VA Mobile at the Department of Veterans Affairs

Transcription

1 VA Mobile at the Department of Veterans Affairs Neil C. Evans, MD Co-Director, Connected Health Office Office of Informatics and Analytics Veterans Health Administration

2 VHA s Current Priorities v Patient Aligned Care Teams (PACT) v Connected Health Care v Access v Homelessness v Mental Health Care v Standardization 2

3 VA Connected Health Aligning virtual care technologies to create a seamless, unified experience for Veterans 3

4 VA Connected Health 4

5 VA Connected Health 5

6 VA Connected Health Connected Health Technologies Year Started Estimated Veterans Served in 2013 Home Telehealth ,250 Clinical Video Telehealth ,823 Store & Forward Telehealth ,369 econsults ,949 SCAN-ECHO ,632 My HealtheVet ,487,000 Blue Button ,000 Secure Messaging ,000 Veteran Mobile Apps 2013 Field testing Staff Mobile Apps 2013 Field testing Veteran Point of Service Kiosks 2010 >4M transactions 6

7 VA Mobile Health (mhealth) 7

8 Why VA Mobile Health v Facilitate high quality, efficient care that is driven by patient needs and health care goals v Allows unprecedented access to health data for Veterans and VA care teams v Utilizes new technologies in the quickly changing health care industry to provide effective, up-to-date tools to best serve Veterans of smartphone owners have used their phone to look up health or medical information 1 of physicians indicate that mobile technology has made a substantial impact in their delivery of care 2 1 PewResearch Internet Project; Mobile Health HIMMS 3 rd Annual Mobile Technology Survey 8

9 VA-DoD Stand Alone Apps VA Mental Health Apps Available on itunes Apps are na9ve and do not connect to the VA network. 9

10 The Road to Connected Apps 2011: Initial Clinician Pilot : Expanded to address the needs of Veterans, and created a new, streamlined process for App development at VA 2013: Family Caregiver Pilot Summer 2014: Launch of first Veteran-facing Apps that connect to the EHR Fall 2014: Large scale field test of providerfacing Apps begins 10

11 A Critical Foundation v Mobile Apps Development/Production Environment v Mobile Architecture v Mobile Device Management Software v Mobile Governance v Mobile Certification Process v Mobile Branding v Veteran App Library v Patient Generated Data Architecture and Policies v Mobile Device Support 11

12 Building On That Foundation v Veteran Facing Apps v Health Care Team Facing Apps v VA Mobile Provider Program 12

13 VA Mobile Health Veteran Apps 13

14 Veteran-Facing VA Mobile Apps v In Field Testing Family Caregiver Suite of Apps Veteran Appointment Request Scheduler Calendar View My Story v Soon-to-be Released Mobile Blue Button Summary of Care VA Launchpad 14

15 VA Family Caregiver Mobile Health Pilot v Cohort: Seriously Injured post- 9/11 Veterans and their Family Caregivers in the VA s Family Caregiver Program v Suite of Apps designed based on needs of Caregivers and Veterans v ipads loaded with Apps loaned to Caregivers for one year August 2012 September 2012 November 2012 May 2013 Timeline Mailing to 4,000+ Caregivers 1,200 Caregivers Responded Yes Mailing to Notify of Selection, Request Loaner Agreement, Invite into Study Distribute 800+ ipads 15

16 Family Caregiver Suite of Apps 1) Pain Coach Supports pain management 2) Care4Caregiver Supports Caregiver stress 3) Journal Allows for the recording of vitals, exercise, meals, contacts 4) RxRefill Assists with refilling VA prescrip9ons 5) Summary of Care Displays data from electronic health record (EHR) 6) PTSD Coach Supports PTSD management 7) Health Advocate Allows Veteran to designate a health advocate 8) Health Assessment Provides Veteran with a convenient way to take health self- assessments 9) NoJficaJons and Reminders Sets medica9on reminders and receive no9fica9ons from VA care team 16

17 What We Learned from Family Caregiver Mobile Health Pilot v Access: Individuals living in rural areas are more likely to use than urban areas v Age: Likelihood of using the Apps declines by 2% for every one year increase in age and this appears to be related to ability to obtain DS Logon creden9als v Mental Health: Caregivers caring for Veterans suffering from mental health- related issues, other than PTSD, are higher users v Polytrauma: Caregivers caring for Veterans receiving polytrauma care are less likely to use the Apps and this appears related to Caregiver s lack of 9me v Caregiver Preparedness: The less prepared the Caregiver feels to provide care, the more likely he/she is to use Mobile Apps v Caregiver Computer Skills: The higher the self- reported computer skills, the greater the use of the Apps 17

18 Coming Soon Available Apps for Veterans 18

19 Mobile Blue Button App If you are a Veteran enrolled in VA health care, the Mobile Blue Button App will allow you to: Better manage your their health care needs Communicate with your care teams Access, print, download and store information from your VA Electronic Health Record (EHR) in a secure, reliable and simple way 19

20 Summary of Care App If you are a Veteran enrolled in VA health care, the Summary of Care App allows you to: Receive and view your VA medical informa9on in one place and from the convenience of your mobile device 20

21 VA Launchpad for Veterans If you are a Veteran enrolled in VA health care, the VA Launchpad houses all Apps that connect to VA s EHR and access your personal VA health information. Group together VA s Mobile Apps that require a secure logon to access your EHR. Access multiple Apps without logging in to each one individually; requires a DS Logon Level 2 (Premium) Account NOTE: Veterans can also access the Apps separately without going through the VA Launchpad. 21

22 Veteran-Facing Mobile Apps in Development v Text Messaging Program (Annie) v My VA Health v Mission Health (Gaming App) v Wellness Check (Bio- surveillance Repor9ng) v Cardiac Rehabilita9on v Chronic Kidney Disease v VA Benefits App v And more 22

23 VA Mobile Health Staff Apps 23

24 Commercial Apps v >40,000 health or medical apps on the Apple itunes App store v ~30% built for clinicians v Most popular Drug Reference General Reference Mobile versions of pre-existing software remain popular, i.e. Epocrates, UpToDate 24

25 VA-Developed Apps v Core Applications to Access and Interact with VistA Examples: Patient Viewer App Nursing Apps v Workflow Focused Apps Examples: Immunization Campaign App Skin Check App Antibiogram Secure Messaging App Maternity Care Coordinator 25

26 Immunization App Single app, which unifies a common workflow Creates appointment in VistA for vaccine administration Provides Vaccine Information Sheet to patient by Pre-Vaccination Questions Documentation of Vaccine in VistA to include TIU Progress Note Immunizations File Updated Patient Care Encounter (PCE) completed

27 Immunization App 27

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32 VA Health Care Team-Facing Apps in Development v Pa9ent Viewer (VistA Data Review, Note Entry, Order Entry) v Immuniza9on v VA Mobile Imaging v Caring for Women Vets v Pre- Concep9on Care v Environmental Exposure App v My Mobile Desktop v Scheduling Calendar View v Chronic Kidney Disease v Safe Women Prescribing v Maternity Care Coordinator v Secure Messaging v Launchpad v Mobile ECG Viewer v Mobile Voice Dicta9on Integra9on v Nursing Ac9on Tracking v Nursing Interac9ve Pa9ent Informa9on 32

33 Overview of the VA Mobile Health Provider Program v Distribute tablets to up to 10,000 providers at up to 19 VA Medical Centers. v Evaluate the potential for mobile technologies to improve the efficiency and personalization of health care delivery by clinical staff. Phase 1: February - September 2014 Devices will include: VA Access to commercially available mobile health Apps that have passed VA security reviews Access to other capabilities to assist providers with accessing information in the medical center as well as off-site Phase 2: October 2014 (Target Date) Devices will be loaded with VA-developed Apps that will: Allow for quick access to real-time information to inform clinical decisions Assist Veterans and Caregivers with selfmanagement Allow providers to write progress notes, enter a subset of orders, and complete other clinical tasks. 33

34 Device Deployment/Training Providers receive configuration/set up support and training on their devices. When picking up their device, providers visited stations for Check In, AppleID, Triage, MDM, and Check Out. Photographs from Washington DC VAMC Deployment Training podcasts are currently available to users via video podcasts available on the Provider Program website. Additional training program are being established on TMS. 34

35 Deployment Efforts to Date v Apple ipads (minis and ipad 4s) have been distributed to more than 5,000 providers at 12 sites. v Technical environments varied at each site. v The amount of time spent at the Apple ID and MDM Stations was consistently the longest part of the process. v Site data and lessons learned were gathered at each site. v Adjustments to deployment processes were made to incorporate lessons learned. This resulted in a decrease in the time, and an increase in the number of devices distributed at each site. 35

36 Tweet from Apple CEO Tim Cook 36

37 Product Effectiveness Survey, Tennessee Valley HCS Respondents v VHA s Product Effectiveness Team is evaluating the success of the program. * 37

38 Product Effectiveness Survey, Tennessee Valley HCS Findings I like the fact that VA is providing new and innovative tools to enhance my ability to perform my job. 94% of respondents agreed The ability to access on the ipad has enabled me to become more productive. 70% of respondents My overall satisfaction with using the ipad in their work setting is satisfied/ very satisfied 53% of respondents The apps and tools on the ipad have improved my ability to make more informed care decisions. 45% of respondents agree/strongly agree 38

39 Contact Information Kathleen L. Frisbee, PhDc, MPH Co- Director (Program Lead) Connected Health Office, Office of Informa9cs and Analy9cs Department of Veterans Affairs Washington, D.C., USA Shawn Hardenbrook Director, Web and Mobile SoluJons Connected Health Office, Office of Informa9cs and Analy9cs Department of Veterans Affairs Washington, D.C., USA Neil C. Evans, MD Co- Director (Clinical Lead) Connected Health Office, Office of Informa9cs and Analy9cs Department of Veterans Affairs Washington, D.C., USA VA Mobile Health Website hdp://mobilehealth.va.gov 39