Wednesday, February 11, 2009

CyLab MRC Mobile Health Workshop: Kinnexxus' Vision -- "With" the Elder Rather than "For" or "To" the Elder

[Image: Dara-Abrams and Pan address attendees]

CyLab MRC Mobile Health Workshop: Kinnexxus' Vision -- "With" the Elder Rather than "For" or "To" the Elder

Benay Dara-Abrams, CEO and Chief Gerontechnology Officer, and Wayne Pan, Chief Medical Officer, Kinnexxus spoke on "Improving Health Outcomes Through Collaborative Gerontechnology."

Dara-Abrams articulated a vision of working to provide healthcare "With" the elder rather than "For" or "To" the elder.

She stressed enabling independence: "The more you can support independence the lower the costs," and characterized the current environment as "chaotic, fragmented, difficult to navigate, isolating, dysfunctional, inefficient and costly."

The current paradigm for the healthcare of elders, Dara-Abrams observed, may provide support for the physical and physiological elements of what it means to be an individual, but it is not addressing the spiritual, social or cognitive elements very well at all.

To view the Kinnexxus presentation, click here.

Q&A on Mobile Health Workshop Themes

What is your vision of how mobile health will improve outcomes, reduce costs and/or improve patient (and provider) experiences?

Benay Dara-Abrams, CEO and Chief Gerontechnology Officer, and Wayne Pan, Chief Medical Officer, Kinnexxus: If you look at the healthcare delivery system today, it can be broadly divided into two major areas: inpatient and outpatient. Healthcare of the near future will also need to take into consideration the third and largest area, the personal health space (the sum of an individual’s behaviors and activities). Mobile health, as part of Health 2.0, is at the junction between the personal health space and outpatient areas. Currently, there are very few tools providers have at their disposal to help patients in their personal health space. Providers, in the outpatient setting, can offer advice (e.g., smoking cessation) and maybe write a prescription and then send the patient on their merry way hoping that what they have said and done will actually improve the patient’s health. Mobile health will provide more tools that can help the patient achieve better health outcomes and consequently, reduce the need for acute care (i.e., emergency room visits and hospitalizations). Development of non-intrusive, intuitive appliances that blend seamlessly into people’s lives, including remote monitoring of physiological parameters, can and will provide valuable, real-time information to help patients with their health self-management challenges. After all, patients spend the vast majority of their time in the personal health space, and Health 2.0 brings healthcare to the patient. The added benefit of linking patients in the personal health space to providers through connected support networks will encourage patients to be more compliant. These connections can also benefit the elderly, as it can reduce feelings of isolation and help them feel less depressed. This type of mobile health environment will also enable providers to detect small changes that may occur over time and enable early detection of trends that might otherwise go unnoticed. Other issues, such as patient compliance with medication can, not only be monitored, but support can be offered at the time when the medication is missed. This support can come in the form of reminders to take medications as well as helping patients understand better why they are taking the medications and the possible consequences resulting from non-compliance. In addition, through improved monitoring of patients in the personal health space via an electronic dashboard of sorts, providers can become more efficient using real-time clinical data to help prioritize scheduling of patients for office and/or home visits.

What are the most pressing business, process, organization, cultural and technical issues in mobile health?

Dara-Abrams and Pan: Gaining adoption of new modes of healthcare delivery. Current mobile health approaches focus on physiological and physical health but do not address cognitive or social health dimensions 1.0 approach to home visits lacks critical information to arm physician with data on the patient prior to the visit to be able to prioritize visits. Current technology is not adaptable to decline in faculties among aging patients.

What are the best opportunities for collaborative university research?

Dara-Abrams and Pan: Identify which of the promising technologies is capable of commercialization in a way that is sustainable to rapidly bring theory into practice. Bring together interdisciplinary teams with different viewpoints to create a unique perspective to evaluate feasibility and optimize product development in mobile health applications.

What is the role of university research in this area?

Dara-Abrams and Pan: Promote a broader view of health and wellness, extending the healthcare model, identify and develop adaptable technology to compensate for declining faculties, focus on technologies that can support outpatient services and patient self-management.