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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

Mobile Technology & Primary Care

Getting through the noise

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

MUSC



Care coordination our care venues
Care Coordination:Our Care Venues…










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 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