http://www.pwc.com/ca/virtualcare

Discussions in Sweden

The New Health Economy: Virtual Care, New Entrants, and Consumerism

@willfalk

November 14, 2014

Five forces shaping the consumer trends in healthcare

1 Demographics Aging society Increased ethnic diversity

2 Consumer empowerment Greater responsibility Demand for value

5 Care

3 S.M.A.C. Social, mobile, analytics and cloud merge

Anywhere Accessible healthcare through mobile, retail

4 New Entrants Non-traditional players disrupt status quo Slide 2

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Shifting Demographics

The aging population drives increased spending, new opportunities Canadians seniors currently represent 14% of the population, but account for about 45% of all provincial and territorial government health spending

25% of the Canadian population is expected to be over 65 by 2031 Source: CIHI -“Health System Performance: Quality of Care and Outcomes," BDC 2013

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Slide 3

The 1% and 5% “frequent flyers” will drive bespoke care solutions… Figure 1. Health Care Cost Concentration: Distribution of health expenditure for the Ontario population, by magnitude of expenditure, 2007 Ontario Population 0% 10%

Health Expenditure

1% 5% 10%

20%

Expenditure Threshold (2007 Dollars) 34%

30%

$33,335 40% 50%

50%

66%

60%

79%

$6,216

70% $3,041

80%

99% 90% 100%

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$181

Source: ICES

What do Canadian Consumers want?

Goal of the report • Report explores Canadians’ attitudes towards pertinent issues in the health care industry • Provides analysis of what citizens expect decision makers to keep in mind when thinking of the future of health care in Canada Key Questions • What improvements are citizens looking for in health care?

• What channels are citizens using to access health care and information now, and in the future? www.pwc.com/ca/virtualcare

• What innovations are citizens ready to use that can make health care delivery more efficient? • What are the future possibilities in health care delivery? 5

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Making Care Mobile Shifting perspectives on the virtualization of health care More than 2,400 Canadians participated in our research to address the central question, “What does the future of health care delivery look like?”

6 PwC

Denmark is already doing email and telephone consultations…

Source: http://www.dst.dk/en/Statistik/emner/sundhed/laegebesoeg.aspx Viewed November 12 PwC

Slide 7

Virtual assessments via apps are good options in the right situation…

52%

77% of Canadians were comfortable with virtual mole assessment app scenario – although, at this time, most prefer doctor-controlled option. Doctor takes the photo and communicates with dermatologist

36%

You send it to your doctor using an app

21%

You use an app for an initial assessment

of patients indicate that faster access to care is the primary appeal of virtual assessment

20%

None of the above

15%

Not sure No answer

8% 1%

8 PwC

Canadians told us they are ready for virtual monitoring for chronic conditions…

79%

Most Canadians indicated they would be comfortable having a chronic condition monitored virtually... Yes, definitely

36%

Probably

43%

Not likely

of Canadians indicate that they are comfortable with virtual monitoring for chronic conditions

Definitely not Not sure No answer

10% 5% 4% 2%

... and 62% of caregivers indicated that virtual health care would help them to provide care for someone else (e.g. parent/ child)

9 PwC

… and virtual visits for post-surgical follow-up.

54%

The majority of Canadians indicated they would be comfortable having post-surgical follow-up visit done by video conference. 24%

Yes, definitely

43%

Probably

of Canadians indicate that virtual visits, home monitoring, and virtual wards are good care delivery options

17% 11%

Not likely Definitely not

5%

Not sure No answer

0

10 PwC

Other industries have undergone similar shifts… Industry Banking

Past

Travel

Retail

Standardized marketing and inventory

Health Services

Pharma

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ATMs and mobile banking available 24/7

Limited bank teller hours and locations

Limited travel agency hours and locations

Industry

Present

1980s – 2010s

Online Booking with real time pricing and on demand booking Customized website with targeted, data-driven promotions

Present

Future

Limited office hours and locations

Personalization of treatments and protocols

Standardized treatment plans

Availability of ondemand services

Blockbuster drug model

Ongoing shift

Personalized medicines with a focus on outcomes

Adoption Rates for technological advances follow a predictable S-curve…

http://cdn.theatlantic.com/static/mt/assets/business/ technology%20adoption%20rate%20century.png PwC

By 2020, more than 25% of care will be delivered virtually (with provider and patient in separate places). - Dr. Ed Brown, Nov. 2011

many small pilots

25%

… we now believe that 25% is low

13 PwC

This is already happening at Kaiser

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Slide 14

Virtual Health Care: We have been through similar shifts before…

1992… More people leave hospital after procedure than remain overnight

Virtual Care Outpatient Care

Inpatient Care

202X?… More virtual visits than physical visits

Each transition involved people, process, and technology changes. Major shifts in how we organize our care delivery services and assets 15 PwC

Consumer mHealth is exploding because as new low cost technologies become available…

16 PwC

Telemedicine and mobility are coming together facilitating delivery of virtual care anywhere

Telemedicine

mHealth

Virtual Care

17 PwC

Solution cost/benefit ($)

Virtual Care is a true disruptive innovation. Scaling using consumer electronics drops costs… High cost solutions supported by high clinical value

10,000

Cost-value tradeoff

01,000

Cost level can only be supported using consumer electronics

001oo 010 5%

25%

50%

Population (%) $41, 8,923, and 700%+ in BC in one year PwC

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How can we use virtual care improve health system access, quality, productivity, and sustainability?

Access

Quality

Productivity

Sustainability

• Deliver care over long distances

• Auditability of decisions

• Automated scheduling

• Reduced travel and wait times

• Use of manufacturing, QI, and QA techniques

• Elimination of • Ability to “politeness time” substitute lower cost care providers • Asynchronous

• Lower infection rates/ Infection control

• Ability to aggregate volumes

• Re-distribution of HHR – access to scarce specialties • Better waiting rooms

consultations

• Avoidance of greenhouse gases

• Auction pricing mechanisms • Artificial Intelligence

19 PwC

S.M.A.C. Shapes Business Models

The spectrum of digital health will continue to evolve as S.M.A.C technologies improve

September PwC

Slide 20

We are working with an AMC on six hospitalspecific use case scenarios … Patient Engagement  Solutions that support patient and family interaction with the organization  Administrative, way finding, information, and clinical  Impact on experience and costs Patient Engagement

Mobile Bedside  mHealth supported EMR, order entry, bed management  Clinical and administrative Mobile Bedside solutions  Impact on workflow, staff and clinician experience, and patient experience

BYOD  Mobile device management  Security and privacy solutions  Budgetary impact

Virtual Care

Transforming service delivery via mHealth

BYOD

Apps Library

Remote Monitoring

Virtual Care  Thoughtful reduction of face-toface interactions where feasible  Shifting % of planned outpatient visits to virtual visits  Impact on operations, and patient and clinician experience

Apps Library  Provision of apps from organizational store model  Aimed at staff & physicians, and patients and family  Integration with workflow and IT  Regulatory and policy requirements Remote Monitoring  Shifting patient management from hospital to community  Alignment with funding models  Coordination of care across sectors  Impact on readmissions, patient experience, and cost of care 21

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What will Your Apps Formulary Look Like? Tech Rx

Apps Pharmacy not Apps Store

Take 2 Apps and Call Me in the Morning Apps Formulary

UK (Cambridge Healthcare): “Europe’s First HealthApp Store” developing certification process for apps it sells. US (Happtique): market-leader in health apps published set of standards to certify apps operability, privacy, security, content reliability

AliveCor

Cardiac

Withings

Blood Pressure

bant

Diabetes

Pain Squad

Pain Mgmt

MyIBD

Crohn’s Disease 22

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The Apps Pharmacy and Apps Formulary will be core elements of DIY health &virtual care delivery

(“Hand-Bought”)

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http://www.pwc.com/ca/en/healthcare/virtual-health-making-care-mobile-canada.jhtml

“Front of store apps” are “mHealth ‘vitamins’” -Supplements for a healthy lifestyle, wellness & prevention Front of Store

Over the Counter

Prescription

Controlled Substance

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24

Over the counter apps may be dispensed after an assessment of the patient's needs… Front of Store

Over the Counter

Prescription

Controlled Substance

Slide 25 PwC

Prescription apps are a Plan of care written by/with physician or other health professional Front of Store

Over the Counter

Prescription

Controlled Substance

Slide 26 PwC

Controlled apps: require active management & use. They are regulated (or will be!) Front of Store

Over the Counter

Prescription

Controlled Substance

27 PwC

10 most popular health & fitness apps in Swedish Ranking in iTunes

Ranking in iTunes

Free

#2 Hatar Träning

#4

A training program involving a mental coach and three personal trainers over 12 training sessions, each 30 minutes long

#2 MammaMage

Allows users to connect with 100+ sports associations across Sweden, and book training sessions

#4 / 9

Guides couples through every stage of pregnancy, with tips and information provided weekly

#7

Mindfulness Appen

Friskis&Svettis

#7 Gravidkalendar

#10 SATS ELIXIA

#11 Promillekoll

Paid

Helps users minimise stress and increase sense of wellbeing through the utilisation of meditation techniques

22 Kr

15 Kr 15 Kr

Utilises mindfulness-based exercises to help users obtain a sense of inner peace and new energy

19 Kr

Utilises mindfulness-based exercises to help users relax and fall asleep more easily

15 Kr

Helps users exercise mindfulness with professional guidance

22 Kr

Pausa

Provides support to fulfil a personal training plan, including booking of group exercise classes with the SATS Sports Club Helps users stay below 0.6 per thousand when drinking alcohol. App developed by Systembolaget.

#10 Somna Mindfulness

#11

Mindfulness av Helena Löwen-Åberg

As of 6 November

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Comes with custom exercises that help the body to heal postpregnancy, while strengthening the inner abdominal muscles

As of 6 November

App Formulary • Front of Store • Over the Counter • Prescription • Controlled Substance

Note: Rankings in iTunes include international (English-based) apps as well as those specific to the Swedish market. The ones identified above are apps 28 developed in Swedish.

November

10 most popular medical apps in Swedish Ranking in iTunes

Ranking in iTunes

Free

#1 Rädda Hjärtat

Provides support in emergency situations, information on CPR, and location of the nearest defibrillator Provides producer-independent information about drug treatment for common diseases

#2

Knip

#4

Kolhydratskollen

KBT Appen

Utilises a fun and pedagogical approach to teaching children with Type 1 diabetes to enable them to lead more independent lives

#5 Medicinsk Ordbok

#6

NuvaRing

Provide support for those who have received a NuvaRing (birth control device) prescription, e.g. reminders for insertion and removal

#38

DiabetesGuru

Aims to make it easier for young people with diabetes (and their parents) at managing the condition and helping them fill better

#6

#7

Contains instructional text and cognitive behavioural therapy (CBT) exercises for use as a self-help program or with a therapist. A digital library which allows the user to search through more than 10,000 medical terms without needing an Internet connection A database with over 700 diseases and symptoms. The app also provides directions to the nearest clinic or hospital.

7 Kr

22 Kr

38 Kr

Läkarappen – sjukdomar och symptom

Allows you to find the closest pharmacy in Sweden Hitta Apotek

As of 6 November

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7 Kr

Provides information on and reminders for pelvic floor muscle training

#3

Läkemedelsboken 2014

#4

Paid

As of 10 November

App Formulary • Front of Store • Over the Counter • Prescription • Controlled Substance

Note: Rankings in iTunes include international (English-based) apps as well as those specific to the Swedish market. The ones identified above are apps 29 developed in Swedish.

November

7 Kr

New Healthcare Entrants See These Opportunities and Focus on Consumers…

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Slide 30

Disruption by New Entrants

Americans spent $267 billion on wellness US total healthcare cost $3T in 2012 US Healthcare system $2.8T Wellness market $267B

$59.20B for sporting goods

$45.40B Natural & organic food

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$93.62B for nutrition

$30.40B Vitamins and nutritional supplements

$11.25B for weight loss

$16.80B $1.02B Functional Nutrition and beverages energy bars

$61.6B for alternative healthcare

$40.33B for fitness

$1.30B for mobile health apps

$25.27B $7.31B $6.85B $0.64B $0.26B Gym Personal Pilates & Boxing gyms Fitness DVD membership trainer yoga studios & clubs production

Slide 31

Care Anywhere, Anytime

In some parts of Canada primary care is moving into pharmacies 9,000 points of care / Broader Pharmacy’s Plan for Improving Access to Affordable Healthcare

Aims at reducing care wait times by shifting 17 million physician visits to pharmacists The broader pharmacy community will be able to deliver a wider array of primary and chronic care services

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Slide 32

It’s not just tech-savvy millennials who want something new

45%

38% 50% 55+ years old

18–34 years old

Middle-aged consumers, caring for their kids, themselves and perhaps their parents, are most open to new, affordable, convenient digital, DIY, home-oriented options.

35–54 years old Source: HRI consumer survey, December 2013

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Slide 33

New strategies across the healthcare eco-system are required Build a full continuum of care Understand, attract and retain new markets

Incentivize value and quality

Increase efficiency Commercialize core competencies

1

2

Consumer

Innovation

Operational Agility

Smart Analytics

4

3

Improve outcomes through discovery Pursue new partnerships

Exploit new technologies Convert data into insights

Slide 34 PwC

Care Anywhere – What is Your Wearables Strategy?

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Slide 35

US consumers have high hopes for wearables.

Many consumers believe wearables will help us live longer, lose weight and be better athletes. Health Research Institute Health wearables: Early days 2014 PwC

Slide 36

Health tops the list of information US consumers want from wearables.

Health Research Institute Health wearables: Early days 2014 PwC

Slide 37

Yet, wearable tech is not mainstream in the US.

Health Research Institute Health wearables: Early days 2014 PwC

Slide 38

Still, it is growing fast. In 2014, wearable tech companies are projected to ship 7.6 million units within the US, a nearly 200% increase over the year before *

* IDC, “US Wearable Computing Device, 2014-2018: Forecast and Analysis” March 2014.

Health Research Institute Health wearables: Early days 2014 PwC

Slide 39

Six pillars of wearable tech and app design

Health Research Institute Health wearables: Early days 2014 PwC

Slide 40

Recommendations Consumer engagement must last after the novelty wears off.

Companies must develop sophisticated algorithms that turn data into insights for consumers and health organizations. Partnerships between healthcare organizations and wearable tech companies can sharpen business models, build credibility and ensure data match system needs. Consumers will share personal health details with the right audience. Careful segmentation can foster social sharing. Consumers may need a human touch to help them choose the right device and associated apps. An “apps formulary” can help steer consumers. Companies exploring health and wellness programs with wearables can expect buy-in with incentives. Companies should ensure privacy policies are crystal clear to consumers. Health Research Institute Health wearables: Early days 2014 PwC

Slide 41

Current Academic Hospital Project is focused on using mobile technologies in six domains…

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Slide 42

We are working with an AMC on six hospitalspecific use case scenarios Patient Engagement  Solutions that support patient and family interaction with the organization  Administrative, way finding, information, and clinical  Impact on experience and costs Patient Engagement

Mobile Bedside  mHealth supported EMR, order entry, bed management  Clinical and administrative Mobile Bedside solutions  Impact on workflow, staff and clinician experience, and patient experience

BYOD  Mobile device management  Security and privacy solutions  Budgetary impact

Virtual Care

Transforming service delivery via mHealth

BYOD

Apps Library

Remote Monitoring

Virtual Care  Thoughtful reduction of face-toface interactions where feasible  Shifting % of planned outpatient visits to virtual visits  Impact on operations, and patient and clinician experience

Apps Library  Provision of apps from organizational store model  Aimed at staff & physicians, and patients and family  Integration with workflow and IT  Regulatory and policy requirements Remote Monitoring  Shifting patient management from hospital to community  Alignment with funding models  Coordination of care across sectors  Impact on readmissions, patient experience, and cost of care 43

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Tele-Intensive Care Unit

Virtual Care Benefits •

Clinicians can remotely provide care and expertise.

•

Time sensitive situations can be managed.

•

Reduced wait times lead to improved workflow.

•

Reduction in costs such as travel.

•

Allows for a system of care without walls, allowing for improved customer experience.

•

Remote Tele-ICU providers had access to bedside clinical data. Video cameras were used to view the patients and the Tele-ICU staff used microphones to talk to the bedside nurse, doctor, and or patient.

•

VA healthcare providers monitored more than 30 ICU patients in several cities at once by viewing live video feeds from a central computer hub.

•

VA healthcare providers saved time, there was a reduction in costs for travel and they had more time to spend face to face with patients.

Virtual Ward

Virtual Care •

Health care providers are looking at new ways to coordinate care delivery.

•

Nurses often find it difficult to monitor multiple critically ill patients simultaneously.

•

A virtual ward is staffed by a team of nurses who work closely with a patient's own GP and a range of health and social care professionals.

•

University Hospital Southampton NHS Foundation Trust looked after 2,366 patients this way and saved 14,228 bed days.

•

Only 2% of patients on this scheme returned to hospital again compared to the average, of 7%.

•

There are now plans to add video consultations to further improve efficiency and allow clinicians to remotely provide care and expertise.

Multispecialty outpatient telehealth services

Early Start Program

•

Physician specialists are often located across the globe.

•

•

Many patients cannot travel long distances to obtain access to care.

Kaiser deployed teleconferencing capabilities for pregnant women deemed at-risk for substance abuse.

•

Using an encrypted, Web-based video interface, the Kaiser Early Start program made a substance abuse counselor available to the women. This helped enhance patient experience. The rate of fatal demise went from 7.1 percent in the control group to 0.5 percent among those women who participated in the teleconferencing program. This resulted in cost savings from reduced admissions and resulted in less strain on hospital staff.

Challenges

•

•

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•

Consults were accomplished using proprietary web browser based telemedicine software.

•

Telemedicine patient consults were scheduled and the visits were documented inside an existing EHR at both sites, facilitating a consistent documentation process between telepresenter and provider, leading to improved workflow.

•

During a 14 month implementation period, 246 telemedicine encounters took place, across 15 specialty services. This permitted clinicians to provide expertise remotely allowing for a reduction in costs and reduced wait times.

•

Current steady state volume is 23–28 encounters 44 per month.

Remote Monitoring

“Health Buddy" •

•

Benefits •

Patients take an active part in managing their own health to become an integral part of their own continuum of care.

•

Reducing travel time, hospital visits, and burdens on both the patient and the healthcare system.

•

Reduces pressure of primary care services.

•

Monitor patients at home and intervene proactively when needed.

•

Eliminating barriers to access to care such as travel.

•

Decreasing healthcare delivery costs for providers.

•

Efficient use of clinical resources.

•

Reduction in hospital readmission.

•

Create a constant connection between patients and their care teams.

Challenges

•

The veteran was connected to the VA facility from their home using a cell phone, landline, internet or satellite connection. This helped eliminate travel, allowing for a better patient experience and decreased healthcare delivery costs as the patient did not need to be admitted. When physicians or nurses receive d information, they could change medications or other treatment plans to prevent serious health problems from developing. This helped nurses track veterans' vitals on a daily basis reducing costs by cutting down hospital readmissions and improving efficiency of care as nurses could intervene when needed. Researchers from Stanford University and Analysis Group found that in 2011 the Health Buddy system helped trim spending by $312-$542 per person each quarter, for Medicare patients with various chronic diseases at two multispecialty clinics in the Pacific Northwest.

Safe Mobile Multi

Remote Monitoring

•

An integrated mobile multi user platform enables personalized care plans to be created, enabling for a better patient experience.

•

53 per cent of required treatment changes were initiated by the patient rather than a clinician.

•

From a sample of 30 Bristol NHS patients, 91 per cent said they felt somewhat confident that they could manage their own health prior to scheme entry, rising to 100 per cent following completion. This improved patient empowerment.

•

Allows carers and nurses to pro-actively and pre-emptively monitor relevant residents in Care Homes allowing for the efficient use of clinical resources.

IP network transformation

BodyGaurdian

•

Over a 48-month transformation, UPMC will work with AlcatelLucent to replace and upgrade its entire existing infrastructure across 19 hospitals and 400 outpatient sites in its serving area.

•

• The recorded information is fed into algorithms, UPMC will benefit from high bandwidth and network performance at giving the health care provider the ability to assess low recurring operating costs which allows for effective remote the patient. This allows for efficient resource use. monitoring.

•

•

Remote monitoring system that enables continuous or intermittent physiologic monitoring and detection.

• Data is transmitted to physicians via mobile phone UPMC can continue to grow its network and easily address additions, technology in real time. This allows for improved moves and changes without compromising the reliability of voice, workflow and decreased healthcare delivery costs. data and video services. This will ensure workflow is not disrupted.

45 PwC

Patient Engagement

VA Mobile Health Family Caregiver Pilot

Benefits

•

VA selected more than 1,100 Caregivers to participate.

•

Caregivers received loaned iPads loaded with a suite of apps to test over a 12-month period.

•

The suite was comprised of nine apps that were designed to support Caregivers and the needs of the patients they assisted.

•

Easier accessibility to information which would improve workflow.

•

Nearly three quarters of iPad recipients used the apps on the devices which showed that there was high levels of user engagement.

•

Empowers the patient to take a active role in managing their health which can lead to an improved patient experience.

•

Information was readily accessible and this helped improve the efficiency of care which in turn led to a better patient experience.

•

Potential reduction in re-admissions thus leading to cost reductions.

HealthTrak

Patient Engagement •

Engaging patients to take an active role in managing their health.

•

Safer transitions of care from a hospital discharge to community care.

•

Providing patients with the knowledge and means to manage their own health.

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A patient portal tethered electronic medical record and patient database.

•

Allows the provider and patient to look at the same data, allowing for complete transparency.

•

The portal grants patients the ability to schedule appointments, review medical histories and test results, renew prescriptions, and ask billing questions.

•

This facilitates improved accessibility to information and improved workflow.

My Health Manager Patient App • •

Challenges

•

•

The Mayo Clinic patient app provides patients with access to their health information. The functionality is personalized for each patient, providing secure access to their medical record. This provides patients with the knowledge and means to manage their own health. Future updates to the app will potentially include personalized feedback tailored for users. This would allow for a unique and better patient experience.

•

Online health management tool, which securely connects patients to their health care teams and their personal information.

•

Members can access My Health Manager from anywhere in the world via mobile apps for Android and Apple smartphones.

•

Empowers members with 24/7 access to email their care providers, schedule appointments and refill prescriptions.

•

This leads to improved workflow and allows patients 46 health. to take a more active role in managing there

VA Mobile Health Provider Program

Mobile Bedside

•

Mobile devices will be deployed to 10,000 providers and up to 19 VA Medical Centers (VAMCs) for clinical use.

•

The mobile devices will initially include VA email and a VA App Store with commercial mobile health apps that have passed VA security reviews.

•

Virtual Private Network (VPN) capabilities will be used to access information in the medical center as well as off-site. This allows for information to be accessible when it is required. This will lead to an improved workflow.

•

Apps will eventually allow clinicians to write progress notes, enter a subset of orders, and complete other clinical tasks. This will improve efficiency , workflow and allow for mobility of patient information.

Benefits •

Mobility of patient information throughout the medical center.

•

Easy access to medical tools at work, home and on-the-go which can lead to reduced costs.

•

Improved access to patient generated data which improves workflow.

•

Simultaneous and instant access by physicians in several locations to the same patient records.

eConsults

Mobile Bedside •

•

Healthcare providers often do not have a patient's up-to-date information available when needed. Providers cannot access information when on the move which can lead to delays and slow down workflow.

Challenges PwC

•

eConsults offer diagnostic collaboration to Mayo Clinic Health System providers.

•

Through a review of electronic medical records including imaging studies and laboratory testing.

•

Specialists found e-Consults useful in situations where they were managing patients who had secondary concerns that could be addressed with an eConsult.

Telemedicine robotic virtual rounds •

The use of a telemedicine robot used for virtual evening rounds by intensivists in an ICU.

•

An observational and qualitative pilot study in a 10 bed ICU was run.

•

The ICU nursing staff, intensivists, and hospitalists satisfaction ratings and comments indicated that the evening telemedicine robot rounds improved patient care, communication among the care team, and that the technology functioned well.

•

The average pre-pilot ICU length-of stay was 3.2 days and 3.1 days during the pilot.

•

Pages from ICU staff to the on-call hospitalist during after-hours shifts experientially decreased by 50% during the pilot. 47

Apps Library

VA Application Library

Benefits •

Easier accessibility to information for patients and providers.

•

Applications in the library can be approved by the provider thus addressing security concerns.

•

Allows for data to be produced in a way which can be used by clinicians and caregivers.

Develop a central location for both patients and providers to obtain access to information.

•

Allow patients to take a proactive approach in managing their own health.

•

Make it simpler for people to find safe and trusted applications.

Challenges PwC

The VA are developing apps for enterprise deployment to both VA clinicians, patients and their caregivers.

•

Currently the application library consists of 11 applications which are focused on supporting the patient and health care providers.

•

The ‘Clinic In Hand’ application enables physicians to view patient information and allows for patient-to-provider secure messaging. This helps workflow by improving efficiency.

NHS Application Library

Apps Library •

•

•

The application library offers numerous applications to help a patient manage and become engaged in their health.

•

Applications are reviewed by the NHS to ensure they are clinically safe.

•

Applications are rated by patients and the health care community.

•

Currently the application library consists of close to 100 applications.

Cancer Care Ontario Application Library •

The CCO application library currently offers three clinical apps which aim to support healthcare providers in their delivery of care.

•

The cancer screening application provides healthcare providers with a summary of CCO's breast and cervical cancer screening guidelines.

•

The Drug formulary includes monographs for drugs and regimens used in systemic cancer treatment, and symptom management information used to care for cancer patients in Ontario.

•

The Symptom management app guides care providers through clinical assessment and care planning based on symptom severity.

•

Apps are available on various platforms such as Windows phone, Android and iPhone.

48

Ottawa Hospital

BYOD Benefits •

Users can carry one device for both professional and personal use.

•

Significant cost savings for an organization as there is no need to provide devices.

•

Increase in productivity as users can work while mobile and have continuous access to information.

•

A pilot program with a select group of users enabled support services to learn how to manage unexpected issues.

•

Used Apple’s first-generation iPad device as their starting point . A single iPad was registered to each physician. A device could be remotely wiped in the event it was lost or stolen and security measures could be configured to be unique to each individuals device. Physicians, residents and nurses found value in using a mobile device in accessing patient information, ordering tests, and communications. This resulted in improved efficiency, workflow and user satisfaction.

•

•

Intermountain Healthcare •

BYOD •

Standardized protocols and clear guidelines are needed.

•

Need to adhere to laws with regards to personal health information.

•

Risk of security breaches.

•

Device Type – Hardware interoperability concerns.

•

Effective contingency planning is needed in the event of Wi-Fi downtimes or spikes in demand.

•

• •

St. Joseph Health • • • •

Challenges PwC

Intermountain’s mobile fleet is comprised of more than 5,000 company-owned devices – a mix of Android, iOS, Windows Mobile and Windows Phone devices. Employees were quick to participate in the BYOD program, which now includes 1,600 devices. End users rely on mobile devices to access email, calendar, contacts and applications to stay connected. There has been an improvement in efficiency and workflow as users can communicate on the go with their personal devices as apposed to needing to carry a professional device as well.

•

SJH uses MobileIron to secure thousands of employee owned iPhones and iPads. Reduced costs by replacing bedside computers with iOS devices. Replaced paper charts with iPads for doctors and nurses, which improved workflow and accessibility of information. Complied with the Affordable Care Act by freeing up caregivers to work more effectively outside hospitals. Avoided liability issues by maintaining control over employees’ use of corporate email during off-hours.

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