Yes, Ok.
So I want to take a quick survey.
Who here has a cell phone in their pocket?
Alright, everybody is participating, everybody feels good.
Alright, who has a Smartphone in their pocket?
Alright good, who has or owns a tablet?
Alright, who has ordered a burrito, pizza or a cup of coffee from their Smartphone?
Excellent.
Who has done online banking from their Smartphone or their tablet?
Excellent, and who has accessed health information or communicated with your healthcare provider
using your mobile device?
Right, a significantly lower number.
But this gets to the important point about mobile health.
Patients want to be able to use their devices that they are carrying around with them in
their pocket to take care of patients.
And what you will see on the slide that comes up in a minute is that mobile health, you've
heard many mentions of mobile applications throughout several presentations is really
part of our connected health vision.
This is an opportunity for us to connect with patients exactly where they are because most
people carry their cell phone with them in their life spaces.
The average patients spends maybe 100 to 200 minutes with their healthcare provider face
to face and there are 525,600 minutes in the year if you ever watch the musical Rent, you
can always remember that information because they sing it over and over again.
So it's good to be able to share that fact, in talks.
Anyway So apparently I'm not plugged in.
Ok I'll try again there.
Let's start over.
Here we go.
Excellent.
So its up and now it's not.
Alright, I apologize for this, there we go.
Perfect.
So the cell phone is the largest technology platform in the history of mankind.
There are 6 billion cell phone subscriptions in the world, there are not many more people
than 6 billion in the world and if we look at Veterans who receive care in the VA compared
to Veterans who don't receive care through the VA healthcare, compared to the population
at large, essentially, many people have a cell phone, 91-92% have a cell phone.
The third set of data shows essentially access to a Smartphone. 40% of individuals in the
United States access the internet through the cellular network.
Interestingly at the moment, only 21% of Veterans access the internet through a cellular network.
But we know that number is increasing and will continue to increase over time.
So in the context of that, we know that our healthcare providers, team members, are using
mobile devices.
Within 6 to 8 months of the Ipad being on the market, in a survey of 3000 physicians,
30% already owned an Ipad and 28% said they intended to buy one in the next year.
One year later about a year and half after the Ipad came out, 60% of US physicians had
owned an Ipad and around 50% of those said they used it at the point of care and found
that it was a useful way to deliver healthcare.
Between 2010 and 2012, the number of cell phone users who use their device to access
health information double so that 31% of users were using health information and I did a
quick calculation when you raised your hands and it was exactly 32% of this audience.
So you guys are leading edge individuals.
So we in the VA have thought carefully about having an overall strategy within mobile health
and I think the value of it's great to be able to order a burrito or pizza or coffee
or even to do online banking.
Banking is an example is more similar to healthcare what's really useful about mobile applications
is when they can securely connect to our back in systems and help our patients take care
of what they need to do when they need to do it so they can close the gap between where
the expertise is in with the expertise needs to be and to do there needs to be a significant
architecture to assure that we can deliver data to mobile devices in a secure way, in
a way that we can become confident the personal information won't be compromised on these
devices but also in a way that allows our veterans and our healthcare team members to
optimize their ability to manage health We viewed our development of mobile health
applications in three areas.
The first is essentially that it technical stuff that needs to happen to make this secure.
All the working security devices when used in the VA and to deliver applications in a
meaningful way to patients and then the rest of our work has been in Veteran facing mobile
applications that's the second-tier at the top provider and staff facing mobile capabilities
and I'm going through just a brief tour of some of what we've been able to accomplish
you can look in more detail in the back at our table were you can see some of these applications
live and play around with them after the session today
So we started with a pilot the Washington DC VA medical center in 2011 and a pilot we
looked at a lot of security implications to be able to deliver data from Vista on a mobile
device for providers to be able to use here's an example of that.
This application I was one of the pilot participants has helped me many times when I was at the
playground with my kids and I got a call about a panic lab value laboratory in the past I
would've had no earthly idea of the context of that information especially wasn't patient
that I had seen over the past few weeks the ability to pull up my smartphone or my tablet
and look up the patients name telephone number and contact information what medications their
on and what their recent laboratory values were and who they had seen recently allows
me to make an informed decision and keeps my kids because they're still on the sliding
board while all of this is all happening.
We're in the process of developing a whole suite of mobile applications and which you
can see some of them appear many of them are self explanatory but imagine this scenario
when you walk into the Apple store somebody greets you with an iPad this is how can I
help you somehow things magically happen and then yours less money in your bank account,
typically.
Well we want too provide value to our Veterans.
Imagine walking into the atrium of a medical center and somebody greeted with you an ipad
and asked if you like a flu shot and worry they were able to take care of the entire
workflow of documenting your consent to the flu shot, sending you the patient information
handout about the flu vaccine so when you got home and had questions about the vaccine
you just received you have information available to you were able to administer the flu shot
and documented in the way that went back into your electronic health record stored one simple
workflow and that's the vision of how these mobile apps that are healthcare team facing
can really improve the efficiency of our care delivery.
Patient facing apps are in my mind going to transform the way our patients can engage
in the healthcare system and is a way to really engage with the technologies that you've seen
here well.
This is what Aden mentioned.
There's a lot of overlap between what we can do a mobile health with some of her other
connected health technologies.
Many of you may have heard about the VA family mobile caregiver pilot which is starting actually
this month.
We will be distributing over 1100 Ipads to the participants of the VA family caregiver
program and these iPads will come with a suite of applications you can see all this application
again at the table that will help caregivers of our most seriously injured and ill veterans
to help manage the care at home, to manage the stress of being caregiver to communicate
with healthcare team, to record different values they are tracking, like blood pressures,
meals activity etc.
And we are going to be releasing those applications on the iPad that we will be providing for
a year to these 1100 participants.
We will be studying their effect to see, do these applications reduce caregiver stress,
do they improve the quality of care do they improve satisfaction and engagement with care
which is what we really care about.
We also several other patient facing applications and development.
One I want to highlight is a pilot that will soon be starting at severalty medical centers
to allow patients to request their appointments and schedule appointments through and through
a mobile application.
Again increasing their connection with their healthcare system, increasing their ability
to receive care when and where they want it.
Again, I put this up to show just that we've spent a lot of time thinking about the technology
behind us and the security all these applications are hosted in the VA's cloud, I think it's
helpful for some to realize the cloud is not a cloud but rather for a bunch of buildings
somewhere the middle of Virginia's surrounded by grassy fields but anyway and we also developing
opportunities to partner with innovators in the field here in the VA and also with with
private sector partners to develop applications within a standardized mobile application environments.
So we are not reinventing the wheel where we're developing applications in a unified
way as a team across the VA.
All the VA mobile applications will be certified.
We've worked on developing branding for them so that the recognizable.
They'll be accessible through the usual app stores as a single application that we call
the launch pad.
I'll show you that in a minute.
It will allow Veterans to quickly find the app that we told them that would be good for
them.
We are to make sure that it'll meet a standard such that the Veterans can trust these apps
that are evidence-based information and that we've tested them to make sure that they're
usable etc.
So I'm going to spend a minute giving you a demonstration a few of these applications
these applications are part of the VA family mobile caregiver pilot.
In the upper left hand corner you see the launch pad app.
The launch pad app is the app that Veterans would go to download from the app store.
And its serves as essentially a bucket where we can provide them access to all of the VA
mobile apps.
This allows VA providers to give a single message go download the launch pad app and
from there you can get all of the VA resources.
We can deliver both applications and web links that we think would be useful for Veterans
to manage their care.
I can give you an example here of the summary of Care app.
You'll see the when I click on the launch pad, it switches over the summary of care.
It allows a Veteran to look at their demographic information that we have, the medical diagnoses,
allergies, medications.
It allows them to look at the vital signs over time with those numbers look like.
Prescription data, their laboratory data, their images and their progress note.
So essentially their data from electronic health record on the mobile device.
Let's just say that they realize that this medication needs to be renewed, they need
some more aspirin.
They can click on the launch pad app, go right back the launch pad app, choose prescription
refill there's list of the medications single click in that medications and it's on their
way to them in the mail from our consolidated mail outpatient pharmacy.
If they're tracking their blood pressures overtime, they can come in into the journal
app and keep track of their blood pressures.
We'll be working on writing interfaces so that devices that collect this data automatically
enter that or that can enter that manually.
So again a whole suite of applications to empower patients to take care of their health.
In summary you seen a lot of great technology today and I think one of the real themes you've
heard this is this technology can help enhance the relationship with our patients, which
is really what healthcare is all about.
William Olsner who is really considered one of the greatest physicians in US history and
decided to go to Britain became Sir William Olsner.
He once said "it's a good physician that takes care of the disease, is the great physician
who takes care of the patients who has the disease".
I would argue that in this modern-day and age it's actually the good healthcare system
that takes care of the disease but it's the great healthcare system that takes care of
the person who has the disease and these technologies allow us to take care of the people who have
entrusted themselves with our care.
Thanks