Technology for Self Management

Transcription

1 Technology for Self Management Brad E. Dicianno, MD Associate Professor University of Pittsburgh Medical Center Dept. of PM&R Director, Adult Spina Bifida Clinic Director, UPMC Center for Wellness Medical Director, Center for Assistive Technology Assoc. Medical Director, Human Engineering Research Laboratories

2 The Problem ½ - ¾ Australians and Americans have > 1 chronic illness Chronic disease accounts for 2/3 of Australia s health spending 5% of Americans with chronic conditions account for > ½ health care expenditures

3 Shocking AND Expensive Preventable Conditions in Spina Bifida Skin and Bladder infections most prominent Account for 1/3 of hospitalizations 1-2% of these hospitalizations lead to death 30 day readmission rates high Expenditures 3-6x higher than general population Each hospitalization costs $30K ~4 hospitalizations/yr/person Total cost is > $360M/yr Dicianno, Wilson. Archives of PM&R, 2010.

4 In Person Wellness Programs Effective Expensive Personnel Travel Time Intensive Phone calls Home visits

5 The Solution Mobile Technology PDAs now out of favor Smartphones ubiquitous Use at home, work, play

6 Chronic Condition Apps Highest rankings -- Apple s Top 1000 Health & Fitness 77. GoMeals developed by Sanofi Aventis 164. GlucoseBuddy developed by oneapponecause 193. Allergy Alert developed by SDI Health 232. Livestrong developed by Demand Media 323. WaveSense Diabetes Manager developed by Agamatrix 331. Diabetes Log developed by Distal Thoughts 432. Diabetes Companion developed by dlife 441. Diabetes Health Mobile developed by Diabetes Health 471. hcg Diet app developed by CodeQ 537. BloodPressure+Pulse Grapher Lite developed by Michael Heinz

7 Handout available

8 The Current Market Over 5,800 health, medical, and fitness phone apps within Apple s AppStore, of which: 73% targeted to consumers or patient-end users, and 23% targeted to healthcare professionals Few provide for patients and clinicians interaction (telehealth)

9 The RERC on Telerehabilitation is funded by NIDRR Department of Education, Washington DC, Grant #H133E040012

10 Telerehabilitation The clinical application of consultative, preventative, diagnostic, and therapeutic services via two-way interactive telecommunication technology. AOTA (2010) Position Paper on Telerehabilitation

11 Rehabilitation Engineering Research Center on Telerehabilitation Mission Statement: dedicated to developing methods, systems, and technologies for remote delivery of rehabilitation services

12 Our Technology imhere (imobile Health and Rehabilitation) Telewellness Support Systems Android Phone Suite of smartphone apps Web based Portal Clinician dashboard

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14 Dynamic 2-way communication 14

15 Specs Android, ios, and Windows 8 platforms Java Drug database from National Drug Code (NDC) Extensible Messaging and Presence Protocol (XMPP) standard Encryption, HIPAA compliant Can erase phone remotely if lost Reliability in spotty wifi or 4G settings

16 COPYRIGHT UNIV OF PITTSBURGH

17 COPYRIGHT UNIV OF PITTSBURGH

18 COPYRIGHT UNIV OF PITTSBURGH

19 COPYRIGHT UNIV OF PITTSBURGH

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21 COPYRIGHT UNIV OF PITTSBURGH

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28 IBM Post-Study Usability Questionnaire n=8 Likert scale 1-7 Lower scores indicate higher satisfaction 2 Phases Scrolling Bundling of alerts Font and color Reliability with spotty wifi

29 IBM Post-Study Usability Questionnaire Apps Tested Range of Average PSSUQ Scores Round 1 Round 2 MyMeds (all scored 1.0) TeleCath (all scored 1.0) BMQ s (all scored 1.0) MyMood SkinCheck COPYRIGHT UNIV OF PITTSBURGH 2012

30 Timeline Usability studies Clinical trial Phase I SBIR Improving dashboard Partner sites Other diagnoses = TBI, SCI Phase II SBIR Validation, clinical testing Commercialization

31 Krainak Program on Adult Care Phase I -- resources for physicians in the community VIDEOS TRANSITION WORKSHEET and COVER PAGE Phase II -- comprehensive list of clinics where patients can receive care Phase III -- revamping health care guidelines Phase IV -- national outreach programs Phase V -- coalescing resources for the patient during transition PERSONAL ELECTRONIC HEALTH RECORD

32 Transition Discharge Kit

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