mHealth and Patient Care in Radiology

mHealth is a big buzzword right now but it needs to be clarified what mHealth actually means, Gorkem Sevinc of Johns Hopkins University said at SIIM 2015.

mHealth is more than just phones, Sevinc said. “It’s home monitors and other communication; the devices we send people home with.”

He acknowledges that mHealth is booming with the advent of more affordable smartphones.

“We are carrying around our computers in our pockets, so we are able to do quite a bit more,” he said. “And of course what’s helping with that is the lower costs of smartphones.”

Sevinc cited that 60% of physicians and 70% of nurses are using tablets and smartphones, and about half of those devices are used at the point of care. Couple that with the approximately 40,000 medical apps in app stores, and it’s easy to see that the mHealth for medical data is growing.

Sevinc discussed several initiatives using mHealth inside and outside of hospitals.

Inside the Hospital

Enterprise Viewers
“We have standards like DICOM web and HL75, and we can use modern web technologies that make it very easy to get images on iPads and iPhones,” Sevinc said. “You can go anywhere in the hospital and get to your images.”

Communication
At Hopkins, Sevinc said that they have started using mobile apps for communication. There are still physicians unwilling to let go of their pagers, but they created a web-based system that lets physicians communicate with each other securely, and page them.

Remote Consultations
“When PACS and RIS rolled out, radiologists lost touch with the clinical folk,” Sevinc said. “Clinicians are not coming down to radiology to discuss a case anymore.” At Hopkins, they are prototyping a communication add-on to the viewer. When a clinician views a patient’s report and images, they can decide they want a consult with the radiologist. They can call the radiologist from the viewer via a FaceTime-like tool and have a face-to-face with the radiologist. The viewer becomes a shared PACS session so that both the radiologist and the clinician can scroll through the images and point things out while the other watches.

Access
Vendor apps to access patient records can reduce the need for a physician to access a workstation to view a patient’s record. Apps also have situational awareness and geo-location programming so you can know where a patient or a device is in the hospital, Sevinc said.

Outside the Hospital

Remote Patient Management
Remote patient management has been happening for years, Sevinc said. There has been text-based data collection, web and mobile-based forms and surveys. But mobile health can also be helpful in collecting data for research studies from the population health perspective.

Medication Adherence
Medication adherence is an interesting problem, Sevinc said. He gave the example of a patient with TB that is required by law to have a social worker observe the patient taking a pill. A solution to this is a video-based drug observe therapy, Sevinc said. The social worker doesn’t have to travel to see the patient but can still observe the patient taking the drug through a HIPAA-compliant video capture.

The future of mHealth, Sevinc said, is about enabling patients with their data and helping them understand their data. He also said that it’s about enabling clinical personnel with data that’s available through mHealth, for example, surveys, medication adherence, and wearables.

Sevinc said he expects to see that clinical data from the EMR and patient-collected data form wearables will begin to combine, but it still needs to be figured out how that will happen.