Care Coordination and Interoperable Health IT Systems

1. Care Coordination and Interoperable Health IT Systems Unit 9: Expanding Access with Technology Lecture a – Introduction to Mobile Health Technologies This material (Comp 22 Unit 9) was developed by Columbia University and The University of Texas Health Science Center at Houston, funded by the Department of Health and Human Services, Office of the National Coordinator for Health Information Technology under Award Numbers 90WT0004 and 90WT0006. This work is licensed under the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by-nc-sa/4.0/.

2. Expanding Access with TechnologyLecture a – Learning Objectives • Objective 1: Name and describe three mobile health (mHealth) technologies (Lecture a) • Objective 2: Describe a real world scenario in which a mHealth technology is used to achieve better coordination of care (Lecture a) • Objective 3: Explain ways in which mHealth data can be used by clinicians (Lecture b) • Objective 4: Identify access to telehealth solutions in a variety of settings (Lecture c) • Objective 5: Compare models of telehealth systems (Lecture c) • Objective 6: Evaluate populations served with telehealth tools and services (Lecture c)

3. Some Definitions: mHealth • Provision of health-related services using mobile telecommunication and multimedia technologies (mHealth Alliance, 2010) • Medical and public health practice supported by mobile devices, such as mobile phones, patient monitoring devices, and personal digital assistants (PDAs) and other wireless devices (World Health Organization, 2011)

4. mHealth: Additional Definitions • Data from mobile apps and sensors • To inform health care decisions and / or treatments • To drive communication and connect patients and providers • Health interventions delivered using mobile technologies: • Prevention • Treatment • Behavior change • Synonymous with: • Digital health • eHealth • Telehealth

5. mHealth Tools • Pager • Phone Calls • Website • Video • Smartphone • Tablet • Portal / personal health record (PHR) • Email • SMS (short message service) messaging • Physiological sensors • Glucometer • Blood pressure cuff • Connected devices • Bluetooth scale • Wearables / trackers • Electronic pill boxes

6. Using Mobile Phones for Health • Consumers use Mobile phones in Three ways for Health • The mobile web for understanding symptoms, researching available treatments, and learning about a disease • Mobile apps for tracking symptoms and for understanding and managing conditions • SMS (text messaging) for medication reminders, talking to a healthcare provider and getting a refill

7. mHealth Functions • Wellness support • Communication • Health coaching • Chronic care management

8. mHealth Potential Benefits • Refer to Component 25 for more information on Patient-Provider Communication and Patient Engagement. 9.1 Figure (Tiase, V., 2016)

9. Care Coordination Activities • Avoid readmissions • Schedule follow-up visits • Reinforce education • Shared decision-making • Refill medications • Support adherence and compliance

10. Unit 9: Expanding Access with TechnologySummary – Lecture a – Introduction to Mobile Health Technologies • mHealth is the use of mobile apps and digital health tools for health and health care • Patient / provider communication may be enhanced with mHealth tools • The use of mHealth applications spans the continuum from wellness to illness, but may be useful in the support of care coordination activities

11. Unit 9: Expanding Access with TechnologyReferences – Lecture a References Azumio Inc. (2012). Glucose Buddy (3.7.0) [Mobile application software]. Retrieved from https://itunes.apple.com/WebObjects/MZStore.woa/wa/viewSoftware?id=294754639&mt=8 Calm.com. (2016). Calm: Meditate & relax with guided mindfulness meditation for stress reduction (2.6.3). [Mobile application software] Retrieved from https://itunes.apple.com/us/app/calm-meditate-relax-breathe/id571800810?mt=8 Cipherhealth. (2016). Echo Care Instructions [Computer software]. Retrieved from https://cipherhealth.com/echo/ Cipherhealth. (2016). Voice Follow up Calls [Computer software]. Retrieved from https://cipherhealth.com/voice/ FitBit Inc. (2016). Retrieved from www.fitbit.com Gaiam, Inc. (2016). Yoga Studio (3.2.1) [Mobile application software]. Retrieved from https://itunes.apple.com/us/app/yoga-studio/id567767430?mt=8 Jawbone. (2016). UP by Jawbone (4.17) [Mobile application software]. Retrieved from https://itunes.apple.com/app/apple-store/id916240764?mt=8 Lumos Labs, Inc. (2016). Lumosity Mobile (7.3) [Mobile application software]. Retrieved from https://appsto.re/us/yY9zI.i  MyFitnessPal.com. (2016). Calorie Counter & Diet Tracker by MyFitnessPal (6.17) [Mobile application software]. Retrieved from https://itunes.apple.com/us/app/calorie-counter-diet-tracker/id341232718?mt=8 Noom, Inc. (2016). [Computer software]. Retrieved from www.noom.com

12. Unit 9: Expanding Access with TechnologyReferences – Lecture a (Cont’d – 1) References Omada Health Inc. (2016). Prevent [Computer software]. Retrieved from https://omadahealth.com/ Teladietitian Inc. (2016). Retrieved from https://teladietitian.com/ Under Armour. (2016). Map My Fitness – GPS Workout Trainer for Fitness, Step and Activity Tracking (16.4.0) [Mobile application software]. Retrieved from https://itunes.apple.com/us/app/imapmyfitness/id298903147/?mt=8 Urbandroid Team. (2016). Twilight (6.3) [Mobile application software]. Retrieved from https://play.google.com/store/apps/details?id=com.urbandroid.lux&hl=en Aranda-Jan, C. B., Mohutsiwa-Dibe, N., & Loukanova, S. (2014). Systematic review on what works, what does not work and why of implementation of mobile health (mHealth) projects in Africa. BMC public health, 14(1), 1. Digitas Health. (2012). The m.Book. Retrieved from http://mdot2012.digitashealth.com/mbook_2012_digitashealth.pdf Free, C., Phillips, G., Galli, L., Watson, L., Felix, L., Edwards, P., ... & Haines, A. (2013). The effectiveness of mobile-health technology-based health behaviour change or disease management interventions for health care consumers: a systematic review. PLoS med, 10(1), e1001362.

13. Unit 9: Expanding Access with TechnologyReferences – Lecture a (Cont’d – 2) References Gagnon, M. P., Ngangue, P., Payne-Gagnon, J., & Desmartis, M. (2016). m-Health adoption by healthcare professionals: a systematic review. Journal of the American Medical Informatics Association, 23(1), 212-220. mHealth Alliance. (2010). Economics of eHealth. Retrieved from http://mhealthknowledge.org/resources/economics-ehealth Silva, B. M., Rodrigues, J. J., de la Torre Díez, I., López-Coronado, M., & Saleem, K. (2015). Mobile-health: A review of current state in 2015. Journal of biomedical informatics, 56, 265-272. World Health Organization. (2011). mHealth: New horizons for health through mobile technologies. Retrieved from http://www.who.int/goe/publications/goe_mhealth_web.pdf Charts, Tables, and Figures 9.1 Figure: Tiase, V. (2016). mHealth potential benefits. Used with permission.

14. Unit 9: Expanding Access with TechnologyLecture a – Introduction to Mobile Health Technologies This material was developed by Columbia University and The University of Texas Health Science Center at Houston, funded by the Department of Health and Human Services, Office of the National Coordinator for Health Information Technology under Award Numbers 90WT0004 and 90WT0006.