Craig Richardville, SVP & CIO, Carolinas HealthCare System
With more than 100,000 health and medical apps in the Apple and Google Play stores, consumers are finding ways to better manage and understand their health status. The plethora of these apps and the entrance of Apple and Samsung and other technology companies in this space provides clinicians with some unique opportunities. At Carolinas HealthCare System, we’ve been working to address the burgeoning opportunities in the mobile health world. The explosion of the adoption of smart phone technology has provided us with a technology path that can easily connect our thousands of clinicians to their patients, in a manner that is convenient and clinically-valid. We see three key areas of focus for us and our patients:
• Mobile technology that enables consultative care
• Mobile technology that leverages remote health monitoring
• Mobile technology that enables better health habit formation and maintenance, like MyFitness Pal or Runkeeper
"The explosion of the adoption of smart phone technology has provided us with a technology path that can easily connect our thousands of clinicians to their patients"
mHealth for Consults
For consultative care, Carolinas HealthCare System launched a virtual visit through an app and through our web site. It is one service of many, provided by our Virtual Care initiative. It allows consumers in the Carolinas to connect via embedded video technology with our providers for common treated conditions including cold, cough, sinus and upper respiratory infections, seasonal allergies and minor skin conditions. These video visits through the smartphone and computer have proved enormously popular with patients. It gives patients and consumers easy access from the comfort of their home. Patients are seen where they are, when they are sick, 24-7. Later in 2015, we will expand this capability to schedule and deliver primary care visits via this technology.
mHealth for Remote Monitoring and Fitness
To address remote monitoring and the fitness interest of our patients and consumers, we are offering a new, free mobile app called Carolinas Tracker for consumers and MyCarolinas Tracker for our patients. These two apps both consume data from the evergrowing number of Bluetooth-enabled devices, such as Fitbit, Jawbone, glucometers, weight scales, pulse oximeters and blood pressure cuffs. The apps also take from the Apple Healthkit and several popular apps like Runkeeper. The apps receive all the patient-generated data, collating that data into easy to read and understandable patient dashboards. It analyzes that data in the dashboards, providing clinical context for the patient and consumer. In the app, the user knows whether their daily weight is in a good range; they’ll understand how their daily glucose values matter. For patients of Carolinas HealthCare System though, we take the app a few steps further. Patients will have access to a version of this app, MyCarolinas Tracker, which consumes all the patient-generated data but also presents to them the clinical data we are holding on them in our electronic medical record system, Canopy.
Right now, physicians see only a portion of the picture of their patient’s true health. The combination of the patient health data and the clinical data provides both patients and clinicians with powerful information on the total health status of the patient. We believe that having all that information in one place provides an opportunity to improve the care delivered as well as see an increase in patient engagement. Finally, for those patients enrolled in Carolinas HealthCare System's programs, such as our diabetes coaching programs, they will be able to receive coaching through the app. Each day their coaches can see how their patients are doing with their prescribed care and how they are doing with their daily glucose readings.
Having that information in patients and caregivers hands, we believe, makes it easier to better manage this large population. Our remote monitoring also extends to nearly 340 intensive care unit beds across several of our hospitals in the Carolinas. Using virtual technology, clinicians are monitoring patients in ICUs across geographical lines, providing quality clinical care to patients. Home-based monitoring for patients also is on the rise at Carolinas HealthCare System. Nearly 20 percent of all sleep studies now are done from the patients’ homes. In addition, we are providing direct virtual care services between providers. Clinicians at Carolinas HealthCare System are providing behavioral health, stroke and other scarce consultative services to providers in rural areas in our markets. Leveraging this technology has allowed us to efficiently and effectively provide quality care to patients. Our march toward using technology as an enabler to connecting patients and their providers continues here at Carolinas HealthCare System.
This is only the beginning of our work in finding technologies that meet the needs of patients and providers. Each day, we’re looking at technologies to determine if they can enable the high quality service and care our patients and providers expect. The mHealth aspect of care delivery is in its earliest stages. How people adopt these technologies and integrate them into their daily lives remains to be understood. Just as importantly, we need to ensure that these new technologies also make sense in our clinical workflows and truly deliver clinically valid results.