Patient Engagement

Microsoft and Vision Australia unveiled a new 3D audio app designed to give blind and vision impaired people greater independence to explore the world around them. Dubbed Soundscape, the software enables users to set audio beacons at destinations and landmarks, and through a stereo headset the 3D audio is perceived as coming from the point of interest as they walk, allowing them to build a mental image of what’s around from the acoustic environment. The app also calls out roads, intersections and landmarks, and was designed to be used in addition to mobility aids such as guide dogs and canes. For David Woodbridge, Access Technology Advisor at Vision Australia, the app helps him to create a mental map of his surroundings. “Soundscape gives me confidence in an outside environment by helping me understand what’s around me – whether it’s a restaurant, café, railway station, walking [or] bike track, park, business or even a street name. It allows me to build a mental map of my neighbourhood,” Woodbridge said. The app provides more sensory information than traditional navigation maps that give directions. “Rather than dictate what I should do, it allows me to make my own decisions based on the information it is providing, meaning I am always in control. For me, it really is about feeling stress free when I’m out and about,” Woodbridge added. “I have my own personal markers set for different locations. My local coffee shop is always a priority and the ‘coffee shop’ marker on Soundscape gets a lot of use.” Microsoft’s Artificial Intelligence and Research team has been collaborating with Vision Australia for the last six months to test and integrate use of the app into the not-for-profit’s services for people with blindness and low vision. More than one billion people live with disabilities worldwide but only one in 10 have access to assistive technologies and products. In Australia, 384,000 are blind or have low vision, with the number predicted to grow to 564,000 by 2030. This article originally appeared on Healthcare IT News Australia.

Glen Tullman has served as the CEO of a major EHR vendor and the founder of a startup app maker focused initially on diabetes. That background gives him a unique insight into the possibilities and constraints of each. For our Focus on Innovation, I spoke with Tullman about the foundation EHRs have created for the future of digital health, what to expect next from Livongo, and where he expects next-gen innovations to come from. Q: You formerly ran Allscripts and now lead Livongo. Given that perspective, what’s your take on the innovation happening in so many corners of healthcare right now? A: EHRs are fundamentally data repositories, so what do you need to do? You need to make them much easier for physicians to use on the front-end. On the back-end a lot of companies like IBM Watson and smaller startups are saying ‘we’ll take the data from the EHR and analyze it to give you real feedback on how to provide better care.’ But EHR vendors aren’t doing any of that innovation. Q: We are seeing EHR vendors take steps to open their platforms to third-party developers and enable them to drive some of that innovation but is that the answer? A: EHRs were an important step to get things digitized but they have not realized the promise of making it easier for physicians to deliver care and they haven’t been connected to each other. Why not? Technology-wise, they could be connected. Q: Well, there’s a lot of innovation happening in healthcare and much of has little to with EHRs. Where is it all going? A: The future of healthcare is not about big software systems in hospitals. That’s important but healthcare today is about how we empower people with chronic conditions, how we empower those people with software and technology to make it easier to be happier and healthier. Everything people can rip out of a hospital they’re ripping out of a hospital. Surgery centers, urgent care. Q: In which case, what’s next for Livongo? A: We’re going to release a cellular-enabled blood pressure monitor so we have hypertension data and give people real-time feedback outside the doctor’s office because 24 percent of people on meds actually have white coat hypertension instead of high blood pressure. Imagine if we could get them to check their blood pressure at home versus in the doctor’s office? It’s available now but the official release will happen at Health 2.0.   Q: And what about the broader industry, not just Livongo? A: We’re going to see a lot of innovation.  The world we’re talking about, tons of activity in digital health, making people smarter, helping them navigate the complex world of healthcare, making payments easier — that’s where the innovation is going to come from. .jumbotron{ background-image: url("http://mobihealthnews.com/sites/default/files/u751/Innovation-month-jumbotron-1.jpg"); background-size: cover; color: white; } .jumbotron h2{ color: white; } Focus on Innovation In September, we take a deep dive into the cutting-edge development and disruption of healthcare innovation. Twitter: SullyHIT Email the writer: tom.sullivan@himssmedia.com

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The Einstein Medical Center wanted to decrease readmissions for liver failure patients by 50 percent. Caregivers had a longtime interest in the potential for remote patient monitoring and turned to telehealth technology to address this mandate. Thus far, since implementing the RPM processes, the hospital has gone more than two months without any readmissions. "The problems we encountered included issues that come up with all patients with a severe chronic illness," said Richard Kalman, MD, assistant professor of medicine SKMC in the department of digestive disease and transplantation in the division of hepatology at the Albert Einstein Healthcare Network in Philadelphia. Despite requiring all patients to attend follow-up appointments within two weeks, the readmission rate still was 40 percent. Patients often would come to the clinic and be readmitted directly because they were too sick, or would be called to come to the hospital for severe laboratory abnormalities, or would present to the emergency room feeling sick due to non-compliance. And some readmissions were unavoidable, of course. The hope with the initiation of the telehealth remote patient monitoring program was to find problems when they were still small and could be managed as an outpatient, thus avoiding a readmission. Einstein Medical Center uses remote patient monitoring technology from Vivify Health. Other vendors of remote patient monitoring technology include Biotronik, Boston Scientific, GE Healthcare, LifeData, Medtronic, Philips Healthcare and Spacelabs Healthcare. "The technology allows our patients to have a remote visit within 48 hours of discharge with one of their liver providers, and also allows the patient to relay information including symptom assessment and vital signs to the liver clinic as well as to our partnered visiting nurse program," Kalman explained. "The device is set up with the help of the visiting nurse, and the patient then uses the device to log symptoms and vitals." The program, which lasts for 30 days, is not currently integrated directly with the organization's EHR, but the online portal is user-friendly and allows for good communication, he said. Telemedicine technology allows the liver team to find small problems before they become major issues that might require hospital admission. The team is constantly adjusting blood pressure pills, diuretics and medications to control high ammonia levels that can lead to hepatic encephalopathy. "One example that comes to mind is of a rather cantankerous older gentleman who is on the list for liver transplant," Kalman recalled. "He would always claim that his blood pressure was elevated in the office because he disliked doctors so he never allowed me to prescribe a blood pressure pill. This technology allowed him to take his blood pressure at home, and I was able to demonstrate that his blood pressure was more than just white coat hypertension." His blood pressure is now under much better control, and although he has not yet reached the top of the transplant list, when he does, he will have a decreased risk of stroke and cardiac pathology because his blood pressure is under good control pre-operatively, Kalman added. The remote patient monitoring technology is not just having an impact on patients and readmissions, it is having an impact on value-based care. "The impact of this technology on value-based care is simple," Kalman said. "It allows the patient to provide more data to providers, thus allowing for more efficient and timely care that also allows for less frequent office visits and improved communication." Twitter: @SiwickiHealthIT Email the writer: bill.siwicki@himssmedia.com

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