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MHealth and Big Data Are Catalysts for Personalized Patient Care

Although there are many complexities wrapped around our healthcare system, Stanford University’s 2016 Medicine X Conference starts finding solutions to improving patient care by focusing on increasing patient engagement and transforming how patients are treated in the system.

Wellpepper CTO Mike Van Snellenberg, who spoke at MedX in September with digital health entrepreneur and physician Dr. Ravi Komatireddy, addressed several important aspects of big data collection.

“Collecting big data is like planting trees. You need to plant the seed of the process or tooling,” says Van Snelleberg. “Over time, this matures and produces data.”

Mr. Van Snellenberg, who has collected and analyzed patient data at Wellpepper, discovered several key aspects of data collection that could improve care continuity for both patient and providers. He shared this to his MedX audience.

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“Wellpepper has already uncovered new understandings about which patients are most adherent as well as indicators of readmissions,” says Van Snellenberg. “That’s very valuable information.”

“We’ve discovered that, as you collect patient-generated data, these types of insights as well indications about the effectiveness of certain clinical protocols will be available to you. This will help allow for providers to encourage positive patient behavior,” he stated.

Mr. Van Snellenberg spoke further at an interview in October about collecting and using patient-generated data.

 

Question: What groups can benefit off the collecting of big data?

Snellenberg: Collecting patient-generated data can ultimately produce better outcomes and patient care for hospital and clinics as well as the patients themselves. The more in quantity and detail, the better it is to help produce good results. Data collection has tremendous value that can allow hospitals and clinics to learn more about their patients in between hospital visits, thereby filling in missing gaps in patient information. We also realized that collecting big data can potentially prevent complications or readmissions by identifying warning flags before the patient needs to return to the clinic.

And as mentioned, analyzing big data has provided us insights about which patients are most adherent. For example, we have found that patients with 5-7 tasks are adherent while patients with 8-10 tasks are not.

 

Q: What are some things you have discovered using patient-generated data?

MS: We were able to make observations on the patterns. We also discovered a strong linear correlation between the level of pain and difficulty of patients.

Traditionally, patient data remained in the hospital. This often left big gaps in knowledge about the patient in between hospital visits. By collecting and data in between visits to the hospital, you can discover important correlations that would not have been discoverable without data.

 

Q: What are some possible methods to collect patient data?

MS: Dr. Ravi Komatireddy, who worked in digital health, suggested several programs such as Storyvine and AugMedix.

Usually, data is collected by patients recording symptoms and experiences on a daily basis in a consistent manner and then managed afterwards. For example, patients themselves tend to keep track of their progress in diaries or using the FitBit to record the number of steps and heart rate.

 

Q: What are some of the most unique aspects about this year’s MedX?

MS: One unique aspect about the MedX Conference is that it provided more opportunities for diverse voices to be heard in addition to health professionals – including a mix of health patients, providers, and educators.

The mindset was also encouraged to change. Some of the convention’s most progressive talks on stage happened when phrases such as “How might we…” and “Everybody included” are brought up in the discussion.

The term “Everyone included” came up most often, pushing for more perspectives outside of JUST the physicians. MedX’s solution-oriented focus proves to be heading down a successful route to improving patient care in the healthcare system as well as acting as the initiative to open doors for new voices to be heard.

Posted in: Clinical Research, Healthcare motivation, Healthcare Research, Healthcare Technology, Outcomes, patient engagement, Research, Seattle

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Mayo Transform 2016: Change

There was method to the madness, but the feedback for John Hockenberry, host and moderator of this year’s Mayo Clinic Center for Innovation Transform Conference at the first night reception was that the keynote was a bummer.

And it was. This year’s theme was change, and the keynote highlighted three key areas where we need fast and effective change: climate, diet, and early childhood education.Mayo Transform logo

Will Steger, a lifetime adventure and outdoorsperson and founder of Climate Generation, kicked things off with a dire warning that it was no longer possible to make a living running sled dog tours because the Arctic is melting. This was followed by Karen Watson who talked about the successful DrinkUp campaign to combat the challenge that 75% of Americans are chronically dehydrated from consuming sugared beverages instead of water. The campaign was focused on driving people to reach for bottled water instead of soda, and while this seemed counter to the first session on climate change, she cited that 22 million Americans have no access to potable water so bottled water is a good choice for them. Next up George Halvorson from First 5 California and former CEO of Kaiser Permanente talked about programs the state of California and KP have created for early childhood health and education, noting that the years from 0-3 were crucial for childhood development, and that a child of a working mother is read to for 1,500 hours during this period while the child of a typical Medicaid mother (who could be working) is read to for 30 hours during this period. This year 51% of children will be born to Medicaid mothers.

DrinkUpWhile both DrinkUp and First 5 provided solutions to the problems they raised, the overall impact of the keynote was depressing. While the intention was to catalyze people to change the schedule left us had the tools for making change delivered in sessions on days 2 and 3, which left us to drink our sorrows at the opening night reception (and not with bottled water).

Moving into days 2 and 3 of the conference, we did get tools for thinking differently, and the first session on day 2 provided richly in this area with Roger Martin, former dean of the Rotman School making the case for using both scientific method and rhetoric, and in particularly pointing out the short comings of scientific method if you want to innovate, in particular that it only looks at past data and does not imagine a future. Denny Royal of Azul 7 asked us to get out in nature for creativity, inspiration, pattern matching, by using biomimicry to use nature’s solutions for pressing problems, like how Sharklet used the natural antibiotic properties of sharkskin as inspiration to create a substance that naturally repels bacteria, or considering how to create adhesives that work better when wet, like the silk of the Cadis Fly, and could be used internally during surgery instead of our crude methods today like stiches or stapling. Teri Pipe, of ASU led us on a meditative path by asking us to notice what was happening in this moment, and apply these skills to build compassion and reduce stress in delivering care.img_0055

The day 2 keynote provided us with tools for imagining things that don’t exist, have the courage to quiet our own cleverness and learn from nature, and be resilient and empathetic. Given the day 1 keynote, this was just the antidote to embark on the rest of the conference.

Posted in: Healthcare Disruption, Healthcare motivation, Healthcare Research, Healthcare Technology, Healthcare transformation, M-health

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Is Connected Health Entering The Mainstream?

I’m just back from Parks Associates 3rd Annual Connected Health Summit. The summit, which began with a focus on consumer health and devices, is broadening to include the consumer experience in all digital health. Most attendees were from technology, payer, and device industries rather than healthcare organizations, and I was struck that a lot of the discussion of about the data from devices, predictive analytics, and natural language processing was beyond what we’re seeing in implementation in healthcare industries today.

Evolution of Digital Health

Evolution of Digital Health

Possibly because Parks Associates focuses on consumer data, and also that the conference has been consumer-device focused in the past, attendees and presenters included telecommunications companies, and even home security companies. This was my first time at the conference but from the data presented by Parks it seems as though digital health, and consumer focused health has become accepted as inevitable and mainstream. A few examples include ADT, the home security company talking about in-home sensing to enable seniors to stay in their homes longer, and Wal-mart talking about meeting healthcare consumers where they are. All of this is a far cry from traditional healthcare delivery. There was also a belief that digital health and the digital health consumer touches everyone from seniors, to the example that for many homeless people their most prized possession is their mobile phone.

Top takeaways:

  • There is no silver bullet for mobile health, digital health, or sensors.
    • Personalization is going to be key as the drivers for engaging in health are different for each person
  • There is no digital health consumer. Segmentation is very challenging in this market. Parks Associates Research identified 4 consumer groups, and 14 segments within those groups.

Digital Health Segments

  • Technology is currently out-pacing implementation possibly due to a slower transition to value-based care than the speed of consumer technology adoption.
  • People are sometimes consumers and sometimes patients, and this is not mutually exclusive.

From Fee For Service To Value-Based Payments

I had the pleasure of participating on a panel on moving to value-based care with Dr. Alexander Grunsfeld, Chief of Neurology from our customer Sentara Healthcare, and Angie Kalousek  from Blue Cross/Blue Shield of California. Too often value gets lumped into the idea of bundles versus fee for service, instead of considering the triple aim of healthcare and delivering the best patient experience and outcomes cost effectively. Fee for service remains the stumbling block to value-based care and organizations have to straddle two worlds when considering implementing two programs. Those who can effectively cross the chasm from fee-for-service to value-based care will be the ones who succeed in the long run, and especially those who consider options before they are legislated to do so.

Crossing the chasm from fee for service to value-based payments

Crossing the chasm from fee for service to value-based payments

Our headache management project with Sentara started from the need of one neurologist to manage his caseload. He had too many patients and not enough data, and needed a way to identify patients that needed the most help and also to enable patients to self-manage their headaches. Interestingly, though although the problem that he was trying to solve was focused on access, in a fee-for-service world, initial appointments are compensated at a higher rate that follow on appointments, so decreasing the need for follow on appointments could actually increase revenue. In an exact opposite scenario, this project has caught the attention of those in Sentara’s health plan, Optima, and they are looking to use this patient self-management to decrease ER costs by enabling patients to better self-manage.

Audience poll on in-home care

Audience poll on in-home care

Posted in: Adherence, Behavior Change, Healthcare Policy, Healthcare Research, Healthcare Technology, Healthcare transformation, M-health, Managing Chronic Disease, patient engagement

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Patients As Designers Of Their Own Health

Seattle’s grassroots healthcare community continues to gain traction with a new meetup for patient-centered design. Last week’s meeting was generously sponsored by MCG a subsidiary of Hearst Publications who are quite active in the healthcare world with content and education. The panel discussion featured Dana Lewis, a patient-maker who is active in the open source movement for diabetes care and built her own artificial pancreas, Christina Berry-White from the digital health group at Seattle Children’s, and Amy London, Innovation Specialist at Virginia Mason. The group talked about how to effectively get feedback from patients, and how patient hackers like Dana can take poor design into their own hands build tools they need, and ultimately influence large healthcare companies, in this case device manufacturers.

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Dana, Christina, and Amy, photo credit Alina Serebryany

The panel had great advice for understanding and developing products and improving processes for patients, as well as for soliciting feedback from patients. Here are a few of my takeaways.

Tips for developing products and process

  • Understand patient’s goals and desires. Often the goals of the hospital or health system are not the same as the patient’s. After meeting with a group of patient advocates one Virginia Mason surgeon realized that the only outcome that really mattered was whether the patient had a positive experience.
  • Let patients customize their views and experiences. Amy talked about a particular chart where she wanted to see the graph rising to show increasing blood sugar and another user she talked to wanted to see the graph lowering to show insulin lowering and a need for intervention. Amy was confused by this view but created her open source artificial pancreas interface to enables people to choose their own view, and the result was that people who had diabetes looked at it the same way Amy did and parent-caregivers of diabetic children wanted the second view. Which brings us to the next point–
  • Differentiate between users. Patients often have different requirements than their caregivers, whether that’s parents caring for a child or teen, or adult children caring for a parent. As well, the clinical workflow shouldn’t dictate the patient experience.
  • Get feedback early. Amy mentioned meeting with a device manufacturer who showed her an almost ready for release glucometer that was intended to fit in the pocket. She quipped “you obviously didn’t test this with women’s pockets.”

Tips for collecting feedback

  • Build it into the product. Christina from Children’s mentioned that when they switched from reams of paper to an iPad-based tool for patient on-boarding forms the physicians wanted to stop using it because it did not immediately integrate with the EMR. Luckily the tool had a feature to survey users on whether they preferred using it to paper, and the answer from parents was overwhelmingly yes. The digital health team showed these results to the physicians, and the tool stayed in place.
  • Be creative when soliciting feedback. Children’s knew from experience that parents and patients were reluctant to give them negative feedback after a lifesaving experience like an organ transplant, so they used techniques that are often used in brand market research: analogies. For example, they asked teens to describe a digital tool as a car, and found out that their tool was like a pick-up truck to them: useful but utilitarian.
  • Use patients to collect feedback. Patients are also often intimidated to provide direct feedback to healthcare professionals as they see them as authority figures. At Virginia Mason patients who have already had a successful joint replacement visit post-surgical patients to find out how they are doing, and talk about their own experiences. Patients are a lot more candid with each other, and Virginia Mason was able to benefit from understanding the questions they asked the peer ambassadors and incorporate that information into formal programs.
  • Ask the questions at the right time. If you want to understand post-operative experiences ask within a few weeks of the actual experience, not 6 months later.
  • Be aware of selection bias. Patients who volunteer for focus groups are often those who have the time and money to be able to do so. Your feedback may be skewed towards retired patients, and those who are not hourly workers. Consider how you will cast a wide net.

Lots of great advice at this event, much of which we already incorporate into our processes and products at Wellpepper, although I definitely got some new ideas and it’s great to see the community coming together to share best practices. My only disappointment with the event was that with a title of Patients as Designers, I expected to see more patients on the panel. While there was a last minute cancellation of a patient-maker, it would have been amazing to have Children’s and Virginia Mason bring one of their patient-designers to be on the panel. Maybe next time?

Posted in: Healthcare Disruption, Healthcare Research, Healthcare Technology, Healthcare transformation, Lean Healthcare, Research, Seattle

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Intelligent Disruption in Healthcare

Two recent webinars tracking recent trends and outlooks on the future of digital health presented interesting perspectives on how the healthcare industry is evolving, but also trigger some concerns about such advancement. The first webinar, Digital Health Tech Vision 2016, hosted by Accenture Consulting, featured Kaveh Safavi, M.D, J.D. (Senior Global Managing Director of Accenture Health) and Jane Sarasohn-Kahn (Health Economist, Industry Advisor and blogger at Health Populi) addressing their prediction of the top five digital health trends in the coming year:

  • Intelligent Automation – the merger of humans and artificial intelligence in a health setting (citing an intriguing example of a company integrating AI into a therapy setting).
  • Liquid Workforce – technology enabling the application of healthcare across geographies.
  • Platform Economy – an economy based on multiple technologies to platform architectures that allow them to work together.
  • Digital Trust – the importance of ensuring patient information isn’t shared improperly by those who have legal access to it.
  • Predictable Disruption – industry leaders agree that the nature of healthcare services will change faster in the next ten years than the last thirty

The second webinar was the MobiHealth News Digital Health 2016 Midyear Review, featuring Brian Dolan (Editor-in-Chief of MobiHealthNews) and Ryan Beckland (CEO and Co-Founder of Validic), who spoke about the past year in digital health, including key acquisitions, policy news, and the importance of patient generated health data in the future.

Both webinars addressed the fact that there is significant consumer demand for digital health innovation. Patients want a more seamless and efficient experience that gives them a better “life-health balance” and does so inexpensively. From the physician point of view, MobiHealthNews pointed out that doctors have about seven minutes on average to spend in person with a patient, most of which is spent doing data entry on a computer, so physicians are looking for solutions that enable them to be more “present during care” and not miss out on any important clinical information. As for healthcare systems, the Accenture webinar touched on the “Predictable Disruption” trend, noting a recent poll showing 86% of healthcare executives feeling pressured to “disrupt” their business model or face disruption from the outside (e.g. companies like Wal-Mart, Apple, Google, and financial service firms are entering the healthcare space).

This high demand for digital health solutions is certainly good news for any companies operating in the space, especially in light of regulations pushing the industry more towards value based care. But is it good news for patients?

With such multipronged pressure facing hospital systems, a concern might be that in trying to keep up with the industry, they too quickly install digital health solutions that aren’t adequately designed for interoperability with other technologies and EMRs and in doing so, could make the patient experience worse. The American Medical Association CEO recently commented on the influx of “ineffective” and “mixed quality” digital health products, going as far as comparing them to modern-day snake oil, and Dr. Sachin Jain, the CEO of CareMore, said that most remote monitoring solutions are not currently working because they aren’t adequately integrated into a system of care, and are just “bolted on” to a current system.

In such a fragmented market, it will be important for healthcare systems to take the time to make decisions based on how well these solutions can integrate with the current systems and EMRs (which aren’t patient-facing, but need to integrate with these new technologies for a seamless patient experience), work with other digital products within the system (achieving the platform economy mentioned by Accenture), and enhance the patient and physician experience and interaction. Perhaps then the industry can claim a new trend: intelligent disruption.

Posted in: Healthcare Disruption, Healthcare Technology, Healthcare transformation, Interoperability, Patient Satisfaction

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The Consumerization of Healthcare

While Healthcare is sometimes criticized as being behind other industries when it comes to technology, being behind this can have advantages. The first is that early adopters in other industries have worked the kinks out of new models like Saas or not-new models like single-sign-on. The second is that you can understand how technology and usage might evolve by seeing what happened in other industries, and the third is that you can skip steps in technical evolution and potentially move faster. This is what’s happening with the Consumerization of Healthcare IT, as evidenced by the proliferation of mobile and consumer-facing health technologies, topics at a few key healthcare events I’ve attended lately, and conversations I’ve had with senior healthcare leaders.

The concept of consumerization is the idea that consumer perceptions, expectations, and consumer technology can have an impact on an industry. This sometimes results in direct applications, like “it’s Uber for ambulances” or “Netflix for CPE credits” but more frequently it’s a subtle shift in thinking.

When I was working at Microsoft preparing for the launch of Office 2010, the consumerization of IT was a major theme of the release. We talked about the influence of the expectations of end-users on the tools they used every day: users were always on and always connected and they expected the same of their companies. We talked about the impact of BYOD on security and also the expectations to be able to communicate and collaborate from anywhere. The same is happening in healthcare today. Patients and physicians alike want to be able to communicate in the ways they communicate elsewhere and wonder why they can’t. They want applications that are as easy to understand and interact with as those on their phones.

One health system CIO I spoke to recently envisioned providing a “productivity stipend” and enabling all his staff to use whatever type of computer and smartphone they wanted. He would make sure they kept patient-health information secure but they would be responsible for choosing and maintaining their devices. Where BYOD was seen as a threat back in 2010, it’s now an opportunity. (I checked in with some of my former colleagues and they are seeing BYOD for phones but not computers, so this CIO is ahead of the industry pack and could even be seen as an example of skipping a step.)

When we started Wellpepper a little over three years ago, people commented on how patient-friendly and patient-focused our software was, and how it was a shame because it didn’t really matter what patients thought or what the patient experience was. (Not everyone said this, but we did hear it more than you’d hope.) Today, leaders in the industry are laser-focused on the patient/consumer experience. There are a number of reasons for that, which are both carrots and sticks.

  • Meaningful Use, while not always driving the best technology, has put an emphasis on communicating electronically with patients
  • High-deductible plans have made patients into consumers, carefully evaluating the service and value they can get for their healthcare dollars
  • New technology players like ZocDoc with online scheduling and MDLive with telemedicine delivered at Walgreens have trained people to expect on-demand services
  • New care delivery players like Iora and Zoom+ have set expectations for wellness and preventative care, and have attracted healthcare professionals who want to practice differently
  • We are all consumers. These supercomputers in our pockets and the constant connection and sharing they provide, and the ease of use of the applications that run on them have trained us to expect the same in our healthcare whether we are patients or providers.

At two recent conferences, I participated in conversations about the consumerization of healthcare service and tools. At the annual Health Evolution Partners Summit in Laguna Beach I had the opportunity to participate in a workshop where we were asked to imagine what it would be like if healthcare were run by customer-focused brands like Nordstrom, Amazon, Apple, and Uber for example.

@griotsyeye draws the consumer revolution in healthcare

@griotsyeye draws the consumer revolution in healthcare

At a local Seattle event hosted by the University of Washington Foster School of Business and sponsored by Providence Healthcare and Premera, I participated on a panel with Bill Frerichs, VP of Clinic Operations from Zoom+ and Paul Stoddart, VP of Marketing for Providence, and hosted by Curtis Kopf, VP of Customer Experience, Premera Blue Cross. We had all joined healthcare from other industries: Bill from running Target’s Store Operations and Paul from Microsoft, like me. We had all had personal experiences that had moved us into healthcare to try to change the system from within. Similar to many that choose healthcare as a career from day 1, we had become vocation-driven.

While it’s easy to come up with ideas for how healthcare can improve by looking at the customer focus from other industries as we did in these two sessions, for example, taking a concierge model like Nordstrom’s personal shopper or pattern-matching what’s important to each patient like Amazon’s “people like you also bought”, or using data to predict pregnancy like Target, it’s important to remember two things. First, if history of adoption of technology is any indicator, healthcare will evolve like other industries and will move to the cloud and more end-user and patient-friendly tools. It’s already happening. And second, that we need to remember the goals of healthcare while transferring best practices from other industries, and emulate only what’s best in healthcare settings: compassion and care, not greed and a ‘gig-based’ economy that is sometimes the focus in other industries. As well, while patients want to share data with their care teams, they want this data protected and used appropriately. Those who question the status quo, embrace change, and yet do it while remaining true to the ideals of healthcare should be the winners in this new consumerized world.

Posted in: Healthcare Disruption, Healthcare Technology, Healthcare transformation, M-health, patient engagement, Patient Satisfaction

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Risk Taking Doesn’t Have to Be Scary

Taking risk is an important part of being human, in order for us to succeed or get what we want out of life, we have to take a path towards uncertainty. Minimizing risk or simply feeling more prepared, can be obtained through resourcefulness and can help us gain a level of confidence in order to take the next step. In the recent article written by our CEO Anne Weiler, she describes the pillars to her own decision making and how she has applied them to starting a healthcare technology company. Anne uses a simple analogy for risk evaluation; rock-climbing. How can this analogy help you with your next big decision?

Please read Anne’s article here and post any comments below. Are you evaluating taking a risk right now? We would love to hear your thoughts!

Posted in: Healthcare Technology

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Patient Engagement Goes Mainstream: 5 Observations from HIMSS 2016

A walk through the trade show floor, and a glance at some of the sessions at HIMSS, quickly indicates that patient engagement is everywhere, which is great because an empowered patient is key to improving outcomes and lowering costs of care. There is still a lot of noise in this space however, with anything from wayfinding applications to billing services being billed as patient engagement. Let me set the record straight: making sense of things that are very confusing and often poorly designed, like hospitals and healthcare billing is not patient engagement, it’s explanation. That said, there are many innovative companies and healthcare organizations who are taking patient engagement seriously.

Here are 5 impressions or things heard at HIMSS about patient engagement and the state of healthcare IT:

  1. There are a lot of solutions in this space/competition is good. While there may be companies that have joined the space because patient engagement is a hot topic, real competition shows a real need and market.
  2. Clinical workflow does not equal patient engagement. True patient engagement solutions are designed around the needs of the patient.
  3. Engagement does not equal alignment. While this was said about physicians it’s also applicable to patients. A surgical patient can’t help but be engaged, but are the patient and physician aligned on the patient’s goals.
  4. Healthcare IT is emerging from the EMR era. Meaningful use drove widespread adoption of EMRs and monopolized IT resources for the past X years. IT is now ready to take a seat at the table and proactively suggest solutions to the clinical side of the house.
  5. People are asking how a solution is different rather than why they need a solution. This is a huge shift: at our booth we spent a lot less time explaining what we do and how we do it.

We’re looking forward to what the next year will bring. It seems like we’re at the starting blocks for some real value-based implementations of patient engagement solutions.

Patient Engagement Hits The Mainstream

Posted in: Healthcare Disruption, Healthcare Technology, M-health, Outcomes, patient engagement

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Did HIMSS deliver on its Charter? Transforming Health through IT

HIMSS Annual Conference
February 29-March 4, 2016

Another HIMSS has come and gone for me. I will not brag about how many times I have attended this conference, but I will brag about it being the first time with Wellpepper. Overall, the level of activity exceeded our expectations and validated the need for innovative patient engagement technologies like ours.

Being with a new company gave me a whole new perspective on the HIMSS annual event. Reflecting back, years of HIMSS events can blur together and it can seem like the same old same old. This year was different: the healthcare ecosystem is going through a profound change and the providers and payers know this. Health systems are beginning to understand that the model is moving away from a passive engagement with the patient, to a model where the patient is taking more initiative to include their own wants/needs to participate in their care delivery.

With that, comes a whole new set of demands from the patient consumer and that I believe is where HIMSS is trying to make the transformation.  For the second year, HIMSS has partnered with HX360’s Innovation Pavilion to showcase pioneering health IT solutions that are addressing these challenges. As a start-up company, we can often get lost in the maze of vendors at a large conference such as HIMSS (estimates suggest more than 1200 exhibitors). The HX360 Innovation Pavilion provides an opportunity for entrepreneurial health IT companies to shine… and that we did.

Along with this venue, HX360 sponsors an Executive Program that runs concurrent with HIMSS. These educational sessions attract leaders such as Chief Innovation Officers, Nursing Informatics Officers and Vice Presidents of Digital Health who are looking for innovative solutions from companies like Wellpepper. Because of this venue and opportunity, we were able to have meaningful conversations with IT and executives that are looking to get a head of the curve and provide innovative solutions for their patients and systems.

Upon my travels home, I felt optimistic this shift to value-based healthcare will really drive innovation and allow companies like Wellpepper to part of the conversation and solution. The future appears to be bright and full of opportunity.  It is an exciting time for both the healthcare community and the consumer.

So, did HIMSS hit their mark? In part, yes. HIMSS is making great strides to keep up with the changing landscape of healthcare. No longer is it just about the EMR, servers, networks and storage in the IT back room. It’s about patient facing solutions that provide ownership and accountability for the patient while securing that brand loyalty for the provider.

The transformation of healthcare is now. Healthcare does not take to change lightly. But, companies like Wellpepper will continue to pave the way to innovation and the industry will take notice.

Posted in: Healthcare Technology, Healthcare transformation, M-health, patient engagement, Telemedicine

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Flexible Care for Independent Aging: Don’t Dumb It Down!

I had the pleasure of participating on a panel on technology for aging, along with Honor founder Seth Sternberg and CareTicker founder Chiara Bell during the HX360 event at HIMSS 2016. (HX360 is a “conference within a conference” focused on innovation and C-suite leadership.) The panel was hosted by Jeff Makowka, Director of Market Innovation for AARP, and ranged from topics on entrepreneurship and whether there is a venture rush to technology for aging now to approaches for delivering care for aging in place.

Interestingly, all three panelists were inspired by personal experiences to found our companies. For me, it was poor discharge instructions and lack of continuity of care when my mom was released from 6 months in a long-term care facility. For Seth and Chiara, it was trying to figure out how to enable their parents to age at home. It’s a classic entrepreneurial model to experience a problem and try to find a solution to it, provided the market is big enough, and this market certainly is based only on demographics of the aging baby boomers. Seth and I both made the leap from technology, Seth from Google, and me from Microsoft, and Chiara from a long history in healthcare and homecare.

We were much sharper in real life.

We were much sharper in real life.

Honor’s $20M in funding lead by Andressen Horowitz is proof that Silicon Valley is paying attention to homecare, which can be viewed as important from two aspects: first we need innovative and new thinking to approach these challenges, and second these solutions could require a lot of money. (Although I would posit that we need patient capital in this space, something that Silicon Valley is not always known for. Interestingly, the same week as the panel Dave Chase and Andrey Ostrovsky posted a piece on why Silicon Valley does not belong in homecare. Maybe they should be on next year’s panel.)

The three panelist companies took similar approaches in using technology to scale and empower the people in the process, both patients and caregivers. For Wellpepper it’s about empowering the patient to follow their care plans and get remote support from the healthcare team. Honor and Careticker are more focused on the patient and their homecare team, whether that is professionals or family members. What was similar in the approach was providing information in real-time to the people who need it, and treating everyone in the process with respect. Honor does this by ensuring homecare workers are paid a living wage. Careticker does this by recognizing for people to age in place, the family caregivers need the right information and supports and Wellpepper does this with patient-centered and highly-usable software that is not dumbed down for the aging.

We were perhaps the outlier on this panel as our solution is not aimed specifically at the elderly. However, you could say we are the most representative of the way we need to approach the challenge: we need solutions that are designed with empathy, putting the patient first, and are not categorizing people into “young” and “old.” Well designed solutions and products should can address a broad spectrum of users, and we need to treat those aging in our population as another audience in this spectrum.

Posted in: Aging, Behavior Change, Healthcare Disruption, Healthcare motivation, Healthcare Technology, Healthcare transformation, M-health, Managing Chronic Disease, Patient Satisfaction

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Wellpepper goes to Vegas for HIMSS16!

Screen Shot 2016-02-24 at 4.03.54 PM

 

Sunny and 70’s all week,Vegas here we come! We will try to bring some sun back with us.Vegas Weather HIMSS Blog

We will be in booth #5 @ the HX360. Let us know if you’ll be attending HIMSS16 by sending us a tweet @wellpepper.

Contact us, to set up a meeting with Anne Weiler CEO or Robin VP of Business Development 

The annual HIMSS conference is almost here! A few tips.  Wear comfortable shoes and your Fitbit, you will be walking miles. With over 43K in attendance at HIMSS15, the lines for coffee and food were long.  Bring a few snacks and get your morning coffee before you get to the conference!

So many interesting and inspiring education sessions, so little time! Between walking and navigating the crowds, it can take up to 10-15 minutes to get where you are going so take some time to plan out your education sessions. Get to the sessions early if you want a seat, many sessions end up being standing room only. 

Stop by to see Wellpepper CEO Anne Weiler on this panel which is part of the HX360 Innovation Leaders Program

Date: Monday, February 29, 2016: [Time: 2:30 PM – 3:15 PM]

Session Title: Flexible Care to Fit the Second Half of Life: from Independent Aging to Acute & Long Term Care

Session Description:  How can technology support flexible, high quality, cost-efficient care delivery that meets patients’ needs in the second half of life? Where are the most egregious gaps in care for older patients? These are the questions that will be explored by our panel, covering topics ranging from aging independently to rehabilitation, home care support, family caregiving and honoring end-of-life wishes.

Here are some of our  education session picks.

Connected Health

March 1, 2016 — 08:45AM – 09:45AM : Trends & Resources in Connected Health: Harnessing the power of mobile for research 

Clinical and Business Intelligence                                                                

March 1, 2016 — 10:00AM – 11:00AM: Actionable Analytics: From Predictive Modeling to Workflows

March 3, 2016 — 02:30PM – 03:00PM: Getting to Big Data Insights in Healthcare

Consumer and Patient Engagement

March 2, 2016 — 10:00AM – 11:00AM: Patient Engagement – The Next Chapter

March 4, 2016 — 12:00PM – 01:00PM: Patient Engagement Beyond Patient Portal-Strategic Approach

Care Coordination and Population Health

March 1, 2016 — 10:00AM – 11:00AM: Too Many Patient Portals – What Can You Do About It?

March 1, 2016 — 01:00PM – 02:00PM: Coordinated Health: The Experience You Should Expect

March 1, 2016 — 03:15PM – 03:45PM: mHealth solution for remote patient engagement

March 1, 2016 — 04:45PM – 05:15PM: Rethinking patient engagement and provider workflow

Clinical Informatics and Clinician Engagement

March 1, 2016 — 04:00PM – 05:00PM: Enhancing Patient Outcomes with Big Data: Two Case Studies

March 2, 2016 — 10:00AM – 11:00AM: Taking Plans of Care from Clinician to Patient-Centric

March 2, 2016 — 01:00PM – 02:00PM: Seven Essentials in Clinical Information Technology Adoption

 

Posted in: Healthcare Research, Healthcare Technology, Healthcare transformation, M-health, Outcomes, Patient Satisfaction, Uncategorized

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mHealth and big data will bring meaning and value to patient-reported outcomes

Anne Weiler
Wellpepper, Inc., Seattle, WA, USA
Correspondence to: Anne Weiler. CEO, Wellpepper, Inc., Seattle, WA, USA.
Email: anne@wellpepper.com
Abstract: The intersection of widespread mobile adoption, cloud computing and healthcare will enable patient-reported outcomes to be used to personalize care, draw insights and shorten the cycle from research to clinical implementation. Today, patient-reported outcomes are largely collected as part of a regulatory shift to value-based or bundled care. When patients are able to record their experiences in real-time and combine them with passive data collection from sensors and mobile devices, this information can inform better care for each patient and contribute to the growing body of health data that can be used to draw insights for all patients. This paper explores the current limitations of patient reported outcomes and how mobile health and big data analysis unlocks their potential as a valuable tool to deliver care.

Link to full article can be found here

Posted in: Adherence, Healthcare Technology, M-health, Telemedicine

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APTA Combined Sections Meeting Wrap Up

Walking the floor at APTA CSM 2016 Anaheim, CA

Last week, I attended the American Physical Therapy Association Combined Sections Meeting (APTA CSM) in Anaheim, CA. The show was well attended by about 18,000 Physical Therapists and professionals in related roles. The packed house meant lots of energy, a few full sessions, and long lines for coffee at the two overwhelmed Starbucks kiosks in the nearby hotels. Wellpepper started out in physical rehabilitation, so it was great to be back in the company of many talented ‘movement system experts’ and associates working together to gain knowledge in order to achieve best practices for healthcare systems, patients and/or caregivers.

I attended a number of sessions, mostly focused on the shift to value-based payment, and outcome measurement. The healthcare value equation has penetrated deep in this community. I saw the same basic slide in at least 3 talks:

* This formula has been widely discussed by Michael Porter and others.

I attended two presentations on outcome measurements by Beth Israel Deaconess Medical Center (BIDMC) and Johns Hopkins. Both organizations spoke about the task of adopting outcome measurements in an acute settingand their thoughtful deliberate steps to take research-based measurement techniques and apply them into clinical practice;BIDMC’s applied the Knowledge Translation framework, and Hopkins’ applied the Translating Knowledge Into Practice (TRIP) initiative. There were many similarities that both organizations encapsulated in their task of adopting outcome measurements; both organizations had to fight against “don’t give me more documentation work” attitudes, worked cross-functionally with PTs, nurses, physicians and administrators to gain support for their plans. And both adopted process measurements to observe the rollout of outcome measurement tools and practices. Furthermore both had some crossover in the specific measurement tools they used (e.g. AM-PAC / 6 clicks).Another common thread I believe important to note was the development of practical tips and tricks for how to make it easy to capture data into their EMRs that weren’t always designed to capture this kind of data (real nuts-and-bolts stuff like how to copy and paste boilerplate text).

Finally, armed with data on patient functional outcomes, Johns Hopkins shared some of the work they were doing on risk-stratifying patients to help control costs. In a world where Post-Acute Care costs represent one of the largest and most variable cost centers for many procedures, this is critical. The quantity and richness of this data is something I hadn’t seen presented at this conference before. Here is real objective data on how real patients progress through their care journeys that can be used to at the individual level to have an informed conversation with the patient and provides fantastic optics into the most important work product of the healthcare system: making people better.

I was struck that both presentations concluded that measuring outcomes was less of a technical feat than an organizational one. It is, as Michael Friedman a presenter from Johns Hopkins articulated, “About culture change more than anything.”

Throughout the conference, there were also mentions of Patient-Reported Outcomes (Oswestry, HOOS, KOOS were frequently mentioned – thankfully ones that Wellpepper supports!) My sense was that these are still not as widely deployed and not as consistently measured to have made their way into any of the mainstream presentations. As Wellpepper and other companies keep pushing to measure (and improve!) the patient journey with patient reported outcomes, I expect this will change in the coming years.

The one disappointment I had from the conference was that the excellent session on the Patient Experience was not better attended. Jerry Durham (a minor celebrity in the PT world!) introduced a panel of 2 patients to present on their experiences and lamented that often the Triple-Aim objectives are reduced to a Double Aim, ignoring the patient experience. So we had the excellent chance to learn and hear real patients talk. Both patients were both doing great thanks to their Physical Therapists, but both talked about the significant failings they’d seen in their medical practitioners (of all stripes). In a string of wrenching, quotable sound bites, one said “I couldn’t have gotten this bad without the help of PT”. It’s a shame that despite the healthcare rhetoric about putting patients first that more attendees didn’t put this into practice and take the opportunity to learn from some honest patient-driven conversation.

All told, this was a good conference, notable for the increasing use of patient data to measure and improve. If the attendance for CSM 2017 in San Antonio is anything like this one, let’s hope for more coffee and more chairs!

Posted in: Adherence, Healthcare Disruption, Healthcare Technology, M-health, Telemedicine

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EvergreenHealth Selects Wellpepper as Mobile Patient Engagement Solution for Total Joint Replacement

SEATTLEJan. 20, 2016 /PRNewswire/ — Wellpepper, Inc., a clinically validated platform for patient engagement, today announced that EvergreenHealth, an integrated health care system that serves nearly 850,000 residents in northern King and southern Snohomishcounties in Washington State, has selected Wellpepper as the mobile engagement solution for all total joint replacement and musculoskeletal care plans. The project was made possible at EvergreenHealth with a generous donation from The Schultz Family Foundation, a private not-for-profit foundation founded by Howard Schultz, CEO of Starbucks Corporation, and his wife Sheri.

Patients with musculoskeletal issues that require surgery or rehabilitation will use Wellpepper on their mobile devices to track their outcomes and adhere to their care plans. This information will enable patients, physicians, and other healthcare providers to track progress and patient-reported outcomes in real-time to improve care. Wellpepper enables health systems to implement their own care instructions on its task-based platform and makes it easy for patients to understand and adhere to their care instructions.

“Across our organization, we strive to be a trusted source for innovative care solutions for our patients and families, and our partnership with Wellpepper helps us deliver on that commitment,” said EvergreenHealth CEO Bob Malte. “Since we began using Wellpepper in 2014, we’ve seen how the solution enhances the interaction between patients and providers and ultimately leads to optimal recovery and the best possible outcomes for our patients.”

The Wellpepper remote care management solution is designed to be easy-to-use and highly engaging for patients while being flexible and easily customizable for use in clinical practice. It is clinically-proven to improve patient adherence and outcomes with over 70 percent patient engagement.

Health systems are increasingly looking for solutions to enhance patient care while reducing costs, and this is particularly true in total joint and musculoskeletal scenarios. The new Comprehensive Care Model for Total Joint replacement announced by the Centers for Medicare and Medicaid aims to reduce the cost and quality variability of procedures.

“We are seeing a lot of interest in using the Wellpepper platform in orthopedic and total joint replacement scenarios,” said Anne Weiler, co-founder and CEO of Wellpepper. “Interest and adoption are largely being driven by our ability to customize the care plans based on the health system’s own protocols, personalize the plans for each patient and collect the standardized outcomes required as part of the new Center for Medicare and Medicaid requirements.”

The Wellpepper platform doesn’t dictate care plans; instead it provides a set of task-based building blocks that health systems and providers can customize to reflect their own methodologies and practices. The patient interface is simple and straightforward, so patients get only the tasks and questions they need on a given day.

For more information about Wellpepper or to find out how the Wellpepper patient engagement solution can support value-based payment models, please visit wellpepper.wpengine.com or email info@wellpepper.com.

About EvergreenHealth
EvergreenHealth is an integrated health care system that serves nearly 850,000 residents in King and Snohomish counties and offers a breadth of services and programs that is among the most comprehensive in the region. More than 950 physicians provide clinical excellence in over 80 specialties, including heart and vascular care, oncology, surgical care, orthopedics, neurosciences, women’s and children’s services, pulmonary care and home care and hospice services. Formed as a public hospital district in 1972, EvergreenHealth includes a 318-bed acute care medical center in Kirkland, a network of 10 primary care practices, two urgent care centers, over two dozen specialty care practices and 24/7 emergency care at its Kirkland campus, Monroe campus and at a freestanding center in Redmond. In 2015, the system expanded to include EvergreenHealth Monroe – an accredited, full-service 72-bed public hospital district, established in 1960 in Monroe, Washington. EvergreenHealth has clinical and strategic partnerships with several health care entities, including Virginia Mason, Seattle Cancer Care Alliance and dozens of independent practices that are part of the clinically integrated EvergreenHealth Partners network. In addition to clinical care, EvergreenHealth offers extensive community health outreach and education programs, anchored by the 24/7 EvergreenHealth Nurse Navigator & Healthline. For more information, visit www.evergreenhealth.com.

About The Schultz Family Foundation
The Schultz Family Foundation, established in 1996 by Howard and Sheri Schultz, creates pathways of opportunity for populations facing barriers to success. The Foundation invests in innovative solutions and partnerships that unlock people’s potential, and strengthen our businesses, our communities, and our nation. For more information about the Foundation and its work: schultzfamilyfoundation.org.

About Wellpepper
Wellpepper is a healthcare technology company that provides a clinically validated platform for digital treatment plans delivered via mobile devices. The Wellpepper patient engagement solution improves patient adherence and outcomes with its patent-pending adaptive notification system and just-in-time, task-based instructions and by fostering communication between healthcare providers and patients. Wellpepper is used by major health systems that are moving to an accountable care organization model and need to track and improve patient outcomes while lowering costs. Wellpepper was founded in 2012 to help healthcare organizations lower costs, improve outcomes and improve patient satisfaction. The company is headquartered in Seattle, Washington.

Media Contact:
Jennifer Allen Newton
Bluehouse Consulting Group, Inc.
503-805-7540
jennifer (at) bluehousecg (dot) com

SOURCE Wellpepper

RELATED LINKS
http://wellpepper.wpengine.com


Posted in: Healthcare Technology, Healthcare transformation, Interoperability, M-health, Outcomes, Physical Therapy, Prehabilitation, Press Release, Rehabilitation Business

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2016: The Year of Telehealth

Judging by the freezing rain hitting my window pane and the darkness that comes at 430 pm, it is evident we are coming to the year’s end here in Seattle. As always the approach of a new year brings a great number of predictions and I don’t mean the kind that are derived just out of hope, but out of reality. A quick Internet search produces many real 2016 telehealth predictions; some are witty, honest and steadfast, others more conservative. However one common thread not to ignore is the ever increasing benefits of telehealth and the great strives by the US Congress to regulate and support such. For instance there are 17 telehealth bills pending in the Senate and 21 in the House; from excise tax on medical devices to the “VETS Act to improve the ability of health care professionals to treat veterans via telehealth…” The 114th Congress ends in January 2017 so the progressive reality of telehealth to have a presence in your healthcare entity is undeniable and if such already exists it will be more palatable.

Another common thread in my searches is the statement: 2016 will be the Year of Telehealth. It is easy to believe this statement without any gullibility especially after experiencing first hand the steadfast innovation of telehealth over the last few months of 2015. Coupled with the readmission penalties, competitive advantage, telehealth parity laws, quality reporting outcomes incentives, and transformation of rural care it is no surprise that this statement is used liberally. Furthermore every year it is becoming increasingly more difficult to find skeptics of telehealth, the list of benefits are always increasing and scrutiny of our healthcare system forces many to find solutions. Telehealth is on that strong progression towards not just being an added bonus to way we provide care to our patients, but in some cases the only way we provide care.

I would never claim to be an elite expert in the field of healthcare innovation and policy, so I do not want to go into what I think will happen in 2016, but one cannot help feel the buzz in our Wellpepper office in Fremont, Seattle, WA. Our group serves has an example of what is going on in the mhealth field; we have grown in leaps and bounds just over the last 6 months in order to keep up with the demands of the industry. I cannot believe how incredibly lucky I am to be part of such great innovative team of professionals that have one goal of many in mind that brings my sentiment home, to make healthcare better for all of us.

Happy New Year!

Posted in: Healthcare Policy, Healthcare Technology, Healthcare transformation, M-health, Seattle, Telemedicine

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Digital Health and the Influence on Healthcare: Wearables, Telehealth, & Treatment

Things are looking up in the world of digital health at least this was the view from “Digital Health and the Influence on Healthcare: Wearables, Telehealth, & Treatment.” The WBBA held their last event of the season with a panel on digital health, hosted by Russell Benaroya, CEO of Everymove, and featuring Dr. John Scott, Director of Telemedicine at UW Medicine, Davide Vigano CEO and co-founder of Sensoria, Mike Blume, independent healthcare consultant, and myself. I’d characterize the overall event as being optimistic and realistic, both from the panel and the attendees.

Digital health event

It was a dark and stormy night

No one said that the road to digital health was easy or fast, but the consensus that things like moving to the cloud, and the acceptance and adoption of patient-driven digital care is reaching a turning point.

Both Sensoria and Wellpepper’s business models are made possible by the cloud. For Sensoria this was the ability to process millions of datapoints coming from their wearable technology. For Wellpepper, this is our ability to rapidly implement solutions working with department heads facing a particular challenge in patient engagement and outcome tracking and improvement. Dr. Scott remarked on the dramatic drop in the cost of telemedicine solutions over the years he’s been an advocate and solutions due to both Moore’s Law and cloud computing over his tenure running telemedicine at UW.

Sensoria's Quantified Socks

Sensoria’s Quantified Socks

As well, although Dr. Scott highlighted how telemedicine was limited by arcane reimbursement models that did not allow for patients to receive telemedicine consults in their homes, he and other panelists discussed that they were not waiting for billing codes to do the right things in using technology to deliver better care. As usual, the Affordable Care Act was seen as a big driver as patient-centered and digital care.

Possibly because there were two ex-Microsoftees on the panel (Davide and me) a cloud-based platform approach was touted as the best way to both collect, analyze, and sort the data that came in directly from patients. In the case of Sensoria and Davide, this was to look for trends and patterns coming from sensor-integrated clothing, and in the case of Wellpepper it was to collect patient outcomes in the context of care and compare these across patients, procedures, and healthcare organizations.

This view led to a discussion about the proliferation of data, and everyone agreed that digital health has the ability to overwhelm health systems with data that they are currently not prepared for. EMRs are not set up to include sensor or patient-reported data, and as Dr. Scott pointed out, physicians are not looking for every data point on a patient, only the anomalies, like glucose out of range.

One audience member asked about whether healthcare organizations had an overall data strategy, and whether digital health data should be collected as part of that. It’s an interesting idea to consider but it seems like it’s still a long way off in healthcare. Does your organization or CIO have an overall data strategy? It seems that quality measures and the need for patient reported outcomes are introducing new requirements for data, but this is at the departmental or initiative level. Grappling with questions like this will be important as connected devices, digital, health, and patient reported outcomes enter the mainstream.

Posted in: Health Regulations, Healthcare Disruption, Healthcare Policy, Healthcare Research, Healthcare Technology, Healthcare transformation, M-health, Outcomes, Telemedicine

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Reverse Innovation: What We Can Learn From Global M-Health

Whenever possible at conferences, I try to attend at least one session that is outside my particular area of focus and expertise. While almost everything at the recent HIMSS M-Health was relevant, global health is a bit outside the target for Wellpepper right now. Attending a few sessions on M-Health got me thinking about similarities between some of these initiatives and the situation at home.

Global M-HealthWhen we started Wellpepper, we got a lot of feedback on our mobile first strategy, not all of it positive. We believe that people have an emotional connection with their mobile devices and that when people’s mobile devices ask them to do something they generally do it which is why we optimize our patient experience for mobile. Concerns were that people of lower socio-economic backgrounds or older people would not be able to use the technology.

We and other startups have found this to be untrue, and given the success of mobile programs in the developing world, it seems that this is a red herring of an argument as m-health initiatives are successful with people with widely varying literacy levels and for whom this is often their only connection with technology. Basically if people with low tech literacy can engage in their health through mobile devices in the developing world, we’re pretty sure everyone can in the US as well. In the developing world, mobile infrastructure has leapt over landline infrastructure. A similar thing has happened for lower income people in the US: they are more likely to only have Internet access through a smart phone than through a computer and home Internet connection.

The session “Innovative Content & Mobile Delivery Tools: Driving Healthcare Utilization & Coordinating Care” covered a number of private and public partnerships to bring culturally relevant and timely information health issues related to childbirth to women, caregivers, and families in Africa. There were a number of similar initiatives involving different players in different countries both not-for-profits and telecommunications companies. Rather than recapping one initiative this post is a survey of some of the learning and best practices from a few different ones.

Most projects were either focused on preventing unwanted pregnancies and also reducing child mortality. Really two sides of the same coin: making sure women and families had the information and resources they needed to care for their children. Information needed to be localized to the needs of the audiences that included mothers, mothers-to-be, midwives, and others caring for pregnant women, and their spouses. Customized content was key, for example, nutrition advice needed to address what was available in each country, and medical advice for the types of caregivers that were in the area, not always licensed medical professionals.

While the projects were shown to work, sustainability was key. There needed to be benefits to the telecommunciations companies that were providing free texting between expectant and new mothers and providers, and access to video content. There are definitely benefits for the telecommunications companies, which included:

  • Customer loyalty. By supporting women and families in this crucial time, the telcos were able to let them know that they would be with them through thick and thin and supporting them in important life events.
  • While the phones were provided for this particular educational program, people started using them for other activities which provided a revenue stream for the telecommunication companies.
  • Lack of churn. Many women were repeat users of the program when they had their second child.

Content for Global M-HealthChallenges of the programs mostly revolved around content. Creating and managing content was a big cost for the non-profits involved. Video content was seen to be best as it didn’t require a high-level of literacy, but keeping content both culturally-relevant and up-to-date was a challenge. As a result, one organization provides a free content library for front-line health workers.

In addition to the similarities of access to information, the content problem is also one we see here. However, the difference is an abundance of content for patient treatment plans. Each organization has their own content and best practices. During the session, I thought that donating care plans and instructions to some of these not-for-profit might be an interesting way to solve this problem, collect more feedback on care plans and accessibility, as well as give back.

Posted in: Healthcare Disruption, Healthcare motivation, Healthcare Research, Healthcare Technology, Healthcare transformation, M-health

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