Tag Archives: mobile health

Addiction treatment has gained much attention with the veracity of overdose deaths and a spike in the increase use of opioids. (Substance Abuse and Mental Health Services Administration, 2017)(1). Much has been studied and learned about the disease of addiction, including elements necessary to support and sustain long-term recovery. However, solutions beyond traditional inpatient and outpatient treatment have been slow to evolve. One women’s residential treatment program in the Northeast enhanced their evidence-based treatment program to expand support to their graduates. They augmented their Modified Therapeutic Community treatment program with recovery coaches and Health Helm’s mobile app, Trusted Success CoachTM, to stay connected with graduates over a year following graduation. Read more about the success of this innovative program and the use of Trusted Success CoachTM as an integral program element.

(1) Substance Abuse and Mental Health Services Administration. (2017). Key substance use and mental health indicators in the United States: Results from the 2016 National Survey on Drug Use and Health. Substance Abuse and Mental Health Services Administration, Center for Behavioral Health Statistics and Quality. Rockville: SAMHSA.

To request access to a copy of Health Helm’s full white paper, please contact us below to receive access to our Information Dashboard:

Dashboard Access Request

 

Interview with Nurse Practitioner About Patient Reported Outcomes

Health Helm’s CEO, Pamela McNamara, sat down with a Nurse Practitioner in a pain management practice in New England, to discuss patient centered care, patient reported outcomes, and how these could enable her patients to receive a more holistic approach to care.

close-up-doctor-health-42273-300x300 The Importance of Patient Reported Outcomes from the Perspective of an NP

What does patient centered care mean to you and your practice?

We follow the CDC guidelines and apply judgment given the risk factors. For example, we ask patients how long they have been on pain medications — opioid or others. We treat each patient holistically, considering her/his situation: How functional are they, are they working or disabled? What activities do they want to be doing with or without medication? What are they doing to avoid pain? What other medical considerations, such as social and mental health ailments are they affected by?

We consider and encourage trying alternatives to opioids for each patient, such as aquatic therapy for an osteoarthritis patient, chiropractic care for a younger patient, acupuncture, massage and/or yoga.We also attempt to use other pain management options including non-opioid prescription including over-the-counter aspirin, ibuprofen and acetaminophen, pain creams and patches. Medical cannabis including CBD creams and oils can be beneficial for chronic pain helping patients with anxiety, sleep and muscle spasms. We offer surgical procedures high-tech treatments using radio waves and electrical signals or implantable spinal cord stimulation. Unfortunately not all patients have access to these alternative therapies. Many of these therapies are not covered by insurance or these patients have access to care issues causing barriers to receiving this type of care.

How would a mobile patient reported outcomes tool fit in to your practice: supporting you as a clinician, while aiding in the treatment and management of your patients, as well as enabling them to better manage themselves?

A top priority for our patients is to gauge the extent to which they are trying to manage themselves and deal with their pain, and pain-related issues, rather than solely seeking more pain medications. If we know a patient is trying, we can work with them to utilize alternative approaches to opioids.

One benefit of patient reported outcome data will be to see evidence of how the patient is trying to manage their pain and with what result.

This patient reported outcome data can provide me, as a clinician, with a better basis for building an ongoing relationship with my patients to manage their pain and make progress.
Patient reporting would enable me to track their pain and other medication, track the extent and circumstances in which pain meds including what doses, numbers, and pills are being taken.

How would the PRO tracking work in your practice?

Typically we see a patient on chronic opiate therapy monthly. Patients on non opioids therapy are followed every three to six months.

During that four week period, we monitor their pain using pain scale tools. The use of a pain scale can help guide the clinician in creating a treatment plan as well as measure the effectiveness of the treatment. Indications a treatment plan may be ineffective include if a patient scores a 10 consistently (on the traditional pain scale of one to 10), the patient also reporting that they’re repeatedly out of medication early? The mobile tracking would help us monitor that more closely.

A mobile tool to monitor patient reported outcomes would be useful during the middle of that two month period, to alert us if problems are occurring. For other patients, patient reported outcome data is useful just before or during the four week follow-up visit to assess clinical status, progress, or problems, and to focus the patient visit on key issues. In preparation for this type of patient, the data would be scanned for sleep pattern variations, increased or decreased activity levels, issues related to ambulation, and responses to questions such as “ Do the current medication you are keep you functional and able to perform the daily tasks you need to do?”

The clinician would look at a snapshot for that patient over the prior month and be better prepared for a discussion about what’s going on, what can be changed in the pain management regimen, and what may need to change in other related activities.

A Patient May Be Using EMR, But What About Post-Surgery or -Procedure Communication?

Patients are more savvy users and consumers of their medical records thanks to EMR systems. If the patient’s physician is connected to the network’s EMR system, the patient is solicited to register on the patient portal.

There are many advantages to doing this. The patient can reorder prescriptions, update her prescription list, see her latest lab results, check her next scheduled appointment, verify the insurance information on file, ask for a referral – all without having to call the office. Easy, convenient management of her static health records.

But what does the patient do after a procedure or surgery?

She goes home with discharge instructions. She follows them – sometimes. What happens when something doesn’t feel right a week into her recovery? She calls the office. She leaves a message on the nurse’s line. Three times. She then dials “0” to get the front desk. But she gets put on hold for 10 minutes.

Frustrated, she hangs up and sends a message to her primary physician via the patient portal. She thinks, “Ok. This can wait until tomorrow. Perhaps I’m overreacting.”

She goes online to find information. Nothing. Sleepless into the night with increasing pain and discomfort, she finally decides at 4am to go to the ED. The patient’s surgeon and office staff have no insight into this scenario whatsoever. And no control to do anything about it.

Preventing Readmissions with Trusted Patient Coach and Patient Reported Outcomes

Let’s rewrite that scenario.

The patient is discharged with discharge instructions. She downloads the Trusted Patient Coach™ mobile app recommended by her clinician onto her own mobile device – phone or tablet. She reports her symptoms immediately after getting home starting on day 1.

She follows her discharge instructions, which are reinforced by Trusted Patient Coach’s daily questionnaires and tasks. She reports her level of fever, pain, swelling and other common post-surgical indications of problems.

Her doctor now has real-time daily data to know that his patient is still experiencing fever and swelling after 7 days. The doctor messages – directly – to his patient: “Please send me a photo of what your incision looks like.” He doesn’t like what he sees and replies: “Please come into the office. Nurse John will be waiting for you this afternoon.” ED visit and potential readmission avoided.

This is a real scenario of preventing readmissions using real-time Patient Reported Outcomes.

  • It creates direct communication from patient to clinician.
  • It records recovery progress with daily, real-time reports directly from the patient.
  • It provides trending so that clinicians can spot potential issues.
  • It creates a better patient experience.
  • And it reduces costs by allowing the clinician to intervene before the ED visit.

Learn more about Trusted Patient Coach™ as an integral piece of your healthcare solution.

 

Last month, our CEO, Pam McNamara, shared her insights into the European mobile healthcare market with Springboard Enterprises’ blog on Medium. The article can be found here and is also posted below.

As CEO and leader of high growth healthcare and technology businesses that have operated successfully in the US, European, and global markets, I share 5 key lessons that have made the difference in scaling profitably and successfully into Europe.

ball-shaped-bokeh-geography-893179 5 Tips to Expand Your Business to the European Market Successfully

Leverage entry and “adoption” opportunities recognizing market drivers and maturity from one market to others

Mobile health in the early 2000s was leading edge in Europe, where clinicians and patients alike were adopters of the earliest generations of smartphones, while US clinicians still used old fashioned pagers. In my last company, we drove early adoption of mobile health for e-patient reported outcomes in Europe in part by demonstrating solid patient compliance and clinical evidence that would ultimately earn our product platform credibility in the US market. Today’s market needs point us in the other direction: our Health Helm mobile health enables prevention of unnecessary Emergency Room visits and hospital readmissions. These are a priority in the US today, but not yet in Europe’s country markets, which are likely to be tackling similar cost and quality initiatives in the future. And, we are leveraging best software and cyber talents through our strategic partnership with development partner, based in Prague — another facet of our cross-Atlantic strategy.

Navigate the Regulatory Environment with Seasoned, Practical Leaders — Experience Counts

During the last 15 years, mobile health has grown in a regulatory landscape shaped by the US Food and Drug Administration, the European Medicines Agency, and the General Data Protection Regulation (GDPR, implemented May 25, 2018), among others. Regulatory insights and experience is a critical element to develop, deploy, maintain and service products, processes and solution platforms — to doing the right things in a thorough way. A key member of our team is our GDPR expert, a trained/qualified Data Protection Officer brings deep and practical regulatory and quality expertise. While we are currently focused on the US customers, our regulatory expert’s guidance, we are staying ahead by reflecting GDPR requirements in plans, product development and operations.

Respect and embrace local culture and practices — Viva Les Differences!

Regional and country market differences can be major or more subtle — navigating these and choosing the most practical, feasible and impactful entry markets (with savvy local tactics) enables smarter, rapid scaling. Cultural norms and people differences are key. For my businesses, understanding local clinicians and patients has been essential: how to gain their early adoption? What barriers must we overcome? What are their fears, concerns and preferences? We have built sales teams nimble in navigating these distinctions professionally and with integrity.

Build your team: who think globally, act locally

Recently, I’ve been asked to address how to cultivate high performance teams. Critical to any successful team is a combination of bright, curious minds, shared passion about our business and our core purpose, outstanding skills and expertise to get the job done and shared common values. Entering new markets — into EU country markets from the US or going the other direction — these attributes combined with local knowledge, acumen and integrity make all the difference. We define clear goals and accountability, enabling local team members to make local decisions while trusting them to confer/connect when needed. They must be “utility” players with a primary focus (e.g., sales or delivery) and the ability and initiative to cover local business needs, e.g., controller/finance, human resource matters, other issues as they arise.

Achieve credibility with compelling, locally relevant evidence and early wins — Scoring early and impactful “wins” in a new local market with great customers, followed by delivery excellence, builds the credentials for a locally knowledgeable team. This ultimately translates to a successful record. Our experience is to string the “pearls” of local market successes to build an effective, competitive regional position.

In my businesses, we have achieved impact and speed by embracing the lessons from each market, driven by a diverse, bright team to navigate successful entry into new markets. We’ve done this by competitively positioning our products and services to fit local needs while leveraging global best practices.