Mobile Solutions in Healthcare: Technical and Managerial Issues - PowerPoint PPT Presentation

1 / 28
About This Presentation
Title:

Mobile Solutions in Healthcare: Technical and Managerial Issues

Description:

Real or virtual technical and managerial issues moderate ... International Association for Development of the Information Society (IADIS), Lisbon, Portugal. ... – PowerPoint PPT presentation

Number of Views:193
Avg rating:3.0/5.0
Slides: 29
Provided by: mihailc
Category:

less

Transcript and Presenter's Notes

Title: Mobile Solutions in Healthcare: Technical and Managerial Issues


1
Mobile Solutions in Healthcare Technical and
Managerial Issues
  • Mihail Cocosila
  • Ph.D. Candidate
  • DeGroote School of Business, McMaster University
  • February 14, 2006

2
Agenda
  • Introduction
  • Why mobile in healthcare?
  • Mobile answers
  • Technical issues
  • Managerial challenges
  • Conclusions and future research

3
Introduction
  • Essential challenge of healthcare provision
    today

population demands for higher quality healthcare
limited resources of the system to meet the
demands
4
Introduction
  • Demands aggravated by
  • growing incidence of chronic diseases and
    conditions (54 of the burden of all illnesses
    worldwide in 2001 and over 65 in 2020)
  • ageing population (ratio working
    people/non-working pensioners in the developed
    world from 3/1 in 1999 to 1.5/1 in 2030)
  • impatient patient (better educated, more
    dynamic, and asking for higher quality
    healthcare).
  • Healthcare system strained by
  • limitation of resources (shortage of hospital
    beds and healthcare personnel)
  • health providers always on the move and short of
    time
  • time and efficiency have become critical factors.

5
Introduction
  • Possible responses
  • increasing focus on prevention besides curing
    diseases and conditions
  • treating some diseases in out-of-hospital
    conditions.
  • Intended gains
  • reducing costs
  • easing the work of health providers
  • improving patient quality of life and saving
    lives.
  • A potentially innovative approach implementing
    mobile and wireless healthcare solutions.

6
Why mobile in healthcare?
7
Why mobile in healthcare?...
8
Why mobile in healthcare?...
9
Mobile answers
  • Access To Evidence Based Data
  • Tough decisions
  • opting for or against a certain medical
    intervention
  • deciding the most appropriate procedure for the
    patient
  • choosing the treatment with the best-expected
    outcome and the highest cost-effectiveness.
  • Possible mobile IT answers
  • electronic versions of useful medical books
    (e.g., The Handbook of Evidence Based Critical
    Care Medicine)
  • specialized software (e.g., InfoRetriever
    containing all InfoPOEMs-The Clinical Awareness
    System-, all Cochrane Systematic Review
    abstracts, 230 decision rules, over 2,500
    predictive calculators, 750 summaries of
    evidence-based practice guidelines).

http//www.infopoems.com
10
Mobile answers
  • Electronic Medical Records
  • Existing approaches
  • physicians review hard copy of medical records,
    or
  • access patient information from a server through
    desktop PCs.
  • Both interfere seriously with physician hospital
    mobility.
  • Possible mobile IT answers
  • wireless solutions offering physicians, among
    others, data on patient lab test results,
    previous consultations, surgical reports, and
    medical treatment history (e.g., Cedars-Sinai
    Medical Center or MData Enterprise System
    both in the U.S.).

http//www.itechresearch.com http//www.mercur
ymd.com
11
Mobile answers
  • Drug Reference
  • Problems
  • physicians choose from lists of thousands of
    drugs the most appropriate to be prescribed to a
    patient in a certain health condition, and
  • there is an avalanche of information continuously
    being revised which is impossible to remember or
    maintain in hard copy.
  • Possible mobile IT answers
  • database with recommended dosages, possible
    interactions and warnings, adverse reaction
    factors, restrictions, test interactions, brand
    names, spelling of various medical terms, drug
    costs (e.g., EPocrates, Skyscape, Handango
    Software Suite).

http//www.sciencedaily.com
12
Mobile answers
  • Checking and Validation
  • Problems
  • physicians when writing prescriptions must ensure
    that the drugs do not result in adverse reactions
    or side effects for specific cases
  • pharmacists can help to check this, but doctors
    are at the intersection of the two relevant
    branches of information patient and drug.
  • Possible mobile IT answers
  • early checking and validation for mismatches at
    the point of care (e.g., PocketScript ).

http//www.wirelessnewsfactor.com
13
Mobile answers
  • Prescription Writing
  • Problems
  • each year there are a reported 7,000 deaths
    attributed to medication errors, and more than
    150 million calls from pharmacists to physicians
    to discuss prescription problems in the U.S.
    alone.
  • Possible mobile IT answers
  • sending prescriptions electronically (e.g.,
    OnCallData service which is said to allow
    significant timesaving of up to 10 minutes per
    prescription and a total of 2-6 hours a day for
    an office by sending prescriptions electronically
    or via fax to one of over 72,000 participating
    pharmacies in the U.S.).

http//www.oncalldata.com
14
Mobile answers
  • Other Professional Needs
  • Physicians
  • have a very busy agenda
  • must consult specialized reference books for
    medical calculations or try to remember formulas
  • must communicate with healthcare providers
  • should communicate with their patients
  • may have other diversified off-duty needs.
  • Possible mobile IT answers
  • combinations of PDAs (personal digital
    assistants) and cell phones with increased
    capabilities and loaded with appropriate
    applications (e.g., Archimedes medical
    calculator).

http//www.skyscape.com
15
Mobile answers
  • Issues Specific to Physicians in a Hospital
    Setting
  • Physicians should
  • have access to patient data in emergency
    response
  • be able to communicate, no matter where they are
    in a hospital (because patient situations may
    become acute at any time)
  • be able to locate specific patients fast in large
    hospitals
  • have access to discharge summaries of patients
    for future reference.
  • Possible mobile IT answers
  • using of handheld devices for collecting or
    retrieving needed information (e.g., American
    Medical Responses system that captures patient
    information at the site of an emergency response
    or during transport to the hospital).

http//www.pdamd.com
16
Mobile answers
  • Issues Specific to Physicians Outside a Hospital
    Setting
  • Physicians should develop communications with
  • hospitalists (about the state of patients who
    were referred to hospital physicians or
    specialists, especially for follow-up
    appointments)
  • homecare personnel (for improving the quality of
    home care services).
  • Possible mobile IT answers
  • using of handheld devices relying on central
    systems (e.g., 300 physicians of IPC-The
    Hospitalist Company of North Hollywood,
    California, empowered with wireless PDAs can
    share information both with a central server and
    with primary care physicians - advantages time
    and cost savings, and early diagnosing of patient
    conditions)

Singer, A.D. (2003) A good connection.
Hospitalists and primary care physicians keep in
touch best via wireless. Healthcare Informatics,
http//www.healthcare-informatics.com
17
Mobile answers
  • Homecare Nursing
  • A significant part of the daily activities
    involves paperwork on
  • patient admission/status change/discharge
  • supply ordering
  • wound care.
  • Possible mobile IT answers
  • using of handheld devices communicating with a
    central system (e.g., handheld devices equipped
    with Pixalere - a software helping nurses to
    treat patients with minor wounds at the scene
    and, if necessary, get wireless access to a
    healthcare professional at a local hospital - may
    save in some situations the 1,000 cost for the
    health system and the 60 amount from the
    patients own pocket required by a round trip to
    the Emergency Room, or handheld devices provided
    with a supply ordering application under
    development at Simcoe County CCAC).

Zeidenberg, N. (2003) Wireless solution allows
nurses to better serve patients at bedside. CHT,
8 (2), p. 4
18
Mobile answers
  • Outpatient Self-Management
  • Outpatients often have difficulties with
  • self-managing chronic diseases while living an
    active life
  • adhering to the necessary medical treatment and
    behavioural changes.
  • Possible mobile IT answers
  • using of handheld devices as virtual healthcare
    providers (e.g., a wireless text messaging system
    reminding about upcoming appointments and
    experimented at Homerton Hospital in London,
    U.K., was considered a success since, at less
    than 10 U.S. cents per message, the savings -
    less missed appointments with 8 - significantly
    offset the costs)

Dyer, O. (2003) Patients will be reminded of
appointments by text messages. BMJ, 326, p.1281
19
Technical issues
  • Technology selection criteria
  • Answering the targeted user needs (e.g.,
    communication and data exchange needs of homecare
    nurses in a mobile context)
  • Matching infrastructure requirements (e.g.,
    real-time or by synchronization data access,
    local or wide area networks)
  • Ensuring integration with existing systems (e.g.,
    multiple systems and health records maintained by
    hospitals, home care organizations, and private
    physicians)
  • Using mobile devices with satisfying capabilities
    (e.g., data input/output features, expandability,
    weight, processing power, memory, battery life)
  • Ensuring that benefits substantially outweigh
    costs.

Mobility does not necessarily involve wireless
access
20
Technical issues
  • Real or virtual reasons of concern
  • Security and privacy
  • of wireless communications and patient data
    storage and updating involving patient data
    (regulated by HIPAA or PIPEDA and PHIPA).
  • Connectivity
  • one hundred percent wireless connectivity is not
    an achievable goal
  • limited communication bandwidth.
  • Interference
  • with sensitive electronic equipment in hospitals
    or clinics, or with patient medical devices.
  • Reliability and flexibility
  • of applications (e.g., always on, fit to users
    needs, device-independent)
  • of devices (e.g., robustness, voice and data
    capabilities).
  • Ease of use and learning time.

21
Managerial challenges
  • Management problems generated by the use of the
    latest technology
  • uncertainty of investment in an immature
    technology
  • difficulty of choice among similar products in an
    incipient stage of the market
  • uncertainty about vendor and technical support
    stability in a new market
  • concerns about technical and human consequences
    of using the new technology
  • necessity of a smooth implementation (both
    technically and human) so as not to disturb
    patient care and healthcare work processes in the
    transition period.

22
Managerial challenges
  • Implementation of new technology considerations
  • system design
  • device and vendor choice
  • planning of the deployment
  • actual installation
  • support and training
  • prototype and usability testing
  • installing of control mechanisms for the
    deployment stage and for the future.
  • Essential for success early and continuing
    involvement of all major stakeholders
    (physicians, nurses, homecare workers, hospitals,
    homecare centers, funding institutions, and last,
    but not least, patients) in the development and
    evaluation of new technology.

23
Managerial challenges
  • Human issues
  • User perceptions and apprehensions
  • doubts of the mobile solutions usefulness
  • difficulties with technology
  • interaction with devices
  • perceived risks with wireless applications
  • user acceptance obstacles.
  • Changes of the existing health care providing
    pattern for
  • physicians (e.g., handling devices while with
    patients, overwork, liability, and reimbursement
    issues)
  • homecare nurses (e.g., less time for nursing
    visits and more time for remote interactions with
    patients)
  • patients (e.g., handling and carrying potentially
    invasive devices).

24
Managerial challenges
  • Healthcare system issues
  • Alteration of existing healthcare system
  • setting up or improving call centers empowered by
    wireless technology for remote care of
    outpatients
  • re-design or reduction in jobs
  • creation of other jobs requiring more IT skills
  • increasing delegation of health care
    responsibilities to outpatients.
  • Important missions of the system
  • appropriate training and education for the new
    technology at all levels
  • managing possible resistance to change from the
    main stakeholders.

25
Managerial challenges
  • Recommendation

Implementation of mobile and wireless solutions
in healthcare should be designed with
intermediate targets that are relatively easy to
reach and demonstrate, so as to increase the
confidence of major stakeholders in the following
steps.
26
Conclusions future research
  • Conclusions
  • Mobile and wireless solutions may address some of
    the information and communication needs of
    todays health providers and outpatients
  • Mobile IT may contribute to better quality of
    care and improved efficiency of the healthcare
    system
  • Real or virtual technical and managerial issues
    moderate the possible use of mobile healthcare.
  • Future research should investigate implications
    for accommodating m-healthcare solutions
  • changes necessary to the existing medical
    information technology systems
  • specific business cases associated with
    implementing the new technology.

27
Messages to remember
  • Technology, no matter how advanced,

could not and should not replace the
relationships between people in the healthcare
system (especially between patients and their
health providers)
cannot solve by itself existing organizational
and managerial problems in healthcare
organizations
should not be justified by its novelty but by
improvements in the quality and cost
effectiveness of health care processes
Archer, N. (2004). The business case for
employee mobility support. International
Association for Development of the Information
Society (IADIS), Lisbon, Portugal.
28
Thank you!
  • Contact
  • Mihail Cocosila
  • Ph.D. Candidate
  • DeGroote School of Business,
  • McMaster University, Hamilton, Canada
  • cocosim_at_mcmaster.ca
Write a Comment
User Comments (0)
About PowerShow.com