MOBILE TECHNOLOGY IN PATIENT CARE

Transcription

1 MOBILE TECHNOLOGY IN PATIENT CARE Elizabeth Urteaga, Pharm.D. National Wellness Conference June 23, 2014 Learning Objectives Identify mobile instruments available to monitor a patient s disease states Educate patients, the public, and health care professionals regarding the selection and use of self-monitoring devices to improve health status and medical conditions Discuss the use of mobile technology to enhance wellness Patient Assessment Communication and empathetic listening (interview) Examination techniques Clinical decision making 1

2 Patient Interview Demographics Patient s perceived needs and concerns Medical history Medication history Drug allergies Objective data Vital Signs Physical examination Laboratory tests Diagnostic tests Star Trek Patient Assessment Tricorder 2

3 The Smartphone The number of active smartphone users around the world has topped 1 billion Estimated that another billion will become smart phone users by 2015 Study: Number of smartphone users tops 1 billion: From CBS News. Accessed June 2, mhealth applications for smartphones Mobile device applications intended to improve health outcomes More than 100,000 mhealth apps are published on the ios and Android platforms Estimated that 500 million smartphone users will use mhealth apps in 2015 Majority of smartphone users have >20 apps Research2guidance. mhealth App Developer Economics 2014: The State of the Art of mhealth App Publishing. May 6, Accessed June 2, 2014 Research2guidance. 500m people will be using healthcare mobile applications in Accessed June 2, IMS Institute for Healthcare Informatics. Patient Apps for Improved Healthcare from Novelty to Mainstream. October Accessed June 2, 2014 mhealth applications for smartphones Impact on healthcare in the next 5 years Improve patient outcomes Improve prevention and education Reduce or slow down increase of healthcare costs Improve interaction between patients and doctors Enable people to take better care of their own health Provide (better) access to healthcare in remote locations Research2guidance. mhealth App Developer Economics 2014: The State of the Art of mhealth App Publishing. May 6, Accessed June 2,

4 mhealth applications for smartphones mhealth applications for smartphones 4

5 5

6 6

7 7

8 Validation and Safety of Applications US Food and Drug Administration has regulatory authority over mhealth apps acting as medical devices or as accessories to medical devices Concern for lack of regulation and an evidence base for wellness apps There is a need for alternative application reviews and certification that are free of conflict of interest Happtique Health App Certification Program AppRx AppScript Go you cigna marketplace health and wellness apps National Health Service in England Health Apps Library 8

9 Safety of Applications False claims are a target of federal regulation, as well Acne and light emitted by smartphones Apps which provide a diagnosis will be subject to FDA clearance as a medical device Detection of cancer based on picture of mole Comprehensive analysis As of June 2013, 43,689 mobile healthcare apps categorized as health and fitness or medical existed in the U.S. itunes store 23,682 genuine healthcare related apps Inform 10,840 Instruct 5,823 Record 5,095 Display 2,302 Guide 1,434 Remind/Alert 1,357 Communicate IMS Institute for Healthcare Informatics. Patient Apps for Improved Healthcare from Novelty to Mainstream. October Accessed June 2, mhealth applications for smartphones 9

10 mhealth applications for smartphones 5,400 of these apps relate to diet and fitness Self-monitoring of physical activity and dietary intake are key components of behavioral weight loss programs IMS Institute for Healthcare Informatics. Patient Apps for Improved Healthcare from Novelty to Mainstream. October Accessed June 2, 2014 IMS Health ranking of top apps Prevention/Healthy Lifestyles Calorie Counter and Diet Tracker by MyFitnessPal HD Calorie Counter PRO by MyNetDiary Chest Trainer: powered by Fitness Buddy Cycle Tracker Pro-Training Peaks GPS Quit it 3.0 stop smoking Quit Smoking Now HD Hypnotherapy with Max Kirsten Finding a Provider Healow Vitals Your top 10 doctors! ZocDoc Doctor appointments online! IMS Health ranking of top apps Diagnosis/Education HealthTap itriage WebMD for ipad Filling Prescription GoodRX MyRefill Rx Walgreens 10

11 IMS Health ranking of top apps Compliance Dosecast Pill Monitor Free Medication Reminders and Logs RxmindMe Prescritpion/Medicine Reminder and Pill Tracker IMS Health ranking of top apps Diabetes Daily Carb Glucose Buddy Go Meals Mental health ADHD Angel Live OCD Free T2 Mood Tracker IMS Health ranking of top apps Musculoskeletal system Office-Fit WebMD Pain Coach Zimmer Arthritis 411 Oncology Dr. K s Breast Checker PCR Tracker SkinKepper Nervous system Noteness Parkinson Diary Young Epilepsy iwander 11

12 Choosing Applications Familiarize yourself with a few apps that you can offer Exchange information with colleagues imedicalapps (imedicalapps.com) Consider the source Prescribed Applications Anxiety Breathe2Relax Relaxation Techniques Headache/migraine iheadache Medication management GoodRx MedMory MyPill Menopause mypause Pain WebMD Pain Coach Sleep problems Sleep Diary Voiding Bladder Pal ip Voiding Diary Weight loss Calorie Count Lose It! MyFitnessPal Lippman, H. How apps are changing family medicine. J Fam Pract 2013; 62(7): BlueStar App from WellDoc FDA approved Requires a prescription BlueStar provides real-time coaching, educational content and motivational support on medications, blood sugar readings, diet, and exercise, all based on personal data Guided Compliance tool directs patients to test their blood glucose at optimal times Suggests medical and lifestyle/self management changes (also communicated to provider) Blue Star. Accessed June 2,

13 BlueStar App Three month clinical trial of 30 patients with type 2 diabetes mellitus showed average 3 month A1c decrease of 2.03% compared to 0.68% (p<0.02) WellDoc group improved self-care in diet, medical and exercise as compared to usual care IMS Institute for Healthcare Informatics. Patient Apps for Improved Healthcare from Novelty to Mainstream. October Accessed June 2, The Future Technology is enabling the easy access of health information at the same time as the patient is being encouraged to be more involved in managing their health; however, apps should not replace human care If patients are regularly collecting health data, the data can be evaluated and the information can be used to modify a behavior, better manage their condition, empower patients to live a healthier lifestyle, promote adherence Meaningful evidence of the efficacy of mhealth apps References Study: Number of smartphone users tops 1 billion: From CBS News. Accessed June 2, Research2guidance. mhealth App Developer Economics 2014: The State of the Art of mhealth App Publishing. May 6, Accessed June 2, Research2guidance. 500m people will be using healthcare mobile applications in Accessed June 2, IMS Institute for Healthcare Informatics. Patient Apps for Improved Healthcare from Novelty to Mainstream. October Accessed June 2, Smartphone physical. Accessed May 31, Ozdalga E, Ozdalga A, Ahuja N. The smartphone in medicine: a review of current and potential use among physicians and students. J Med Internet Res 2012;14(5):e128. Lippman, H. How apps are changing family medicine. J Fam Pract 2013; 62(7): Blue Star. Accessed June 2, Powell A, Landman A, Bates D. In search of a few good apps. JAMA 2014; 311(18): Boulos M, Brewer A, Karimkhani C, Buller D, Dellavalle R. Mobile medical and health apps:state of the art, concerns, regulatory control and certification. Online J Public Health Inform 2014;5(3):e

14 QUESTIONS? 14