Acute Limitations to Telehealth (FPOC)

Final Project Jakiyah Jones, Ivy Alomgir, Jared Cannon, Pedro Acosta LIS 4785 Health Informatics Dr. Sanghee Oh, Ph.D. Acute Limitations to Telehealth (FPOC) Project Statement: Telehealth has gone mainstream with huge savings being forecasted. Direct­to­consumer Telehealth models must comply with state and federal agencies while ensuring easy and intuitive ways for patients to engage in their own health. Issues at the forefront of compliance and patient engagement include: Overprescribing, Patient Health Record access, Follow­up care, and E­visit documentation (Quashie, 2014). We present these issues as acute because our solutions will empower the patient and provide “First Point of Contact” (FPOC)​
results by engaging the patient in the process, immediately facilitating real time access and solving foreseeable patient issues via an integrative mobile application. Our target audience is the “​
patient​
” having ​
immediate​
access to ​
vital issues​
such as their prescriptions, their personal health record, and e­visits documentation, along with ways of engaging and managing their results and outcomes (feedback). These tangible results will promote patient compliance, improve patient safety, and reduce costs. Evidence: Prominent TechHealth perspectives continue to shed light on the importance of engaging the patient in his/her own health. Research and surveys predict trends, decipher information, and forecast future progression. The following documented statistics emphasize and validate our direction as we incorporate trends in finding feasible solutions. ● mHealth app users are estimated at 500 million worldwide ● age, gender, and socioeconomic status dictate usage ● 66% of consumers stop using mHealth apps after initial set­up (MIT Technology Review) ● current apps don’t offer what consumers want (McKinsey & Company) ● 76% of surveys indicate that consumers want function specific apps (FICO surveys) ● 33% of physicians are incorporating mHealth apps in their practice ● prescription drug laws create challenges for Telehealth (Freidberg, R. 2012) These relevant and clear analytics predict a viable and accepting marketplace, ripe for innovation and the development of easy and functional applications that will enhance patient health and promote compliance. Potential Solutions / Chosen Approach: The marketplace is saturated with mHealth apps that attempt to address our deliverables, specifically: Overprescribing, Personal Health Records, E­visit Documentation and Follow­up/ Quality of care issues, yet their approach is segmented and limited, not allowing the integration of these fundamental issues. FPOC offers simple intuitive access to patient engagement. ● FPOC would allow the patient to engage in a comprehensive approach to their healthcare. Keeping track of prescriptions, engaging with different clinicians, and being able to provide feedback which will directly affect patient care and outcome. ● FPOC’s Prescription (Rx) function will avoid costly duplication of pharmaceuticals, allowing both the patient and clinicians to better manage drug therapy, increasing patient compliance and reducing prescription costs. ● FPOC’s Quality of care and Follow­up function will further enhance evidence based medicine (EBM) progression by allowing the patient to offer feedback, whether positive or negative to improve and re­access treatment options (Staniszewska, S.H. 2005). It may also provide feedback to promote cost reduction and clinician satisfaction rankings. ● FPOC’s E­visit documentation function will keep everyone on the same page, providing a thorough profile of patient and clinician interaction. Our chosen approach is specific by design allowing the ​
patient​
to engage in their personal healthcare. It is a layered, tiered, approach that involves the patient, clinicians, and prescription specific access. These entities must collaborate and share information securely to enhance patient engagement and involvement. Integration and interoperability are vital as they drive the success of this simple, yet intuitive app. Data input and veracity are indispensable components of this platform and will impact function and costs savings. It is a realistic and feasible approach, yet challenges do exist. State and Federal regulations governing medical and pharmacy practice will need to be standardized and or regulations need to be specific in order to ensure privacy and security. Interoperability is key, as each function will depend on access and transmission of fluid yet vital information. Patients will have access to their pertinent health information via the FPOC app. This app is secure and encrypted allowing interoperable access to their clinicians and active pharmacy profile. Each component can interface with each other allowing a synopsis of patient care and treatment options, thus enhancing a uniform approach. A uniform approach will keep everyone on the same page, avoiding duplications of services and streamlining patient compliance and savings. Lastly, this application will only satisfy its intended result if is it used by the patient, thus our engaging, simple, yet intuitive platform. Deliverables: Overprescribing (Rx) This acute problem is significant and its ramifications are expensive. Telemedicine initiatives lend themselves to quick solutions, especially without access to EHRs. By providing patients with immediate access to their prescription files, real time information can be shared with new and existing clinician eliminating duplicate prescriptions and improving patient compliance and safety (Wicklund, E. 2015). Additional research is needed in an attempt to streamline federal and state regulations that govern the practice of Pharmacy. Patient Medical Record Accessibility: (PHR) Many telehealth models do not have access to a patient’s full medical record. This causes major issues. To provide every patient with the best medical care, it’s important that medical providers know the full extensive background of that person. Not knowing something about a patient's background can cause misdiagnoses and poor quality care. We must close the gap between different medical organizations and telehealth models. This will improve the efficiency and usage of medical records. Improving the access of medical records will enhance the overall quality of healthcare being provided. Follow Up/Quality of Care: This problem is very important with changing healthcare. Doctors and clinicians feel that one of the key parts to providing good healthcare is follow up care and direct patient contact. With everything becoming electronic it becomes harder for physicians to deliver the best quality of care. A solution to this problem may be to provide patients with a means to “chat” or webcam directly with physicians. Another way to improve quality of care would be to have a rating scale where patients or doctors can log what is discussed during the e­visit. E­Visit Documentation: This problem is a smaller problem that is going to only keep getting bigger and bigger as time goes on. As technology advances more and more, meetings are being held over the internet using applications like Skype and FaceTime. The problem with this is that since there is no face to face meeting; it is challenging to keep records of what went on in that meeting for subsequent doctors or health care providers. That being said, doctors cannot reflect off that previous meeting and that could set things back for that patient. After doing more research I am hoping to be able to determine a solution to this in order to make this innovation much more reliable and helpful. Timeline​
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/ Meeting minutes / Team Collaborators: Meetings occurred at defined intervals that were agreed upon by the entire group. Our main source of communication was through google docs as well as our e­mail accounts. We visited and explored suggested template applications once we reached the final stage of our project. 09­08­2015­ initial brainstorm session, topic defined and selected (30 minutes) 09­22­2015­ research and specifics determined, deliverables assigned (30 minutes) 10­26­2015­ progression status, template demo focus and fine tuning (60 minutes) 11­02­2015­ template demo group presentation dry­run (45 minutes) 11­30­2015­ prezi upload, template redesign per feedback, fine tuning (120 minutes) 12­01­2015­ final project presentation run­through and fine tuning (45 minutes) 12­(05­08)­2015­ final project report, input and collaboration (google docs collaboration) Jakiyah Jones: PHR; prototypes, slideshow Ivy Alomgir: Follow­up; prototypes Jared Cannon: E­visits; prototypes Pedro Acosta: Overprescribing; secretary, powerpoint /prezi editing, research, time keeper Solution Prototypes: pre­feedback prototype post­feedback prototypes Final Solution: Our post­feedback images provide our adopted templates, illustrating the simplicity and intuitive nature of our deliverables. We have integrated four essential functions, securely accessible to the patient in order to communicate, manage, and optimally improve patient compliance and engagement. As previously stated essential components of our proposed application rely on systems interoperability and an integrative approach to healthcare. Learning Barometer / Next Steps: We have applied our learning barometer specific to our apps feasibility. These concerns will also translate and determine what steps need to be addressed in order to achieve full implementation. ● A patient centric app must be secure and private, so that pertinent information can be shared and ensure valid results. ● Cooperation between private and government sectors will provide standards and regulations, that dictate feasibility. ● The only constant is ​
change, ​
outcome is only as good as data entry and the veracity of the information that is shared. ● Proceed with caution, implement Beta­testing and vigorous trials, adopt and explore recommendations. ● Personal involvement will directly correlate to compliance and engagement. References: Freidberg, R. (2012). Prescription drug laws create challenges for telehealth. Telehealth perspectives. Retrieved from http:techhealthperspectives.com Quashie, R. (2014). The 5 issues that trouble regulators when evaluating direct to consumer telehealth. ​
TechHealth Perspectives, 2014(10). Staniszewska, S.H., & Henderson, L. (2005). Patients’ evaluations of quality care: Influencing factors and the importance of engagement. ​
Journal of Advance Nursing, 49(5). Wicklund, E. (2015). Are doctors over­prescribing via telehealth? mHealthnews. Retrieved from ​
http://mheathnews.com/are­doctors­over­prescribing​
.