The Intelligent Health Association



Audio Narratives and Scripting for HIMSS 2015 i-Home/Intelligent Medical Home V5- 3.31.15Welcome to the home of the AllensElizabeth, the elderly mother, also known as Beth, lives here with her son Robert Allen who was just discharged from the hospital yesterday after open heart surgery.Likewise, Beth has been home only 6 weeks after a fall resulting in a fractured hip that required a total hip replacement. Beth also has early dementia. Both Beth and Robert have multiple chronic conditions, so they are under the care of Sally in their own home. Living RoomWhen you enter the Allen residence, you are greeted at the front door by Sally, the Caregiver. Beth, the elderly mother and Robert the son are also present. (seated in the room) SKYLIGHT- Use Case #1(Sally and Robert sit down at the home computer and begin to review health education and instructions) This first solution you will observe adds to the growing movement to engage patients and provide better care and communication outside the four walls of the hospital. [Skylight_Living Room1_hospital] Patients like Robert and their families can access procedure-specific education, pre-procedure instructions, complete pre-admission forms, [Skylight_Living Room1_Forms], and prepare for their hospital stay from the comfort of their own home. (Robert reviews his exercise video, and also scans his to-do list) The personalized system provided Robert with a pre-admission To Do schedule [Skylight_Living Room1_ToDo] preparing him for his recent hospital stay. SKYLIGHT- Use Case #2This interactive home solution is also designed to capture patient reported outcomes (Sally watches as Robert completes standard Pain assessment form and also view the aggregated results from his surgeon) across the continuum of care with standard or custom survey instruments. [Skylight_Living Room2_Survey] With a focus on reporting of quality outcomes, patients like Robert are engaged and encouraged to participate with his providers. This provides better feedback to patients, communication, and reporting outside the hospital. In addition to completing these forms, Robert can interact with the post-discharge to do list which includes exercise and therapy, medication, appointments, [Skylight_Living Room2_Appointments] and and other key events and education leading to a more complete healing process. (Robert and Sally conclude their form and view the patient education material).VOCERA- Use Case #1Robert and Sally are preparing to start the at-home treatment plan as detailed by the nurse in the hospital, but need to review the information (Sally picks up Vocera tablet for Robert).? Sally logs into the online link for the hospital audio recording of their discharge instructions from a notification they received via email or SMS on a computer or tablet and enters the secure password provided by the hospital. (Sally appears to enter the password on the tablet)?They are now able to replay the audio of the discharge instructions, and review the detailed plan of medications, diet, and follow up appointments they need to follow. (Sally and Robert listen to the instructions)?Robert may also dial a toll-free number to listen to their audio instructions if they don’t have access to the internet.AMC- Use Case #1By incorporating device-reported biometric monitoring of blood glucose and blood pressure with IVR telephony to collect patient self-reported symptoms, remote clinicians now have a powerful tool to manage Robert’s diabetes. The devices demonstrated here are the blood pressure?monitor (Robert pulls the cuff up your arm and show the BP display), and glucometer. (Robert picks up glucometer with adapter attached). These use Bluetooth technology?to collect biometric data, which is transmitted to a secure telehealth platform via a mobile gateway (Robert lift and show the tablet), where it is stratified against patient goals and set priorities. The patient also receives an IVR call triggered by biometric readings, and a televideo counseling session occurs between the patient and the remote care manager (Robert is speaking on tablet and show screenshot/video of clinician speaking on tablet). Trends and symptoms are detected early enough to intervene as needed, preventing more costly acute episodes such as trips to the Emergency Department or hospital?readmissions.? ASCOM- Use Case #1Both Beth and Robert can obtain immediate assistance if needed. Wall mounted call buttons or a wireless wristband or pendant is used to summon help (Beth presses red button on station). The request may be dispatched in various manners including visual indicators (Robert points to flashing dome light), to a central operator, or to a mobile caregivers wireless device (Robert hold up Ascom Wireless phone) This Emergency Call system has an audio option (Beth points to wall mount call buttons and speaker/mic) allowing the dispatcher to immediately speak to the resident stating support is on the way and prepares responders of the situation. This system offers both wired and wireless architecture. It leverages IP-based communications and precision event location technology. The system enables residents to enjoy an active life style with the confidence that assistance is available when and where they are needed. (Beth cancels the call)VA- Use Case #1It is time for Beth [ SS#1 – Web Page Menu ] to take her medications so she receives a reminder via a verbal prompt [ SS#2 – Watch \ ScreenClientWeb\ Speakers] from speakers in the house as well as an audio and visual cue on her watch. (Beth looks at her watch) Because of Beth’s cognitive condition and recent repaired hip fracture, her risk of further falls is calculated in a risk prediction algorithm. (Beth begins walking toward Kitchen with her cane in an erratic manner) Beth’s?position [SS#3 – Movement & Path]?is always being monitored?and recorded by the transponder in her watch. As Beth heads toward her medication Box, her gait position, velocity and total movements are recorded. This data can be used directly by a remote caregiver or analyzed by a Smart Home system to look for unfamiliar trends. The data can be used in more complex algorithms to analyze her gait patterns. [SS#4 – FractalD]? One algorithm currently used is fractal-D which determines how curvy the person is walkingKitchen(Beth walks into Kitchen toward Med Box and water bottle)VA- Use Case #2The same tracking system records when Beth is within a couple of feet of the area where she takes her medication. [SS#5 – Medication Evidence]? There is a tilt sensor in the medication box (Beth picks up med box), which allows the system to record when Beth picks up her medication box. (Beth takes a pill and holds up water bottle to mouth) Another sensor in the water bottle stand allows us to detect and record when Beth takes her pills since it is likely that Beth will need water to take her medication. The final evidence that Beth is taking her medication is a Kinect that monitors when her hand is near her mouth.(Beth points to the Kinect system) The system can use this evidence to conclude that Beth has indeed taken her medication. If additional evidence is needed, a web cam (Beth points to mounted web cam) may be pointed to the medication area and a snapshot or recording triggered when Beth is in the area or the Medication Box is tiltedIN TOUCH- Use Case #1(Robert walks toward InTouch Viewpoint device mounted on Kitchen counter)Robert’s physician decided that due to Robert’s description of recent symptoms post-hospitalization and his prior history of hypertension and cardiac surgery, he wanted to see Robert virtually [SS#1 – InTouch Health Overview] to accurately assess the situation. The doctor was able to “beam-in” to Roger’s home through a portable technology. (Robert picks up the InTouch Viewpoint and positions in front of the patient in view of the audience The doctor is able to see, speak and interact with Robert and can be moved throughout the home and positioned in place. Also, the doctor can pan, tilt and zoom in order to perform a more thorough diagnosis. (Robert shows the USB cable connected to the device and then lifts up the stethoscope) More importantly, since the device allows active patient monitoring, the doctor can connect peripheral devices that feed data back to the doctor from Robert’s home. In this case, the physician utilized Robert’s medical history, the verbal description of his symptoms and visual observations to quickly identify Robert’s situation. This could be an emergency and the physician could direct an ambulance Robert’s home if needed. (Robert points to the images of heart waves being shown on the screen)LOGICNETS – Use Case 1(Robert now sits at Dining table. Sally grabs LogicNets tablet and begins filling information out while asking questions to Robert.) Sally knows that Robert has just returned from the Hospital and needs special attention paid to managing his diabetes. Sally can access the free site for diabetic management from the medical center. There she can follow its guided questionnaire about Robert’s medications and history to generate instructions based on his specific needs. The system intelligently responds to her input, drawing from the hundreds of possible factors and sequence of steps required in Robert’s case. (Sally shows Robert the tablet with the results and gesture to him if he would like a copy email or printed.) Once done, Sally reviews the Patient Instructions report and emails it to herself. She also prints a copy to review with Robert. (Sally walks to the printer and retrieves document) Sally is unaware that the application she just used isn’t a vendor module or the work of a special programming team. Instead, the specialists at the Medical Center have used a Decision Support Platform to quickly and visually model their protocol for Robert. ACUPERA- Use Case #1WAITING ON SCREEN SHOTSAfter returning home from his cardiac surgery, Robert reviews with Sally another care plan created by a care coordination platform based on Robert’s clinical and behavioral care gaps (Sally picks up Acupera tablet and points to the care plan). They will receive a call from the nurse navigator within 48 hours of discharge to review his care plan, discharge medications, and any other issues that might require attention. ?The medication reconciliation is performed using the care pathways embedded in the care coordination platform. Robert’s pre-admissions home medications from the outpatient EHR (Sally points to the outpatient medication list)and inpatient discharge medications list (Sally points to the inpatient discharge medications screen) are compared. As you can see the system has highlighted a discrepancy and the most likely reasons for the discrepancies, and allows the nurse navigator to confirm or change the reason, and guides the nurse navigator to the best course of action based on the selected reason (Sally points to the screen showing the reconciled medication list). The care coordination platform has an integrated record of Robert’s health data, including data feeds from home monitoring systems and interprets the data in context of Robert’s overall care goals. It alerts the nurse navigator with any negative information or trends and also recommends the appropriate course of action. The nurse navigator schedules an appointment for Robert with their primary care physician to ensure optimal care and a full recovery from Robert’s surgery. The care coordination platform creates a Visit Agenda based on the key clinical and behavioral issues identified using its intelligent clinical and behavioral care engine. (Robert points to the planned visit agenda screen)Acute Bedroom- (Robert leads Beth, Sally and group to Acute Bedroom)As you enter the first Bedroom, you will notice the hospital bed (STRYKER) that allows for additional monitoring and safety features since Robert was recently discharged after his heart surgery SKYLIGHT- Use Case #3(Robert picks up the Skylight tablet and is viewing his login instructions)? This interactive patient solution enables providers to continue caring for their patients after they leave the hospital. After arriving home and using a platform that leverage both high tech and low tech solutions,?by logging in [Skylight SS1_AcuteBedroom3_logging in] Robert continues to access his essential conditions, medication and recovery information, update his status, and manage his appointments using an online calendar. (Robert is interacting with a series of questions on the tablet about his condition.? After answering the questions, Robert sees the calendar pop up.?[Skylight SS2_AcuteBedroom3_calendar]Providing access to the same educational information?[Skylight_AcuteBedroom3_information] that Robert received in the hospital after his discharge allows Robert to more readily absorb and understand his continued care requirements.? Based on clinical data and feedback, a series of alerts via text, phone, and even the home TV prompt patients like Robert to take actions to prevent readmissions.? (Robert indicates to Sally they need to call his physician.)JOHNS HOPKINS- Use Case #1 Resp (EQ)(Robert sits on the side of the bed, places CPAP mask on nose and lays down pretending to sleep) If untreated [SS#1] Robert’s obstructive sleep apnea can lead to dangerous nighttime [SS#2] oxygen desaturations, elevated sympathetic activity, metabolic disturbances, and even an increased risk of cardiac events. (Robert rolls over dislodging the nasal mask while remaining asleep) {Continuous positive airway pressure, or CPAP, is the gold-standard treatment for obstructive sleep apnea [SS#3], although adherence to this therapy is often poor. Doctors, healthcare providers and equipment suppliers need to track adherence in order to motivate and educate patients while reducing the costs associated with ineffective treatment. (Robert sits up, removes mask, placing it on bedside table, stretches arms and yawns as if had a bad nights sleep –then reaches to pick up smartphone) [SS#4]Currently used systems are restricted to proprietary devices and software platforms rather than universally applicable to any device. This CPAP Adherence Monitor [SS#5] delivers accurate, high quality data and fits universally to all CPAP devices. (Robert nods and acknowledges the information displayed on the smartphone) This monitor provides [SS#6] seamless integration into the Robert’s care plan and includes patient motivation and engagement programs [SS#7]. Robert is pleased to be able to immediately [SS#8] share his data and receive helpful feedback and timely advice.ASCOM- Use Case #2The emergency call system in this bedroom enables residents to move about their home, (Robert points to pendant around neck) utilizing a wireless pendant or Wall mounted room station (Robert points to sconce on wall) enabling them the ability to call for help. If living in a senior apartment facility, a sconce will illuminate when resident places a call for help giving visual indication. (Robert turns off light)HID GLOBAL- Use Case #1Clinicians are providing an ever-increasing amount of care to patients in their homes. With this shift, additional challenges arise. (Sally approaches light switch with her phone). Home healthcare agencies, insurance companies and family members need confidence that care is actually taking place and for the prescribed amount of time. Sally uses a secure Electronic Visit Verification and digital documentation solution that requires minimal (Slide 1: Elements in home & caregiver tools) infrastructure and easy to use caregiver tools to perform her assignments, Sally simply taps [Slide 2: Image of ID Card & Mobile phone] her NFC enabled badge (Sally taps her badge to her mobile phone) to her smartphone to sign into the documentation and document [slide 3: Document a visit image Landing Page] her visit using the web application. She documents her visit to Robert’s home by choosing NFC [Slide 4: Select NFC Image]. Now Sally will tap [Slide 5: Tap the NFC image, UI] her NFC enabled phone to a secure trusted tag inside the patient’s room (Sally holds smartphone close to tag on light switch on wall). She now selects the client receiving [Slide 6: Show image choose patient and confirmation image] the care and the activity being performed (Sally uses phone) and she confirms the care was given. This allows in real-time a detailed secure audit trail of the care being provided [Slide 7: Detailed history of visit]CAREVIA- Use Case #1Robert also has a history of CHF, (Robert picks up tablet and steps on scale and checks pulse ox) his care plan post release is remote monitoring of weight, blood pressure and pulse ox.?[SS #1 shows Robert's vitals]? Robert’s weight has increased 2 pounds. The alert is sent to Sally, his Caregiver, his adult son who lives out of state, and to his primary care physician.? Robert's son is concerned when the alert reaches his mobile device and he checks in through video conference (Robert? holds tablet up for video call) with Robert and Primary Care Physician. [SS#2 shows 3-way video chat with Robert's son and Doctor].? The Doctor tells Robert and his son that he has already spoken with Sally, the Caregiver, and she will be picking up a revised prescription . Robert and the entire family [SS#3 - Robert and son single video chat] feel less stressed because he’s connected virtually in real time with his care team, physician, pharmacist, and especially each other. CAREMATIX – Use Case #1 WAITING ON SCREEN SHOTSIn the hospital, Robert was suspected of having early diagnosis of ALS. His physicians want to track his symptoms closely. (Robert picks up tablet). A tablet with a validated app [CarematixSS #1 the ALS app]. is provided to Robert to use and report symptoms every week. The App is very complex and has various modules like Arms and Legs, Speech, Breathing, Well-Being and Nutrition customized to the patient. [CarematixSS#2 –Arms and Legs screen]Robert then starts the App to report his symptoms. PAUSEBathroom(Beth now leads group to the bathroom)We now enter the bathroom which presents a particular challenge since bathrooms are the most common location for fallsASCOM- Use Case #3If Beth should slip while showering, (Beth walks to back of bathroom) she needs to call for help. A pull cord designed for use by persons with arthritic or limited dexterity is located between the shower and toilet locations. These devices can supplement residents with pendants often not worn in bathing situations. (Beth pulls cord) As in the other rooms, this request may be dispatched in various manners including visual indicators (Beth points to flashing dome light), to a central operator, or to a mobile caregivers wireless device (Beth hold up Ascom Wireless phone) This Emergency Call System is a senior living solution designed to streamline communication, improve quality of service, enhance resident satisfaction and boast caregiver productivity. AMC- Use Case #3Lack of visibility into the home of a patient recently discharged from the hospital for heart failure can lead to re-hospitalization. By utilizing IVR telephony together with biometric monitoring and health coaching, patients are better able to manage their health condition at home. The devices demonstrated here are the weight scale (Robert steps on the digital weight scale) and digital stethoscope (Robert holds up the stethoscope and put it on his chest). Patient responses to IVR questions, together with biometric readings are uploaded to a secure platform. A televideo counseling session follows [SS of video/clinician speaking on tablet] where the patient uses the digital stethoscope (Robert places digital stethoscope on his chest) to help the remote care manager detect any difficulty in breathing. Trends and symptoms are detected early enough to intervene as needed, preventing costly acute episodes such as trips to the Emergency Department or hospital readmissions. These remote care technologies also bridge the gap between physician office visits and offers a complete view of the patient’s health condition.CAREMATIX- Use Case #2WAITING ON SCREEN SHOTSAs Robert is getting frail, his physician is concerned about his propensity for falls. Robert likes his independence and does not want to use a walker yet. To convince Robert, his physician has asked him to track his balance scores for a few weeks. (Robert steps on the scale.) Robert takes readings on the WiFi scale that also reports his balance scores. The balance scores are trending downwards and physician is able to convince Robert to start using a walker. [Carematix SS#3]- Robert shows the trend on the web portal screen shot.) This simple solution helps reduce falls and thus cost of care. Now we move to the next Bedroom where Sally the Caregiver is staying. (Robert sits in the chair and Sally kneels beside him)Caregiver BedroomHodei-Use Case #1WAITING ON SCREEN SHOTSWound care has become one of the fastest growing needs for home care services. A smooth transition from in-patient care to care at home without a gap in the continuity of that care is important to successful home transitions. (Robert pulls up pants leg) to sow his wound to Sally)?Sally begins to examine Robert’s leg (Sally dons latex gloves and removes dressing on Robert’s leg).where veins were harvested for his Cardiac Surgery and determines that the Robert has an elevated temperature and his wound site has become reddened and tender? Sally explains to Robert that she would like to consult with his physician (Sally opens the mobile case, turns on the tablet and uses it’s to send an alert to the physician). Using a wearable device that continuity of care can be enhanced. The nurse or therapist in need of real-time consultation or oversight (Sally removes, turns on and dons the Google Glass and earpiece and then activates the HCview streaming app on the tablet). deploys this dual communication solution with its optical wearable device that streams point-of-view images to the attending physician located within the hospital or private practice. The physician on call gets notified through the product’s app and accepts the consult request [Screen shot of physician talking w Sally] The physician’s acceptance is registered on the onsite caregiver’s tablet. (Sally looks at the tablet and then looks at the leg wound) The solution enables the physician to see exactly what Sally is seeing as he guides and oversees the onsite caregiver through the evaluation and rendering of medical care. Through this unique two-way audiovisual feed, the physician can talk directly to the caregiver and even capture what is being viewed, telestrate images to make a point, and send images or information back to the onsite caregiver’s tablet.(Sally looks at tablet then applies new leg dressing)?This methodology eliminates any confusion or ambiguity in the communication process. Both physician and onsite caregiver can visualize the same, offering a unique and effective way of providing remote oversight.COVIDIENT/Zephyr- Use Case #1Robert and Sally, his caregiver, had previous discussions with the Discharge Case Manager during Robert’s recent hospitalization. Prior to discharge, Robert’s physicians ordered a home remote patient monitoring system [Slide#1-image of system) to manage his on-going rehabilitation and monitor for any signs or symptoms of post discharge complications. The system includes a BioPatch to be worn on Robert’s chest (Robert points to patch on chest) [Slide#2-image of patch]. The patch?will send Vital signs to a digital hub and those vital signs will then be transferred to a surveillance center for evaluation [Slide#3-image of clinician at surveliance center]. The system provides Heart Rate, Respiratory Rate, ECG on alert or request, position, activity and calories burned as well as episodic readings from integrated Blue Tooth technology– Blood Pressure, SpO2, Temperature, Blood Glucose and Weight [Slide#4-image zoomed into the parameters on screen of system]. The Physician asks Robert to wear the device during the day for the first 30 days of his recovery. [Slide #5-Show the HeathHub and the BioPatch with location] Robert’s Physical Therapist will be visiting 3 times/week. In addition, his Home Health nurse will monitor his vital signs, including biox, BP and weight, and his activity daily in order to assess his wellness. (Sally looks at the Covidian tablet)CAREMATIX- Use Case #3WAITING ON SCREEN SHOTSRobert’s physician is concerned about his Heart Failure and Diabetes and has asked him to report his vitals every day. The patient has been provided a WiFi Scale, Blood pressure monitor and glucometer. Robert takes a reading everyday which is uploaded to the web portal via a cellular gateway. (Sally assists Robert with the BP Cuff) Unlike Bluetooth devices, there is no tablet or phone to turn on. All Robert has to do is take a reading. (Robert puts on BP cuff). Robert can also use any glucometer that he is familiar with. He is not required to switch to a custom glucometer. A doctor or nurse can view the readings in real time and when readings are out of range they are alerted based on pre-set rules. [Carematix SS #4] - Robert points to the web based portal screen shot to show the readings and alerts)CAREVIA- Use Case#2Sally, Robert's caregiver, receives and alert on her laptop that Robert's weight has increased by 2 lbs since this morning. [SS#1 showing page with Robert’s weights and Alert notification]. Sally verifies that the weight gain is accurate, (Sally does verification on the Laptop computer) and per care plan protocol reports the information to Robert's primary care physician via video chat ?[SS#2 showing Sally video-chatting with Doctor].? Sally confirms that per plan protocol, an automatic dosage adjustment of his prescription has been sent to the pharmacy.? If Robert gains more weight a provider visit will be scheduled the same day.?? Sally video-conferences [SS #3 showing video chat with Pharmacist]?with Robert’s Pharmacist to confirm receipt of new prescription and to review his medication regimen.PAUSE VIVIFY- Use Case #1WAITING ON SCREEN SHOTS(Sally steps away from Robert now and looks at her own smartphone) Sally is pregnant and even while at work (Sally clicks her email to open the smarphone app) she can use a prescribed app from her doctor to improve communications and provide essential data with her care team during her pregnancy. To avoid complications from Preeclampsia, her blood pressure needs monitoring (Sally takes her blood pressure) and she has a care plan with specific questions customized just for her pregnancy. (Sally answers Careplan questions) After answering these questions Sally (Sally enters BP Manually into phone) manually enters her Blood Pressure readings into the app. This reading is high and automatically generates an email alert to her assigned care team who quickly reviews recent readings and trends on the color coded dashboard, as well as her Care Plan answers. Seeing the worsening of Sally’s blood pressure readings, the call center contacts Sally’s OB nurse who begins a virtual visit with 2 way interactive videoconferencing.(Sally accepts video call on her phone) After determining how to control her blood pressure better, the nurse assigns an educational video on Preeclampsia for Sally. (Sally begins viewing educational video)She is able to view this educational content and answer “teachback” questions that ensure her understanding.Master BedroomNow we move into the final room, the Master Bedroom, which Beth occupiesHID GLOBAL- Use Case#2Beth was discharged from the hospital 6 weeks ago to receive in-home physical therapy. (Sally approaches light switch with her phone). Sally needs to document her visit with Beth using the same secure Electronic Visit Verification and digital documentation solution she used with her previous patient Robert. The same (Slide 1: Elements in home and caregiver tools) interface and easy to use tools used to document her care with Beth. (Sally taps her badge to her mobile phone) Sally simply taps [Slide 2: Employee badge and Mobile phone image] her NFC enabled badge to her smartphone to sign into the documentation and document [Slide 3: Document Visit] her second patient visit using the web application. She documents [Slide 4: NFC Image shown] her therapy visit by choosing NFC. Now Sally will tap [Slide 5: Tap tag now and phone wall image] her NFC enabled phone to a secure trusted tag inside Beth’s room. To digitally confirm she is in Beth’s room. (Sally holds smartphone close to tag on light switch on wall). She now selects the patient receiving [slide 6: Choose Client image] the care and the activity being performed (Sally uses phone) and she confirms the care being provided. This allows a detailed secure audit trail [Slide 7: Detailed history of care image] of care being provided.VIVIFY- Use Case #2WAITING ON SCREEN SHOTSBeth is being monitored daily for her chronic conditions and post-hospital care.? Her Care Plan was automatically created in this Remote Care Management Platform via data from the hospital EMR, and is modified based on her progress. .?(Kit box is visible to tour, Beth touches tablet, inputs PIN, wireless devices are nearby) This Care Plan is now present on a tablet, along with appropriate?Bluetooth or BLE?wireless devices, which she brought home from the hospital?in her Kit. No in home set-up is required with this system which is INSTANT ON and utilizes cellular networks for connectivity.? The Remote Care Management Platform manages the tablet and health devices with a patient experience that is intuitive and simple.?(Beth navigates standard tablet user interface)?Beth is guided through her?customized?Care Plan, including vital measurements?(Beth takes her Pulse OX and confirms on tablet)?health surveys, medication reminders,?educational videos, and virtual visits.? The data collected from the patient is delivered in real-time to a remote team, who can immediately react to any escalating issues.? This results in improved patient outcomes and cost savings.?The Remote Care Management Platform??can now engage patients with any condition, anywhere at anytime.VIVIFY- Use Case #3WAITING ON SCREEN SHOTS(Beth sits in chair facing TV)Driven by an intuitive user experience on tablets and even televisions, (Beth picks up TV remote and selects Pulse/Ox Button on TV, then takes a Pulse/ox reading using oximeter.) patients like Beth are more engaged in their own self-care, while remaining connected with their caregivers.? Beth is notified by images, colors, and audible tones when it is time to perform their customized daily Care Plan activities. Biometric data from many different personal health devices and other information is pushed to the cloud via cellular or WiFi.? (Beth uses remote to select answers to Survey questions, last question press “Watch Video Now”) Beth will answer clinical and assessment questions about her conditions, and is able to watch educational videos or other multimedia content to improve self-care, then answer questions to ensure her understanding.? Beth or her Caregiver Sally can even request a phone call or a videoconferencing call with her providers. If Beth gives responses that are outside of parameters in her Care Plan, the system generates alerts to remote providers such as nurses in a call center.? Providers can now manage large populations of patients through these weighted alerts and population filters.(Beth continues to watch TV after the educational video is completed)(Beth sees incoming call and uses TV Remote to select OK to answer and begins (fake) video call with remote caregiver)??The Call Center initiates a videoconferencing call to the patient, includes their Primary Care Physician or other care team members as needed to authorize medication or other care plan changes. To complete the entire loop of remote care, patient information is integrated into Electronic Health Records and to mobile provider platforms.eMEDONLINE- Use Case #1Before Beth was discharged from the hospital 6 weeks ago, she met with the hospital pharmacy staff.[Slide 1: Meet Beth) She has a complicated medication regimen. (Beth picks up her smartphone and opens it to her medication management app. She moves toward med bottle on dresser) She previously downloaded their app from the app store (Beth is looking at her smartphone) Beth receives simulated phone calls [Slide 3: Medication reminder call] from Grace, a synthetic voice, who engages Beth in each dosing event, helps her understand how to take it, and reinforces the purpose of the medication and its importance. (Beth holds phone to her ear) A smart sensing [Slide 4: Smart Sensing] service using RFID, NFC, or barcode helps Beth identify the right drug at the right time. (Beth holds pill bottle up to smartphone) Beth receives refill reminders on her phone, and can check her medication schedule, history, and compliance status relative to goals set by her healthcare team. (Beth holds up Smartphone again and points to screen)She can also view her body map, [Slide 5: Body Map and history] which shows specific problem areas, diagnoses, and prescribed medications. It helps her visualize her health status and internalize how each medication is an important part of her therapy plan.“Grace” also calls Beth each day to see how she is feeling, (Beth holds phone to ear again) collecting information on symptoms and side effects. Natural language processing is used to capture clinical concepts. For example, “irregular heartbeat” can be codified with the proper ICD-9, ICD-10, and SNOMED codes. If Beth reports [Slide 6: Pharmacist intervention]a significant health risk, an alert is sent to the designated caregiver like Sally for follow-up.PAUSEAs we conclude your tour of the I-Home, we hope you have enjoyed the showcasing of some of the latest remote care technologies that make it easier and safer now to provide care-at-a-distance for patients in the comfort of their own home. Thank you for visiting our I-Home exhibit and as you depart, please refer to our handout that lists all the vendors whose applications were demonstrated today. Please visit their kiosk locations to learn more about?their?solutions [ANNE, please edit these last 2 paragraphs to your liking. We can also shorten the conclusion if needed. Alan] ................
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