Mobile technology primary care
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Mobile Technology & Primary Care. Getting through the noise William P. Moran, MD, MS & Patrick D. Mauldin, Ph.D. MUSC. Evolution of primary care. Care Coordination: Our Care Venues…. Evolution of primary care. Evolution of primary care. Wagner Chronic Care Model.

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Mobile Technology & Primary Care

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Mobile technology primary care

Mobile Technology & Primary Care

Getting through the noise

William P. Moran, MD, MS & Patrick D. Mauldin, Ph.D.

MUSC


Evolution of primary care

Evolution of primary care


Care coordination our care venues

Care Coordination:Our Care Venues…


Evolution of primary care1

Evolution of primary care


Evolution of primary care2

Evolution of primary care


Mobile technology primary care

Wagner Chronic Care Model


Workflow in the real world

Workflow in the real world…

PATIENT


Workflow in the real world1

Workflow in the real world…

PATIENT


Workflow in the real world2

Workflow in the real world…

PATIENT


Mobile technology primary care

PATIENT


Have we made his life better

Have we made his life better?


What to do a loud signal must be heard amidst the clinical noise

What to do? A loud ‘signal’ MUST be heard amidst the clinical ‘noise.’  

  • Technology must be targeted to the most appropriate patients: Risk stratification

  • Decision support must be integrated into the data flow process

  • Information must be reliably delivered to the correct team member (frequently not the primary care provider)

  • Clinically actionable signals should be sent to the primary care team member

  • Real time


Risk stratification

Risk Stratification


Risk stratification1

Risk Stratification

Cluster A

Cluster B

Cluster E

Cluster C

Cluster D


Risk stratification2

Risk Stratification

Renal Disease,

Depression, & CV risk

Diabetes & CV risk

Healthy

Obesity & CV risk

Complex, CV disease

& Depressed


Static and dynamic components

Static and Dynamic Components

No static and no utilization* within 365 days

Static variables only (no utilization) or no Static w/Util

within 365 days

Static and utilization history (days 31-365) or top 20% with no utilization within 365 days

Static and util.(Top 20% risk with until <365 days)

Immediate utilization within 30 days (regardless of static results)

Immediate Intervention

The risk strat model is to reduce the number of & .


Mobile technology primary care

Hypertension

Healthy

Obesity & CV risk

Hyperlipidemia & Hypertension


Mobile technology primary care

Chronic lung disease, Depression & CV risk

Diabetes & CV risk

Complex, CV disease & Depressed

Renal Disease, Depression, & CV risk


Cueing the team

Cueing the team

Delete

Patient Data

1

2

Delete

Patient Data

Patient Data

3

Delete

4

Delete

Patient Data


Cueing the team1

Cueing the team


Mobile technology primary care

Real Time

Courtesy of Dr. Frank Treiber


Summary

Summary

  • Primary care environment offers opportunities for technology to improve the quality of patient care

    • monitoring clinical conditions

    • coordination and transitions of care

    • medication management

  • But we have to be careful implementing technology in an occasionally chaotic environment – Primary care


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