Mobility in HealthcareApplication of wireless technology to improve patient care

Trailblazers

Agenda

● Current State - Wahid

● Wireless Technology to the Rescue - Gerard

● Future State - Andy

● Final Thoughts - Andy

Overview of IT in Healthcare

● US health care spending at approximately 17.9 % of GDP● The leading areas of this spend are:

○ Hospital spending: $814.0 billion in 2010○ Physician and Clinical services spending: $515.5 billion in

2010● Focus on Technology spending in healthcare has increased over the

years. However, diffusion is still limited and much less than other industries.

● US Healthcare IT spend to cross $ 40 Billion in 2012.● Growth driven by spending on electronic health record (EHR)

systems, mobile health applications and regulatory compliance (HIPAA).

● The mobile health market estimated at $2.1 billion by the end of 2011. This number translates to a growth by 17% in each of the past two years.

Sources: 1. Center for Medicare and Medicaid Services, 2. Computerworld.

Current Technology LandscapeClinical Patient Communication/

InformationAdministrative Infrastructure

Telemetry Monitoring Systems

Radiological Information Systems

Clinical Decision Support Systems

Provider Care Systems

Electronic Health Record Systems

Prescription Systems

Picture Archiving and Communication System (PACS)

Health Education and Promotion Systems

RFID Systems

Billing Systems

General Ledger and Accounting Systems

Human Resource Management Systems

Patient Registration Systems

Desktops & Servers

Network / Wireless Network Systems

Voice Recognition Systems

Barcode Readers

Security Systems

Our project will focus more on the "Clinical" and "Patient Communication and Information" Systems as Wireless Technology will have the most impact on these two areas.

Existing SystemsArea System Existing Systems Supports Wireless

Clinical Telemetry Monitoring Systems

GE Healthcare - Corometrics®Model340 Yes - supports wireless monitoring

Clinical Radiological Information Systems

Advanced Data Systems - MedicsRIS No

Clinical Clinical Decision Support Systems

UpToDate Yes - supports Mobile Apps

Patient Communication/

Information

Picture Archiving and Communication System (PACS)

GE Healthcare - Centricity® PACS Yes - supports Apple or Android qualified devices

Patient Communication/

Information

Prescription Systems OASystems - RxCure Yes - supports eprescribing with wireless connectivity

Patient Communication/

Information

RFID Systems IBM - RFID Solutions for Healthcare Yes - supports patient tracking, asset tracking, etc

Management and IT GovernanceGovernance and Organization Structure has significant impact on what solutions are deployed and how effectively those solutions are used in clinical and administrative processes.

Source: Healthcare Information and Management Systems Society (HIMSS); 2005 Report on healthcare IT Management and Governance

Management and IT Governance

Healthcare CIO Priorities

Source: Healthcare Information and Management Systems Society (HIMSS); 2011 Survey of Healthcare CIO's and Technology Directors

Wireless in Hospitals

● Cell phones● Wireless LANs● Pagers ● RFID● Monitoring systems

Quiz Review

Standards and Compliance

● Electromagnetic Compatibility (EMC)○ IEC 60601-1-2○ CISPR11-A, CISPR11-B, CISPR22 ○ FCC Part 15.247 (FH-DSSS)

● Maximum Permissible Exposure (MPE)● Specific Absorption Rate (SAR)

Challenges

● More frequencies than ever before to test○ iPhone 4S

■ 800, 850, 900, 1800, 1900, 2100 MHz, 2.4 GHz■ Bluetooth

○ Samsung Galaxy S2 on T-Mobile■ 850, 900, 1800, 1900, 2100, 1700 MHz

○ White Space phones - upper 700s MHz● Assured delivery● Site selection ● Security - HIPAA compliance

Patient Care: Near-term perspective (1-3 years)

Wireless network and wireless network enabled device

Patient Care: Near-term perspective (1-3 years)

● Diagnosis with the help of wireless devices such as tablets\cellular phones

○ Access to EHRs\EMRs, Lab reports, Radiology and other reports,

Prescription information at the point of care

○ Access to patient medical records from disparate systems and geographic locations (Health Information Exchange [HIE])

Patient Care: Near-term perspective (1-3 years)

● Treatment and quality of care with the help of wireless devices such as tablets\cellular phones

○ Real-time collaboration on treatment options among healthcare

providers

○ Real-time communication with pharmacy for medications and other medical supplies

○ Real-time communication with labs for timely access to reports

Patient Care: Near-term perspective (1-3 years)

● Cost efficiencies with the help of wireless devices such as tablets\cellular phones

○ Access to historical medical records at the point of care avoids

duplication of expensive tests and procedures

○ Collaborative diagnosis avoids delays in the treatment thereby resulting in cost-effective "length of stay"

Patient Care: Short-term perspective (3-5 years)

Disparate medical systems and devices integrated over a seamless wireless network

Patient Care: Short-term perspective (3-5 years)

● Diagnosis with the help of wireless devices such as sensors, monitors, and RFID trackers

○ Sensors communicating directly with clinical systems to continuously

report on latest patient condition

○ Monitors communicating directly with prescription systems to track and alert on required levels of medication and dosage

○ RFID trackers communicating directly with telemetry and radiology

systems to ensure timely availability and readiness of equipment and personnel for critical procedures

Patient Care: Short-term perspective (3-5 years)

● Treatment and quality of care with the help of wireless devices such as remote-controlled meters and monitors

○ A blood pressure monitor that periodically checks blood pressure and

automatically sends notifications on mobile devices carried by care professionals for timely intervention

○ A remote-controlled blood glucose meter controlled through an iPhone

app that gathers data from the meter and sends it to a care provider for treatment decisions

Patient Care: Short-term perspective (3-5 years)

● Cost efficiencies with the help of wireless devices such as tablets\cellular phones

○ Improved accuracy of dosage amounts to be administered avoids

resulting costs associated with over\under dosage particularly for critical treatments

○ Timely attending to patient condition and need avoids additional care

costs that might result otherwise

Patient Care:Long-term perspective (beyond 5 years)

● A ubiquitous, pervasive, and fully-integrated wireless technology enabled infrastructure of medical systems and devices such as tablets, cellular phones, RFID sensors, remote-controlled monitors, implants etc. that offers -

○ Timely and accurate diagnosis

○ Effective treatment and excellent quality of care

○ Cost-efficient and reliable utilization of equipment, processes, and

personnel

Mobility in Healthcare - Patient Care: Final Thoughts

● Process innovation-based, extremely efficient, wireless technology-driven patient care

● New governance imperative - Chief Wireless Technology

Officer

● Challenges -○ Integration of disparate medical systems and devices○ Interference and bandwidth issues○ Security of wireless network, devices, and information

Closing

Thank You

ReferencesReferences for Current State

Robert Wood Johnson Foundation. Health Information Technology in the United States: Where We Stand, 2008 3; http://www.rwjf.org/files/research/3297.31831.hitreport.pdf

Report to the Congress: New Approaches in Medicare (June 2004); Chapter 7; Information technologyin health care; http://www.medpac.gov/publications%5Ccongressional_reports%5CJune04_ch7.pdf

President’s Council of Advisors on Science and Technology; Report to the President Realizing the Full Potential of Health Information Technology to Improve Health Care for Americans: The Path Forward; http://www.whitehouse.gov/sites/default/files/microsites/ostp/pcast-health-it-report.pdf

California Health Foundation; Health Care Unplugged; The evolving role of Wireless Technology; http://www.chcf.org/~/media/MEDIA%20LIBRARY%20Files/PDF/H/PDF%20HealthCareUnpluggedTheRoleOfWireless.pdf

HIMSS; 22nd Annual HIMSS Leadership Survey; http://www.himss.org/2011Survey/healthcareCIO_final.asp

9 Tech Innovations for Your Healthhttp://informationweek.com/news/galleries/healthcare/patient/232500827?pgno=2

7 Tools to Tighten Healthcare Data Securityhttp://informationweek.com/news/galleries/healthcare/security-privacy/232500404

Kaiser Permanente Offers EHR App for Androidhttp://informationweek.com/news/healthcare/mobile-wireless/232500470

Wikipediahttp://en.wikipedia.org/wiki/Main_Page