive physiological gathering and transmission of data OPEN MINDS All rights reserved. 4

5 $7.1 billion in 2010 $22.2 billion by 2015 OPEN MINDS All rights reserved. 5

6 Payers Closed integrated systems (VA) Large private insurers Large employers Providers Home health agencies Primary care provider networks with home-based patients Consumers Demand for self-management and convenience OPEN MINDS All rights reserved. 6

7 About 21% of physicians say their patients can access health information and education for chronic condition management 8% of physicians say patients use remote monitoring devices to monitor, record, and report to doctors on their conditions Majority of consumers in US are familiar with the term remote monitoring device Progress toward remote monitoring of patients with chronic conditions is limited 25% consumers report using a remote monitor before OPEN MINDS All rights reserved. 7

8 EHRs Need an electronic health record (EHRs) to fully integrate into practice: 2012 National Council survey estimates almost 50% of behavioral healthcare organizations now have an EHR But also, need interoperability between EHR and devices Workflow Disruptions How to manage the flow of patient-generated data Concerns about legal implications of not responding to a minor anomaly in health data No infrastructure in place for managing remote patient data, devices, and the connectivity issues that patients have National Council 2012 survey found health IT spending in behavioral health care organizations half the level found in general healthcare organizations Regulatory Privacy concerns HIPAA rules apply to covered entities health plans and providers but not consumers Limited regulatory oversight FDA 2011 proposed guidelines limit oversight to applications that "could present a risk to patients if the apps do not work as intended OPEN MINDS All rights reserved. 8

9 Public Sector: Fee-for-Service No coverage for the purchase of health technology devices and no reimbursement for the ongoing monitoring service Exception is for patients living in rural areas that may be eligible for federal funding for telemedicine Commercial/Private Sector Private payers generally follow Medicare lead in granting reimbursement Consumers appear to be willing to pay for wellness and fitness products, but if a product or service is prescribed by a doctor, consumers see this as the responsibility of insurance companies OPEN MINDS All rights reserved. 9

10 Barriers Changes in Large Health care Markets Reimbursement / Regulation Operational Disruptions DoD eliminates requirement for civilian HCPs to be licensed in each state where their military patients are being treated California Medicaid allows asynchronous physician consultation and real time video conferencing between patients and physicians OPEN MINDS All rights reserved. 10

11 ROI to support remote monitoring will be favorably impacted by payer reforms underway with health care reform Public sector: Calculation of cost savings across health care becomes possible with CMS payer reforms that encourage establishment of ACOs and bundled payment models 65 ACOs selected by CMS since January 2012 Serving more than 1.1 million FFS Medicare beneficiaries Private sector: Large health systems are moving ahead with ACO/collaborative organizations to manage the total cost of care Aetna is building a national network of ACOs 10 now and 20 by end of year CIGNA 22 ACOs in 13 states covering 270,000 customers OPEN MINDS All rights reserved. 11

12 Commercial adoption more prevalent in primary care Early adopters in behavioral health tend to adopt: External devices that are readily accessible and easier to use Lower cost of implementation and operation Include patient self-entry and management Provide treatment augmentation not substitution Devices that focus on behavioral change Aligns well with recovery focus and the need for therapeutic engagement Self-management embraced by patients No apparent difference among patients in ability to use and comply with daily entry based on severity of diagnosis 12

13 Dartmouth survey of 1,600 Chicago individuals under treatment for SMI found: 70% had cellphones and used them for calling, texting, and accessing the Internet Compares to 94% for U.S. population overall Emerging evidence that many chronically homeless individuals use mobile devices regularly Potential tools for identification of risk or preventive factors for chronic behavioral health conditions that can be targeted with real-time mobile interventions 13

14 Early Detection of Relapse M3 (My Mood Monitor ) Virtual Handheld Clinic: VA line of products including: PTSD Coach ecbt Mood Motionlogger Watch (Actigraphy) Helius Health Buddy Diagnostics Consumer Education / Decision Support Clinical Treatment Early Detection of Relapse Relapse Prevention Remote Monitoring of Patient Health OPEN MINDS All rights reserved. 14

15 Introduction of Faculty 15

16 Trish Cavestany, MSN, RN, CCM, Director, Clinical Products and Services, Robert Bosch Healthcare Systems Health Buddy. Patients use the device to answer a series of questions about their health and wellbeing. Answers are riskstratified and sent for review by their health professional, enabling proactive intervention before a patient's condition becomes acute. Current modules include health management programs for psychiatric disorders: bipolar disorder, schizophrenia, depression, and PTSD. Drs. Gerald Hurowitz, CMO, and Steven Daviss, CMIO, M3 M3 Clinician portal. Used in identifying depression, anxiety, bipolar disorder, PTSD, and seven (7) domains of health including sleep, impairment, alcohol and substance use OPEN MINDS All rights reserved. 16

17 2012 Planning & Innovation Institute June 6-8, 2012 New Orleans, Louisiana 2012 Executive Leadership Institute September 12-14, 2012 Gettysburg, Pennsylvania 2012 Institute for Behavioral Health Informatics October 17-18, 2012 Baltimore, Maryland 2013 Best Management Practices Institute February 14-15, 2013 Clearwater Beach, Florida 17

18 The market intelligence to navigate. The management expertise to succeed York Street, Gettysburg, Pennsylvania 17325