Digital Health & Clinical Decision Support System Sanjeev Singh Sr Medical Superintendent Amrita Institute of Medical Sciences, Kochi, Kerala, India
Agenda Digital Revolution is the game changer IoT is the brand equity Applications of digital health improves processes and outcomes Clinical Decision Support System Efficacious, Cost effective, EBM, PROM
La Digital Health (Feminine) No one but the creator can understand its own logic Even the smallest mistakes is stored in long term memory The native language is incomprehensible to everyone As soon as you make commitment to one, you pay half the cheque on accessories
Le Digital Health (Masculine) In order to do anything with them, you need to turn them on They have lot of data but still can t think of themselves They are suppose to help you solve problems but half the times they are problems themselves As soon as you commit to one, you realise, had you waited a bit longer you would have got a better model
The Big Picture: Future of Digital Healthcare How can we meet the expectations of the new healthcare consumers? How do we provide patient care with optimized outcomes at reduced costs? How can we leverage personalized medicine and other advancements in digital technology to provide highly personalized care? How can we restructure and empower our workforces? How can we connect our organization to the new digital healthcare network? Which segments within healthcare organizations allow market leadership and competitive differentiation?
Digital Healthcare can address major healthcare solutions..
Triad of Future Healthcare
Digital Disruption
High Precision Healthcare
Personalized Medicine
Digital Public and Preventive Health
E-Learning
One health Global Health
Macro to Micro Thank you BRYANGRIFFITHS.COM
Internet of Things (IoT) Mobile devices can perform ECGs, DIY blood tests, or serve as thermometer. Check weight, pulse, oxygen levels, and enter results into mobile patient portals. Even better: They can transmit the results to my doctor in real time. It can help predict one s risk for heart disease and other illnesses, ultimately saving lives.
Input and feedback from patients organisations, healthcare professionals, app developers, healthcare policymakers and regulators, the pharma, medtech and mobile technology industries, and academia to identify and help address patients unmet needs in health apps. Healthcare Apps
Choose Risk stratification-type 1/2/3 Default screen of AMS app Choose location of patient admitted in- Ward/ICU Choose Site of Infection Hospital name & logo
Life Cycle
What are the building blocks? Data Add Access Share Control Trust Partners System Redress Access Reimbursement Security Mobility Standards Interoperability Integration
Are we nearly there yet???? Standards. Good progress Interoperability in some contexts Integration. Limited We are missing too many opportunities to engage and empower the patient!
Poll 1
What standards govern Digital Health 1. Center for Medicare & Medicaid 2. Food & Drug Administration 3. International Atomic Energy Agency 4. Health Insurance Portability and Accountability Act
Standards (Operability) HIPAA (Health Insurance Portability and Accountability Act) HL 7 (Health level 7)- LIS, RIS, PACS DICOM (Digital Imaging and Communication in Medicine) PACS (Picture archiving and Comm System) ICD 10 (International Code of Diseases) FIHR Fast HC Intra-operability Resources SNOWMED CT Systematised Nomenclature for Medicine Clinical Terms IEEE Institute of Electrical & Electronics Engineers (SDO)
Electronic Medical Record
EMR Viewer
Evaluation
What is the evidence
Process Improvement
CDSS & Medical Informatics Hypothesis tested were: Physician perceived threats to professional autonomy; Physician involvement in planning, design & implementation; Physicians beliefs on performance improvement
Systematic Review & Meta-analysis DHI significantly reduced CVD outcomes. Concomitant reduction in weight and BMI but not BP Framingham 10yr risk %age significantly improved
The way forward PROM
Poll 2
Why do clinicians feel about Digital Health 1. Waste of time 2. Insensitive approach towards patient in OP 3. Improves Efficiency 4. Good only for research
What attracts doctors to adopt digital tool..
Balanced Score Card
Productivity.Efficiency
Regulatory Compliance.. Health Information & Technology for Economics & Clinical Health Act (HITECH) 2009 Food & Drug Administration, Safety & Innovation Act (FDASIA) 2012 HIPAA Affordable Care Act IT 2000 (India)
Incentivizing Digital Health
Challenges in Digital World Acceptance of Digital world by Clinical team Too many applications Non availability of Skilled manpower Too many PCs to maintain and manage Mobility of devices is rapidly increasing Storage demands are increasing fast Serious lack of redundancy Too many servers Highly specialized technical skills required
Poll 3
Next Big thing in Digital Health 1. Nothing 2. Artificial Intelligence 3. Remote Controlled Healthcare (Surgeries) 4. Cloud Computing
Opening up new opportunities for transformation
Benefits for Stakeholders in Employing ehealth Benefits to Consumers:- Improved access to medical professionals - Increased ownership of one s own health Benefits to Consumers: - Improved access to medical professionals - Increased ownership of one s own health Benefits to Payers: Benefits to Providers: - Cost reduction - Resource mobilization - Improved clinical outcomes - Consumer base expansion - Volumes growth via online consultations coverage - Claims reduction due to shorter hospital stay
Thank IS NOW Thank you sanjeevksingh@aims.amrita.edu