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1 9/26/2018
Dr.Mazen Maswady
الذك
ي الصح
ي التثقيف والتعلم
Smart Health Education and Learning
Presented by
Dr.Mazen AA Maswady, PhD Hosp. Adm, M.Sc. ,B.Sc.
Senior Technical Advisor
Nafees International Consultants
Mobile No.00962795500749 ,Amman- Jordan
mazenmaswadey@gmail.com
Presented to
Smart Health Conference
Transformation from Electronic Applications
to Smart Applications
Holiday Inn ,Amman Jordan
23-27 Sept 2018
هُ َ َْ َ َ ه َ ُ َ ُ َ ه َه
م ل س و ه
ِ ي ل ع اَّلل ىُّ ل ص اَّلل
ِ ول س ر قال
هُ ََ ْ ُ ُّ َ ه ْ ْ
ُ َ َ ُ ه ْ ْ َ َ ُّ َ ه ُ ه َ
التعل َمَ ،وال ِفق هه ِبالتفقهِ ،ومن ْي ُ َ ِر َ ِد ُاَّلل ه اس ُِ ،إَّنا ِّال ِعلم ِب
ْ ِّ َ ":يا أي َها الن
َ ْ َ َ َ ِْ ًْ ُ
ين ،و ِإَّنا َيشى اَّلل ِمن ِعبا ِدهِ العلماء" ِب ِه خْيا يفقهه ِِف الد ِ
جممع الزوائد (" :)1/154رواه الطرباني ِف الكبْي
Anatomy of the Presentation
&ILOs
Identify Main Concepts: Health Informatics and Smart Applications in
Healthcare
Conceptualize E-Learning concept , components, tools, and rational
Describe and evaluate the hardware and software, the information system
utilized with E-Learning and Smart Applications in Healthcare.
Analyze E-Learning Information System Core Business Systems
Assess the role and functions of healthcare informaticist when working
with E-Learning and Smart Applications in Healthcare
Discuss the Advantages/Disadvantages of E-Learning from healthcare
providers perspective
Cognizance of Transformation from E-Learning in Healthcare to Smart
Applications in Healthcare such as mH.
Determine the Criteria for Having Successful Smart Health Education and
Learning
Learn What is Required from Smart Application in Healthcare
Substantialize Smart Health Education and Learning Cases and Practical
Solutions(Learned Lessons)
Dr.Mazen Maswady 5 9/26/2018
Health Informatics and Smart
Applications in Healthcare
Main Concepts
Payers
Hospital
Health
Hospitals Information
Exchange
Primary care
Laboratory physician Labs
Pharmacy
Data Server
Network
repository applications
Specialty
physician Outpatient RX
Payers
Ambulatory
center (e.g.
imaging Physician office
centers)
Ambulatory centers Public health
This Photo by Unknown Author is licensed under CC BY
Health Informatics
The intersection of information
science, computer science, and
health care.
It deals with the resources, devices
and methods required to optimize the
acquisition, storage, retrieval and
use of information in health.
https://www.youtube.com/watch?v=0H0fHFtHB
mw
.be/1https://youtucD_g4M-r9c
Dr.Mazen
Maswady 15 9/26/2018
Mobile Learning
WHAT IS IT? Mobile learning is the ability to obtain or provide
educational content on personal pocket devices such as PDAs,
smartphones and mobile phones
M-learning or mobile learning is "learning across multiple
contexts, through social and content interactions, using
personal electronic devices". A form of distance education, m-
learners use mobile device educational technology at their
convenience.
Wikipedia
http://www.yourtrainingedge.com/megatrends-in-moocs-8-
mobile-learning/
What is Required from Smart
Application in Healthcare
Smart Application in Health should provide HCP and
Recipients i.e. Patients., families as far as feasible,
r the right information and
r the right knowledge
r at the right time
r in the right place
r to the right people
r in the right form
so that these people can make
r the right decisions
17
E-Learning
E-Learning
Concept of E-Learning/electronic/online
https://www.youtube.com/watch?v=
77cSY74jZQ0.
Concept of E-Learning/electronic/online
Triology of e-Learning
Just a few examples…
Continuing education requirements for
recertification
Hospital required annual competencies
Unit specific educational updates or
competencies
New or updated hospital-wide policies,
procedures or guidelines
New resources or equipment available to
improve patient care
Optional educational courses available for
professional development
Hardware Requirements
Physical or tangible parts
involved in the performance
or function of the computer
(Mastrian & McGonigle,
2009)
Desktop Computer
Laptop Computer
Personal/Hand held
computer
◼ PDA
◼ iPhone/Blackberry
Software Requirements
Microsoft Office (Word, Excel, PowerPoint)
Windows Media Player
Adobe Flash, Acrobat Reader
Microsoft Windows/MAC
Internet Browsers (Explorer, Firefox, etc…)
And more…
E-Learning Information System
Core Business Systems
Conclusions
Mobile technology is changing the way we heal. The benefits of
mobile devices in healthcare are discussed above to give you an
appreciation of the possibilities in this area. However, the risks
should not be ignored.
Using them without proper standards can lead to unsafe practices
and breach of patient privacy. Healthcare service providers should
thus implement a strategy that will help keep the quality of service
high while keeping the patients safe.
With a robust mobile strategy, healthcare providers can take
advantage of the accurate and real-time information help improve
end-to-end healthcare processes.
Fields of Smart Health Applications
Doctor Network and ( ( األطباء و المراجع الطبية11 (Clinical الرعاية الصحية األولية والمتابعة يف العيادات (1
شبكاتResources) Administration and Backend)
https://www.youtube.com/results?search_query=medi
cal+simulation+training
Simulation and Training
Smart Applications in Health Education
and Learning.
Cases and Demonstrations
Utilization of smart phones
related medical applications
among medical students at King
Abdelaziz University, Jeddah: A
cross-sectional study
considered these helpful in
clinical decision-making,
assisting in differential
diagnosis, allowing faster access
to Evidence-Based Medical
practice, saving time and others.
https://www.sciencedirect.com/science/article/pii/S18760
34116301265
Prescribing Medical
Applications to Patients
Disclaimer
No financial connection to any of the products
and services listed in this presentation.
44
Smartwatches
Advantages over wristbands:
◼ Answer phone
◼ Receive and send texts
◼ Emergency SOS button
◼ Get alerts from programs on
your phone like calendar
alerts, pill reminders
◼ Track odd exercises, get exercise
progress reports
◼ Basal energy expenditure more
accurate
Disadvantage: expensive
May be >60% of wearable market
by 2021
45
Fitness - Smart Scales
Several brands available: Withings/Nokia, Fitbit,
Garmin, Polar Balance, iHealth, Under Armour…
Some work with wearables to add weight to fitness
tracking, calculate BMI
Work with their own app
or others like MyFitnessPal
$25 - $400
Withings (Nokia) Body - Body Composition Wi-Fi
Scale,
Black, $125 at Amazon. Works with
MyFitnessPal
46
Wearables - Smart Tops, Socks and App
www.sensoriafitness.com 47
Continuous Glucose Monitors
(CGMs)
Dexcom (also Medtronic)
Talks to phone, Apple watch
Share with up to 5 others
Alerts high or low
Dexcom.com G5 CGM
48
Artificial Pancreas
CGM and Insulin pump communicate
Medtronic first to gain FDA approval
Several more in clinical trials
49
©ًHealthline 2012
Lab-in-a-Box Health Tracking
Cue systems
Samples blood, saliva, mucous
Monitor Vitamin D, inflammation,
influenza, testosterone, fertility
Sends results to app
https://cue.me/#inflammation
50
FDA Oversight
• Which apps need FDA approval?
• How are they approved?
• How do phony apps get around this?
• Do we need to teach patients to be smart
consumers of apps?
51
Mobile Medical App Oversight
Food and Drug Administration (FDA) must
approve mobile apps that are:
1. An extension of one or more medical
devices which controls the device or
monitors patient or analyzes medical device
data
2. Transform the mobile platform into a
regulated medical device by using
attachments
3. Performing patient-specific analysis and
providing patient-specific diagnosis, or
treatment recommendations.
http://www.fda.gov/downloads/MedicalDevices/.../UCM263366.pdf
52
Remote Monitoring Devices
Body guardian Heart (Zio, Medtronic, others)
Body Guardian
http://www.fda.gov/downloads/MedicalDevices/
.../UCM263366.pdf
54
Other Smartphone Attachments
Ultrasound (Philips)
Stethoscope (Eko)
Pulse Oximeter (I Health)
Otoscope (Welch Allyn)
Ophthalmoscope (WA)
Etc.
Some have AI assisted
diagnostics in app
57
FDA Oversight Discretion
They may decide to regulate apps that:
A. Facilitate behavioral E. Document, show, or
change or coach communicate to
patients providers potential
B.Organize and track medical conditions
patients health F. Interact with the PHR
information or EHR systems
C.Find information about G. Are medical device
patient’s condition data systems
(reference)
H. Will not certify fitness
D.Perform calculations devices and apps
(calculators)
58 Summer 2016
FDA Oversight Discretion
record
◼ Fitness tracker
◼ Symptom tracker
Microsoft HealthVault
59
FDA OVERSIGHT DISCRETION
60 Epocrates.com
Patient self-Education
61
FDA OVERSIGHT DISCRETION
5. Apps that allow patients to
communicate to
providers.
◼ Telemedicine platforms
eVisit.com
◼ Reimbursement Guide
Doxy.me
◼ TeleProviders
DoctorOnDemand.com
HealthTap.com
LiveHealth Online TouchCare.com
Duffy, J. 10 apps that are changing healthcare. PC Magazine. 2/11/15.
62
http://www.pcmag.com/article2/0,2817,2476623,00.asp
AMA Guidelines for Health App Usage
Main concerns;
◼ Support patient-physician relationship
◼ Integrate into clinical workflow
◼ Reimbursement models
◼ Ensure patient safety, quality care and
positive health outcomes
◼ Abide by state laws and licensure
American Medical Association. AMA Adopts Principles to Promote Safe, Effective mHealth
Applications. Press release. Nov 16, 2016.
https://www.ama-assn.org/ama-adopts-principles-promote-safe-effective-mhealth-
applications
63
Apps Make False Claims
Snake Oil Apps
Apps without attachments that claim to
measure BP, pulse ox, or temp.
Look for “for entertainment purposes only”ً
in description
Look for FDA approved on any devices or
app to manage a Dx. Example: Insulin
dose calculator
Watch for healthcare systems to certify
apps and create their own that integrate
with information systems
Misra, D. App claims to measure oxygen saturation with only a smartphone.
Medpages Today, June 2015.
http://www.medpagetoday.com/Blogs/IltifatHusain/51888
64
HIPAA Considerations
65
HIPAA Caution
No texting with patient using personal
account:
◼ If patient initiates, caution in responding.
No emailing patient using personal
account:
◼ Use patient portal instead.
Use HIPAA compliant services
HIPAA compliant texting services
◼ TigerText, qliqsoft, pMD, PingMD
66
How and why
Prescribe an App
67
Benefits of Prescribing apps
Improve physician/patient relationship
Promote self and shared health
management
Assist caregivers in following
instructions
Providing data to patient to self monitor
and physician monitoring uncontrolled
chronic condition
Scher, DL. The big problem with mobile health
apps. Medscape. 2015.
http://www.medscape.com/viewarticle/840335
68
More Benefits
Patients more likely to use app: monitor
symptoms, medication adherence, if they
collaborate with their physician, care
coordination team
Outcomes based reimbursement is an
incentive
Cost savings to patients
Oscar, R. Mobile apps improve medication
adherence, reduce costs. Modern Medicine
Network. 2016. http://managedhealthcareexecutive.modernmedicine.com/managed-
healthcare-executive/news/mobile-apps-improve-medication-adherence-reduce-costs
69
Barriers
Lack of evidence
Limited systematic integration
Patient access gaps
Data privacy and security
Reimbursement challenges
IMS Institute. Patient Adoption of mHealth: Use, Evidence and Remaining Barriers
to Mainstream Acceptance.
http://www.imshealth.com/files/web/IMSH%20Institute/Reports/Patient%20Adoption%20of%20
mHealth/IIHI_Patient_Adoption_of_mHealth.pdf
71
Proactive Institutions
Ochsner: Setting up their own App Store with apps they
recommend to their patients.
Kaiser Permanente: develop certification system for
medical apps.
U of Pittsburg Medical Center and Montefiore in NY
developing apps for affiliated doctors.
Mount Sinai: RxUniverse, system wide platform to
prescribe apps.
75
مقومات نجاح التثقيف والتعلم الصحي الذكي
Criteria for Having Successful Smart Health Education and
Learning
االتصالية •ًالتنقل الذكي• :Smart Mobility
• أنظمة النقل أكثر كفاء وذكاء
• شبكات باالستفاد للكفاء حركة المركبات وا شخاص والسل للحد من الجمود
• السلوكيات االجتماعية الجديد "مثل تقاسم موا ف السيار وتجمي السيارات والتواف بين السيارات
الدراجة
• ادار النقل بما يحق سهولة الوصول وخدمات لوجستية
• تعددية النماذ .
76
مقومات نجاح التثقيف والتعلم الصحي الذكي
Criteria for Having Successful Smart Health Education and
Learning