Mobile Health Symposium #HIMSS15 Session Mh2
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Transcript of Mobile Health Symposium #HIMSS15 Session Mh2
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Establishing Connections –Infrastructure Enabling mHealth
April 12, 2015Tom Reid, Southern Ohio Health Care Network
Ali Youssef, Solutions Architect, Henry Ford Health System
DISCLAIMER: The views and opinions expressed in this presentation are those of the author and do not necessarily represent official policy or position of HIMSS.
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Conflict of Interest
Thomas Reid
Patent Holder: SEED ProtocolOwnership Interest: SEED Protocol LLC
Not directly related to topic of presentation
© HIMSS 2015
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Conflict of Interest
Ali Youssef, Solutions Architect, Henry Ford Health System
Has no real or apparent conflicts of interest to report.
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Learning Objectives
� Identify wired and wireless needs in healthcare settings
� Identify funds and solutions which enable mHealth technologies
� Assess the impacts of sourcing funding to increase capacity
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Tom Reid
Southern Ohio Health Care Network
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� Payers becoming providers
� Employers managing chronic conditions
� Calculated “shots” to identify services offering the strongest ROI
� Reducing costs of chronic disease care a tempting target
Dangerous Game of Battleship
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mHealth for Chronic Disease
9 to 1 Maximum4 to 1 MinimumBut deployed for < 0.5% of chronic disease patients
Costs of $230 PMPMSavings of $980 to $2,030 PMPM
Demonstrated ROI
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� Payers as Caregivers
o Risks shifting the patient’s relationship
o Reimbursement negotiations would become even more difficult
� Innovate now to keep the hearts and minds of the patients
Lead the Disruption or Be Disrupted
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� Fee-for-service dependency
� Lack of reimbursement
� Slow adoption of new practice models
� Broadband availability
The Obstacles
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� Leveraging the FCC Funding
� Power of Consortiums
� Critical Role of Health Care Providers
Expanding Broadband
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Consortia Magnify Impact
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� Expand access to world-class care
� Improve health outcomes
� Defend rural health systems from urban poaching
� Provide professional development for rural health care providers
� Broadband as a key missing ingredient
SOHCN Vision
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� Expand access to world-class care
� Improve health outcomes
� Defend rural health systems from urban poaching
� Provide professional development for rural health care providers
� Broadband as a key missing ingredient
SOHCN Vision
Founding health care providers
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34-County Service Area
� 17,000 square miles*
� Average density = 3.2 households per square mile
� U.S. average density = 33 households per square mile
� Largest city = 10,000 households
*110% size of Massachusetts and Connecticut combined
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Lack of Access� In 2008, policy makers were
declaring victory
� 95% of Ohioans had broadband available
� But the remaining 5% spread across a large area
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Lack of Access� In 2008, policy makers were
declaring victory
� 95% of Ohioans had broadband available
� But the remaining 5% spread across a large area
� 58.9% of the service area without broadband of any kind
� We changed the conversation by visualizing the data
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The Grip of Poverty
� 11 poorest counties in Ohio
� Crushing childhood poverty rates
� High unemployment
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Promise in the Region
Human Resources+ Strong work ethic+ Family-friendly
communities
Natural Resources+ Natural beauty+ Natural gas and coal
Economic Drivers+ Farming+ Niche Manufacturing+ Health care + Tourism
Areas of Growth+ Biomedical research + Engineering development+ Solar and wind energy + Information technology
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� Phase I in 13 Countieso $30 million
o $16 million from the FCC
� Phase II in 21 Countieso $104 million
o $66 million from NTIA
� Incumbent Reaction
Successes!
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Near Flame Out – Phase I
� Community broadband restrictions
� “Excess capacity” and “fair share” provisions
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Smooth Landing – Phase I
� Negotiated solution with FCC on community broadband� IRUs for 16,000+ fiber miles retained by SOHCN� 100+ sites connected� Generating >$2 million in annual savings
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Partnership PotentialMoving Forward� Healthcare Connect Fund
o Expanding reach of fiber broadbando Providing carrier redundancyo Expanding membership
� Health Care as Community Leaderso Continued Broadband Expansiono Economic Developmento Supporting K-12
� Health Care Prioritieso Chronic Disease Managemento Reinvention of Care Model
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Aren’t We Done Yet?� FCC Universal Service Fund Programs Impacting Rural Broadband
o Connect America Fund
o Healthcare Connect Fund
o E-Rate for K-12
o Mobility Fund
Implications of Physical IsolationReduces compliance with follow-up appointmentsIncreases windshield time for home care nurses
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Key Features of New FCC Program� Healthcare Connect Fund (HCF)
o Lessons learned from Pilot program
o “Streamlined” process
� 65% Subsidy Coveringo Site-to-site connectionso Internet accesso Fiber construction
� Support for both primary and back-up connections, including use of multiple carriers
� Acceptance of multi-year contracts resulting from competitive bidding
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Consortium Benefits
� Pooled purchasing power to lower pricing
� Collectively comply with HCF’s 51% “rurality” requirement
� Zero administrative load on the Members, addressed instead through consortium:o USAC invoice processingo FCC reportingo Carrier relationso Intervene on Members’ behalf as needed
� Collective effort will have more impact in expanding broadband across the region
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HCF Myths� Complicated
� Lowest bidder trap
� Costs exceed savings
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HCF Realities� Easy to outsource operations
� “Best value” bid criteria
� Flexible purchasing mechanism (but not mandatory)
� Low operational consortium overhead
� Net 50% or more in savings on telecommunications costs
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� Expansion of fiber-based broadband services across the service area
� Deeper reach of fiber networks
� Speeds 4G deployment by mobile carriers
Bonus Round!
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Key RFP Criteria for “Best Value”� Architecture
� Capacity
� Availability
� Performance
� Tier 1 Internet Capacity
� Key Termso Meet or Beat
o Right to Upgrade
o Escalating SLA Penalties
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Wireless coverage expensive to achieve in our terrain
Expansion of Mobile Coverage
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� Wireless coverage expensive to achieve in our terrain
� Verizon has dramatically expanded 4G coverage riding our fiber
� AT&T has also expanded and upgraded services significantly
� Now 4G reaches a large percentage of our population
� Ready for mHealth deployment even in our VERY rural area
Expansion of Mobile Coverage
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Geo-Referencing� Geographic analysis of locations of patient population to 4G
coverage
� Emergency response improved with mobile location services
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Hard to call the winners at this point
But we’ve learned from previous technological disruptions …
You can’t stop the wave …
Unstoppable
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Hard to call the winners at this point
But we’ve learned from previous technological disruptions …
You can’t stop the wave …
So better to learn how to surf!We can help
Unstoppable
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Questions
� Past seven yearso $900 million in projectso $174 million in Federal funding
� Federal Agency Expertiseo FCCo NTIAo USDAo ARC
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Establishing Connections –Infrastructure Enabling mHealth
April 12, 2015Tom Reid, Southern Ohio Health Care NetworkAli Youssef, Henry Ford Health System
DISCLAIMER: The views and opinions expressed in this presentation are those of the author and do not necessarily represent official policy or position of HIMSS.
![Page 37: Mobile Health Symposium #HIMSS15 Session Mh2](https://reader030.fdocuments.in/reader030/viewer/2022032616/55a71a7a1a28aba8048b478a/html5/thumbnails/37.jpg)
Ali Youssef
Solutions Architect, Henry Ford Health System
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Henry Ford Health System� HFHS is a not-for-profit organization
primarily located in Southeast Michigan.
� More than 23,000 total employees.
� 3.2 million outpatient visits and more than 88,800 surgical procedures (2013)
� More than 89,000 patients admitted to HFHS hospitals
� $6.018 billion total economic impact of HFHS on metro Detroit with revenue accounting for $4.52 billion
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MHealth at Henry Ford
� Wi-Fi instrumental to MHealth strategy� Over 100 facilities and
8 million square feet of Wi-Fi coverage.
� 9,000+ concurrent guests and 14,000 concurrent Wi-Fi devices daily
� Use cases inside, and outside the hospitals, and many apply to both.
� MHealth advisory council/steering committee.
• Guest Access• Medical Devices• BYOD• Employee Devices• Phones• RTLS• IOT
Inside Hospital
• VRI• Telemedicine• Home Care• E-care
Outside Hospital
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Mobility spectrum
Indoor Voice handsets (900-928 MHz; DECT 6.0 1.93GHz)
Medical Body area networks (2360-2400 MHz)
Bluetooth and BLE (2.4 -2.485 GHz)
Cellular Distributed Antenna Systems (3G, 4G)
Zigbee (2.4 GHz)
Telemetry WMTS (608-614 , 1395-1400 , and 1429-1432 MHz)
WLAN/Wi-Fi (2.4 GHz, and 5 GHz)
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� Wired and wireless QoS strategy.� High availability design for
Wi-Fi Aps/controllers � Onsite RF Design surveys� Ongoing Capacity planning� IEC 80001 risk
management framework for networked medical devices� Security strategy� Standard device testing
and onboarding process. � Security strategy and
roadmap� Focus on QoE
Anatomy of Mhealth ready Infrastructure
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Video Remote Interpretation � Targeting Deaf and hard of hearing patients and staff by
providing remote American Sign Language translators.� Custom wired and wireless system developed � End to end QoS implemented� Initial POC deployment in Emergency Departments.� Cost savings realized for short duration sign language
translation requirements by providing timely access to care.
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LTE Unlicensed
� Extension of LTE network in Unlicensed 5GHz space.� One more contender for small cell
deployments� Further coexistence testing with Wi-
Fi in the 5 GHz band in progress.
*Graphic by Qualcomm
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“Wi-Fi Enabled Healthcare”Focusing on its recent proliferation in hospital systems, Wi-Fi Enabled Healthcare explains how Wi-Fi is transforming clinical work flows and infusing new life into the types of mobile devices being implemented in hospitals. Drawing on first-hand experiences from one of the largest healthcare systems in the United States, it covers the key areas associated with wireless network design, security, and support.
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Questions?