‫بسم هللا الرحمن الرحيم‬

‫أهال وسهال بكم‬

‫‪1‬‬ ‫‪9/26/2018‬‬
‫‪Dr.Mazen Maswady‬‬
 ‫الذك‬
‫ي‬ ‫الصح‬
‫ي‬ ‫التثقيف والتعلم‬
Smart Health Education and Learning
Presented by
Dr.Mazen AA Maswady, PhD Hosp. Adm, M.Sc. ,B.Sc.
Senior Technical Advisor
Nafees International Consultants
Mobile No.00962795500749 ,Amman- Jordan
mazenmaswadey@gmail.com

Presented to
Smart Health Conference
Transformation from Electronic Applications
to Smart Applications
Holiday Inn ,Amman Jordan
23-27 Sept 2018
 ‫هُ َ َْ َ َ ه َ‬ ‫ُ َ ُ َ ه َه‬
‫م‬ ‫ل‬ ‫س‬ ‫و‬ ‫ه‬
‫ِ‬ ‫ي‬ ‫ل‬ ‫ع‬ ‫اَّلل‬ ‫ى‬‫ُّ‬ ‫ل‬ ‫ص‬ ‫اَّلل‬
‫ِ‬ ‫ول‬ ‫س‬ ‫ر‬ ‫قال‬
‫هُ‬ ‫ََ ْ ُ‬ ‫ُّ‬ ‫َ‬ ‫ه‬ ‫ْ‬ ‫ْ‬
‫ُ َ َ ُ‬ ‫ه‬ ‫ْ‬ ‫ْ‬ ‫َ َ ُّ َ ه ُ ه َ‬
‫التعل َم‪َ ،‬وال ِفق هه ِبالتفقهِ‪ ،‬ومن ْي ُ َ ِر َ ِد ُاَّلل‬ ‫ه‬ ‫اس ُ‪ِ ،‬إَّنا ِّال ِعلم ِب‬
‫ْ‬ ‫ِّ‬ ‫َ‬ ‫‪":‬يا أي َها الن‬
‫َ ْ َ‬ ‫َ َ ِْ‬ ‫ًْ ُ‬
‫ين‪ ،‬و ِإَّنا َيشى اَّلل ِمن ِعبا ِدهِ العلماء"‬ ‫ِب ِه خْيا يفقهه ِِف الد ِ‬
‫جممع الزوائد (‪" :)1/154‬رواه الطرباني ِف الكبْي‬
 Anatomy of the Presentation
&ILOs
Identify Main Concepts: Health Informatics and Smart Applications in
Healthcare
Conceptualize E-Learning concept , components, tools, and rational
Describe and evaluate the hardware and software, the information system
utilized with E-Learning and Smart Applications in Healthcare.
Analyze E-Learning Information System Core Business Systems
Assess the role and functions of healthcare informaticist when working
with E-Learning and Smart Applications in Healthcare
Discuss the Advantages/Disadvantages of E-Learning from healthcare
providers perspective
Cognizance of Transformation from E-Learning in Healthcare to Smart
Applications in Healthcare such as mH.
Determine the Criteria for Having Successful Smart Health Education and
Learning
Learn What is Required from Smart Application in Healthcare
Substantialize Smart Health Education and Learning Cases and Practical
Solutions(Learned Lessons)
Dr.Mazen Maswady 5 9/26/2018
Health Informatics and Smart
Applications in Healthcare
Main Concepts

‫علينا ان نعمل بحذاقة وليس بكثافة‬

We Have to Work Smarter not
Harder
What is wrong with this picture?
 “Wiring” Healthcare
Current system fragments patient information Future system will consolidate information
and creates redundant, inefficient efforts and provide a foundation for unifying efforts

Payers

Hospital

Health
Hospitals Information
Exchange

Primary care
Laboratory physician Labs

Pharmacy
Data Server
Network
repository applications
Specialty
physician Outpatient RX

Payers

Ambulatory
center (e.g.
imaging Physician office
centers)
Ambulatory centers Public health
This Photo by Unknown Author is licensed under CC BY
 Health Informatics
The intersection of information
science, computer science, and
health care.
It deals with the resources, devices
and methods required to optimize the
acquisition, storage, retrieval and
use of information in health.

Dr.Mazen Maswady 10 9/26/2018

 Why Health Informatics?
Health Informatics provides
information to make decisions
Better information leads to better
decisions
Health care, management, planning
and policy all need good information
https://www.youtube.com/watch?v=rQ
sJmRg_ZO0

Dr.Mazen Maswady 11 9/26/2018

 Informatics ≠ IT

Information Technology is not Informatics

Information technology is hardware &
software.
o IT is to nouns, as informatics is to verbs.
o Informatics helps IT ‘work appropriately.’

Dr.Mazen Maswady 12 9/26/2018

 Health Informatics Tools

Health informatics tools include not

only computers
Clinical guidelines, formal medical
terminologies, information and
communication systems that
facilitate
e learning and smart applications in
healthcare

Dr.Mazen Maswady 13 9/26/2018

 eHealth
eHealth is a broad term for healthcare
practice which is supported by electronic
processes and communication.
The term can encompass a range of services
that are at the edge of medicine/healthcare
and information technology

https://www.youtube.com/watch?v=0H0fHFtHB
mw

Dr.Mazen Maswady 14 9/26/2018

 ‫‪mHealth‬‬
‫‪mHealth‬‬
‫‪Mobile Health‬‬
‫‪Mobile technologies such as mobile phones aiming to collect‬‬
‫‪and access health information.‬‬
‫مصطلح الصحة المحمولة )‪ (mHealth‬أو كما تعرف أيضا )‪ (m-health‬وهي اختصار‬
‫لكلمتين )‪ (Mobile Health‬يطلق على كل ما يخدم الصحة باستخدام الهواتف المحمولة أو‬
‫ما يسمى الهواتف الذكية‪ ,‬و من هنا حصلنا على كلمة (المحمولة) ‪ ,‬تعتبر الصحة المحمولة‬
‫جزء من منظومة الصحة االلكترونية )‪ (eHealth‬التي تعتبر المظلة العامة لكل ما يخدم مجال‬
‫الصحة في مجال تقنية المعلومات و االتصاالت‬
‫تطبيق للهواتف الذكية بمثابة ملفك الصحي االلكتروني في جيبك لك و لعائلتك باإلضافة الى‬
‫عشراء الخصائص االضافية‬
‫هنا فيديو يتحدث عن ميزات التطبيق‪:‬‬

‫‪.be/1https://youtucD_g4M-r9c‬‬
‫‪Dr.Mazen‬‬
‫‪Maswady‬‬ ‫‪15‬‬ ‫‪9/26/2018‬‬
 Mobile Learning
WHAT IS IT? Mobile learning is the ability to obtain or provide
educational content on personal pocket devices such as PDAs,
smartphones and mobile phones
M-learning or mobile learning is "learning across multiple
contexts, through social and content interactions, using
personal electronic devices". A form of distance education, m-
learners use mobile device educational technology at their
convenience.
Wikipedia
http://www.yourtrainingedge.com/megatrends-in-moocs-8-
mobile-learning/
 What is Required from Smart
Application in Healthcare
Smart Application in Health should provide HCP and
Recipients i.e. Patients., families as far as feasible,
r the right information and
r the right knowledge
r at the right time
r in the right place
r to the right people
r in the right form
so that these people can make
r the right decisions

17
E-Learning
E-Learning
Concept of E-Learning/electronic/online

https://www.youtube.com/watch?v=
77cSY74jZQ0.
Concept of E-Learning/electronic/online
Triology of e-Learning
 Just a few examples…
Continuing education requirements for
recertification
Hospital required annual competencies
Unit specific educational updates or
competencies
New or updated hospital-wide policies,
procedures or guidelines
New resources or equipment available to
improve patient care
Optional educational courses available for
professional development
Hardware Requirements
Physical or tangible parts
involved in the performance
or function of the computer
(Mastrian & McGonigle,
2009)
Desktop Computer
Laptop Computer
Personal/Hand held
computer
◼ PDA

◼ iPhone/Blackberry
 Software Requirements
Microsoft Office (Word, Excel, PowerPoint)
Windows Media Player
Adobe Flash, Acrobat Reader
Microsoft Windows/MAC
Internet Browsers (Explorer, Firefox, etc…)
And more…
 E-Learning Information System
Core Business Systems

Supports the management of healthcare within

an organization
Provides the framework for reimbursement,
support of best practices, quality control, and
resource allocation
Four common Core Business Systems:
◼ Admission, discharge, and transfer (ADT)
◼ Financial
◼ Acuity
◼ Scheduling
(Mastrian & McGonigle, 2009)
 Core Business System Review
Administrative Information System with aspects of
Clinical and Special Purpose (education)
Used by nearly all healthcare professionals
Enables users to perform functions ranging from
finances to scheduling
Configuration includes mainframe computer and local
area network
Incorporates data standards likewise Health Level 7
Recommended for future implementation
https://www.youtube.com/watch?v=px2Se1huVdY&index=1
&list=PLO-fTJGm35yeX2RSBmS3XWsO-no8OMpHw
Healthcare Provider Informaticist
Role and Functions

Assist Implement the use of

E-Learning in the workplace
Offer assistance and help
when needed
Evaluate effectiveness
Assist in making changes
when necessary in creation of
E-Learning programs
Educate employees
Health Informatics Competencies
Completion of annual hospital-wide
competencies
◼ Learn and show understanding of

software programs used, often for

E-Learning purposes
 Legal & Ethical Issues
Operates on the honesty policy regarding identity
Cannot guarantee individuals will work independently
if required
Impersonal education resulting in less information
learned
Quality of online certification vs. traditional
classroom/exam certification
Unable to verbalize or show understanding of
important information
Losing vital information in “cyberspace”
Advantages of E-Learning
Independent
Accessible from any location, at any
time
Flexibility encourages learning
Faster communication/Instant
feedback
Changes can be made immediately
Facilitates educational
programs/certification
(Mastrian & McGonigle, 2009)
Disadvantages of E-Learning

Non-traditional setting may deter older

health professionals
Lack of face to face contact
Independent
Requires self-motivation
Must be open to use of technology
Possibility of computer dysfunction
 Summary of E-Learning
Despite minor flaws, as all education programs have,
E-Learning makes education accessible, facilitates
professional development, and
ultimately improves patient
care through educating
healthcare professionals in
a way that is new, exciting
and effective.
 Transformation from e-Learning to Smart Applications in
Health Education and Learning.
8 benefits of mobile devices in healthcare that you need to
know:
Mobile devices have created a new communication channel
between healthcare service providers and patients.
Benefits of mobile devices in healthcare go beyond the
communication channels. They enable better coordination,
improve diagnostic accuracy, and build a bridge of trust.
Here are the top advantages of using mobile devices by
providers as well as patients and how they are transforming
healthcare
https://kaysharbor.com/blog/healthcare/8-mobile-device-
benefits-in-healthcare.
 Transformation from e-Learning to Smart
Applications in Health Education and Learning.
Benefits :
Better point-of-care coordination
Seamless data flow
Direct patient management
Enhances physician efficiency
Increases diagnostic accuracy
Provides convenience
Caters to customizations
Real-time communication
Source:
https://kaysharbor.com/blog/healthcare/8-mobile-device-
benefits-in-healthcare 2017
 Transformation from e-Learning to Smart
Applications in Health Education and Learning.
It is also promoting collaboration, consulting and sharing of knowledge
globally. Experts from different corners of the world can consult each
other in real-time to learn and share. In turn, the patients benefit from
these collaborations and information sharing. In a survey of medical
schools, about 80 percent of medical students used mobile devices to talk
to their fellow students.

Conclusions
Mobile technology is changing the way we heal. The benefits of
mobile devices in healthcare are discussed above to give you an
appreciation of the possibilities in this area. However, the risks
should not be ignored.
Using them without proper standards can lead to unsafe practices
and breach of patient privacy. Healthcare service providers should
thus implement a strategy that will help keep the quality of service
high while keeping the patients safe.
With a robust mobile strategy, healthcare providers can take
advantage of the accurate and real-time information help improve
end-to-end healthcare processes.
 Fields of Smart Health Applications
Doctor Network and ( ‫( األطباء و المراجع الطبية‬11 (Clinical ‫الرعاية الصحية األولية والمتابعة يف العيادات‬ (1
‫ شبكات‬Resources) Administration and Backend)

Online Health Destination Sites)( ‫( المواقع الطبية‬12 (Digital ‫المرض‬

‫ي‬ ‫األجهزة الطبية الرقمية والتشخيص‬ (2
Medical Devices and Diagnostics)
Healthcare ( ‫( نظم ادارة حمالت التسويق الطبية‬13
Marketing and Campaign Management) (Electronic Health / ‫الصح‬
‫ي‬ ‫الطب والملف‬
‫ي‬ ‫نظم السجل‬ (3
Medical Records)
Mobile ( ‫( تطبيقات اللياقة البدنية و الحميات الغذائية‬14
Fitness / Health Apps) (Population Health Management)‫نظم ادارة الصحة‬ (4
‫( ر‬15
‫انتنت األشياء لتطبيقات اللياقة و الحمية و الحياة الصحية‬ (IOT HealthCare) ‫ا رنتنت االشياء يف العناية الصحية‬ (5
IOT Fitness and Lifestyle)( (Medical Big Data)‫البيانات الطبية العمالقة و تحليلها‬ (6
Online Health ( ‫االفتاضية‬ ‫ر‬ ‫( مجتمعات الصحة‬16 (Genomics)‫علم الوراثة‬ (7
Communities)
(Doctor and ‫ادلة البحث عن الخدمات الطبية و األطباء‬ (8
‫( نظم التواصل و معلومات الرسائل الصحية عت الهواتف‬17 Healthcare Service Search)
Healthcare Mobile Communications / (
(Telehealth) ‫الصحة عت الهاتف ووسائل االتصال‬ (9
Messaging)
Healthcare ( ‫( توظيف الروبوتيك يف خدمة الصحة‬18 (Patient Engagement and ‫( تثقيف و تعليم المرض‬10
Education)
Robotics)
Remote ( ‫نظم المراقبة الصحية و صحة األرسة‬. (19
Monitoring and Family Care Management) https://www.youtube.com/watch?v=Y8288eEEsmc

Dr.Mazen Maswady 36 9/26/2018

‫‪Smart Applications in Health‬‬
‫‪Education and Learning‬‬
‫‪Cases and Demonstrations‬‬
‫عل تطبيقات الصحة الذكية‪:‬‬
‫امثلة ي‬ ‫•‬
‫أحد أهم األمثلة عل استخدام تقنية المعلومات الصحية يف زيادة مشاركة المريض بشكل‬ ‫•‬
‫ر‬
‫اإللكتونية ” ‪ ، ” Patient Portal‬حيث يمكن للمريض‬ ‫فعال هو تطبيق المنصة المريض‬‫ّ‬
‫الوصول لجميع معلوماته الصحية والقيام بمهام متعددة مثل حجز المواعيد أو التواصل مع‬
‫الطب دون الحاجة لزيارة المستشف‬
‫ي‬ ‫الفريق‬
‫” ‪ . ” eVisit‬و الزيارة عن بعد‪ ،‬أيضاً يمكن للمريض إكمال نموذج ما قبل الزيارة الكترونياً قبل‬ ‫•‬
‫موعده بوقت كافي مما قلل وقت االنتظار في العيادة و زاد من نسبة حضور المواعيد ‪.‬التطبيق‬
‫سجل واعتمد‬
 ‫‪Smart Applications in Health‬‬
‫‪Education and Learning‬‬
‫‪Cases and Demonstrations‬‬
‫عل تطبيقات الصحة الذكية‪:‬‬
‫امثلة ي‬ ‫•‬
‫المثال الثالث الستخدام تقنية المعلومات الصحية هو توظيف تقنية الواقع المعزز ‪” Virtual‬‬
‫ا‬
‫” ‪Reality‬ف عملية دعم اتخاذ القرار و التثقيف الصح ‪ .‬مستشف جامعة ستانفورد مثل أطلق‬
‫منصة خاصة لقسم الجراحة باسم ” ‪ ” Precision VR‬ف ‪ ٢٠١٦‬م بهدف إيصال معلومة‬
‫دقيقة للمريض عن طبيعة التدخل الجراح الذي يحتاجه – أو يحتاجه األطفال أو أحد األقارب‬
‫– ومساعدتهم التخاذ القرار المناسب ‪.‬‬
‫لرني المغناطيس‬
‫الطيان مدمجة مع تقنية ا ر‬
‫المنصة تعتمد تقنية مشابهة لتقنية المحاكاة ف تعليم ر‬
‫لتمكي الطبيب من لمس وتحريك وقطع‬
‫ر‬ ‫” ‪” MRI‬والتصوير الطب الطبف ” ‪“CT Scanning‬‬
‫وإعادة األعضاء واألنسجة واألعصاب والوقوف بقدميه ربي الورم والوريد بغرض رشح التدخل‬
‫الجراح للمريض وتجاوز عقبة المصطلحات الطبية أو حاجز اللغة أو الرهبة من التدخل‬
‫الجراح ‪ .‬فيديو يوضح طريقة عمل التقنية يف قسم جراحة الدماغ واالعصاب واألعصاب‬
 Sim Center

https://www.youtube.com/results?search_query=medi
cal+simulation+training
Simulation and Training
 Smart Applications in Health Education
and Learning.
Cases and Demonstrations
Utilization of smart phones
related medical applications
among medical students at King
Abdelaziz University, Jeddah: A
cross-sectional study
considered these helpful in
clinical decision-making,
assisting in differential
diagnosis, allowing faster access
to Evidence-Based Medical
practice, saving time and others.

https://www.sciencedirect.com/science/article/pii/S18760
34116301265
 Prescribing Medical
Applications to Patients
 Disclaimer
No financial connection to any of the products
and services listed in this presentation.

Source: Dr. Eric Topol on NBC's Rock Center

43
 Fitness -- Wearables
Activity and sleep trackers are TNTM
Still growth market – 112M by 2018
Fitbit wins in sales 2016
Various styles – features – prices
◼ Heartrate monitor
◼ Sleep monitor
◼ Stairs climbed
◼ Calories burned
◼ Time/date display
◼ Swim monitor
Smartwatches have some of
the above and are competitive

44
 Smartwatches
Advantages over wristbands:
◼ Answer phone
◼ Receive and send texts
◼ Emergency SOS button
◼ Get alerts from programs on
your phone like calendar
alerts, pill reminders
◼ Track odd exercises, get exercise
progress reports
◼ Basal energy expenditure more
accurate
Disadvantage: expensive
May be >60% of wearable market
by 2021
45
 Fitness - Smart Scales
Several brands available: Withings/Nokia, Fitbit,
Garmin, Polar Balance, iHealth, Under Armour…
Some work with wearables to add weight to fitness
tracking, calculate BMI
Work with their own app
or others like MyFitnessPal
$25 - $400
Withings (Nokia) Body - Body Composition Wi-Fi
Scale,
Black, $125 at Amazon. Works with
MyFitnessPal

46
 Wearables - Smart Tops, Socks and App

Monitor Running/walking form, heart

Alert when corrections needed
Works with sports tops that monitor breathing and heart rate

www.sensoriafitness.com 47
Continuous Glucose Monitors
(CGMs)
Dexcom (also Medtronic)
Talks to phone, Apple watch
Share with up to 5 others
Alerts high or low

Dexcom.com G5 CGM
48
 Artificial Pancreas
CGM and Insulin pump communicate
Medtronic first to gain FDA approval
Several more in clinical trials

49

©ًHealthline 2012
Lab-in-a-Box Health Tracking
Cue systems
Samples blood, saliva, mucous
Monitor Vitamin D, inflammation,
influenza, testosterone, fertility
Sends results to app

https://cue.me/#inflammation
50
 FDA Oversight
• Which apps need FDA approval?
• How are they approved?
• How do phony apps get around this?
• Do we need to teach patients to be smart
consumers of apps?

51
 Mobile Medical App Oversight
Food and Drug Administration (FDA) must
approve mobile apps that are:
1. An extension of one or more medical
devices which controls the device or
monitors patient or analyzes medical device
data
2. Transform the mobile platform into a
regulated medical device by using
attachments
3. Performing patient-specific analysis and
providing patient-specific diagnosis, or
treatment recommendations.
http://www.fda.gov/downloads/MedicalDevices/.../UCM263366.pdf
52
 Remote Monitoring Devices
Body guardian Heart (Zio, Medtronic, others)
Body Guardian

Developed with Mayo and ST

Microelectronics
Rhythm monitoring
Set intervals for recording
Patient portal
Care team monitoring
http://www.preventicesolutions.com/technologies/body-guardian-
heart.html 53
 Apps/Devices FDA Regulatory Oversight
2. Mobile apps that use attachments, display
screens, sensors or other such similar
components to transform a mobile platform into
a regulated medical device.
Example:
Kardia Mobile ECKardiaBand ECG
Apple Watch AliveCor.com

http://www.fda.gov/downloads/MedicalDevices/
.../UCM263366.pdf
54
 Other Smartphone Attachments
Ultrasound (Philips)
Stethoscope (Eko)
Pulse Oximeter (I Health)
Otoscope (Welch Allyn)
Ophthalmoscope (WA)
Etc.
Some have AI assisted
diagnostics in app

Philips Humify Ultrasound

55 Summer 2017
 Apps/Devices FDA Oversight
3. Mobile apps that become a
regulated medical device by
performing patient-specific
analysis and providing patient-
specific diagnosis, or treatment
recommendations.
▪ Example: Mole Analysis

(not approved yet because of

problems)
SkinVision.com
http://www.fda.gov/downloads/MedicalDevices/
.../UCM263366.pdf 56
 FDA Health Software Precertification
11/15/2017
Announced pilot program
Fast-track approvals for digital medical
innovations for 9 medical product
manufacturers
Apple, Fitbit, Johnson & Johnson, Pear,
Roche, Samsung, Tidepool, Verity

57
 FDA Oversight Discretion
They may decide to regulate apps that:
A. Facilitate behavioral E. Document, show, or
change or coach communicate to
patients providers potential
B.Organize and track medical conditions
patients health F. Interact with the PHR
information or EHR systems
C.Find information about G. Are medical device
patient’s condition data systems
(reference)
H. Will not certify fitness
D.Perform calculations devices and apps
(calculators)

58 Summer 2016
 FDA Oversight Discretion

2. Apps that provide

patients simple tools to
organize and track
their health
information.
◼ Personal health

record
◼ Fitness tracker

◼ Symptom tracker

Microsoft HealthVault
59
 FDA OVERSIGHT DISCRETION

3. Apps that provide access

to information related to
patients’ًhealth conditions
or treatments (reference)
4. Perform simple
calculations routinely
used in practice.
◼ Epocrates
◼ QxMD Calculate

60 Epocrates.com
 Patient self-Education

Apps designed for patients

◼ iTriage
◼ WebMD
Symptom checker
Procedure information
Condition information
Medication information
Allergy information
◼ AskMD
◼ KidsDoc

61
 FDA OVERSIGHT DISCRETION
5. Apps that allow patients to
communicate to
providers.
◼ Telemedicine platforms
eVisit.com
◼ Reimbursement Guide
Doxy.me
◼ TeleProviders
DoctorOnDemand.com
HealthTap.com
LiveHealth Online TouchCare.com
Duffy, J. 10 apps that are changing healthcare. PC Magazine. 2/11/15.
62
http://www.pcmag.com/article2/0,2817,2476623,00.asp
 AMA Guidelines for Health App Usage
Main concerns;
◼ Support patient-physician relationship
◼ Integrate into clinical workflow
◼ Reimbursement models
◼ Ensure patient safety, quality care and
positive health outcomes
◼ Abide by state laws and licensure
American Medical Association. AMA Adopts Principles to Promote Safe, Effective mHealth
Applications. Press release. Nov 16, 2016.
https://www.ama-assn.org/ama-adopts-principles-promote-safe-effective-mhealth-
applications

63
 Apps Make False Claims
Snake Oil Apps
Apps without attachments that claim to
measure BP, pulse ox, or temp.
Look for “for entertainment purposes only”ً
in description
Look for FDA approved on any devices or
app to manage a Dx. Example: Insulin
dose calculator
Watch for healthcare systems to certify
apps and create their own that integrate
with information systems
Misra, D. App claims to measure oxygen saturation with only a smartphone.
Medpages Today, June 2015.
http://www.medpagetoday.com/Blogs/IltifatHusain/51888
64
 HIPAA Considerations

HIPAA was written before smartphones

Only clinicians covered by HIPAA
DHHS has issued new guidance for health
app developers. : http://hipaaqsportal.hhs.gov/
ONC has site with tutorials on mobile device use for providers:
Office of the National Coordinator for Health Information
Technology (United States Government Health and Human
Services)
https://archive.healthit.gov/providers-professionals/your-mobile-device-
and-health-information-privacy-and-security

65
 HIPAA Caution
No texting with patient using personal
account:
◼ If patient initiates, caution in responding.
No emailing patient using personal
account:
◼ Use patient portal instead.
Use HIPAA compliant services
HIPAA compliant texting services
◼ TigerText, qliqsoft, pMD, PingMD
66
 How and why
Prescribe an App

67
 Benefits of Prescribing apps
Improve physician/patient relationship
Promote self and shared health
management
Assist caregivers in following
instructions
Providing data to patient to self monitor
and physician monitoring uncontrolled
chronic condition
Scher, DL. The big problem with mobile health
apps. Medscape. 2015.
http://www.medscape.com/viewarticle/840335
68
 More Benefits
Patients more likely to use app: monitor
symptoms, medication adherence, if they
collaborate with their physician, care
coordination team
Outcomes based reimbursement is an
incentive
Cost savings to patients
Oscar, R. Mobile apps improve medication
adherence, reduce costs. Modern Medicine
Network. 2016. http://managedhealthcareexecutive.modernmedicine.com/managed-
healthcare-executive/news/mobile-apps-improve-medication-adherence-reduce-costs

69
 Barriers
Lack of evidence
Limited systematic integration
Patient access gaps
Data privacy and security
Reimbursement challenges

IMS Institute. Patient Adoption of mHealth: Use, Evidence and Remaining Barriers
to Mainstream Acceptance.
http://www.imshealth.com/files/web/IMSH%20Institute/Reports/Patient%20Adoption%20of%20
mHealth/IIHI_Patient_Adoption_of_mHealth.pdf
71
 Proactive Institutions
Ochsner: Setting up their own App Store with apps they
recommend to their patients.
Kaiser Permanente: develop certification system for
medical apps.
U of Pittsburg Medical Center and Montefiore in NY
developing apps for affiliated doctors.
Mount Sinai: RxUniverse, system wide platform to
prescribe apps.

Scher, DL. The big problem with mobile health apps.

Medscape. 2015.
http://www.medscape.com/viewarticle/840335
72
 RxUniverse
• Sinai AppLab has partnered with Mount
Sinai Innovation Partners
• Plans to launch new company:
Responsive Health [Oxheart]
• License RxUniverse for use by other
health systems
Mount Sinai Launches Rx Universe - Mobile Health
Prescription Platform
http://www.mountsinai.org/about-us/newsroom/press-
releases/mount-sinai-health-system-launches-first-
enterprise-wide-platform-to-prescribe-apps-to-patients
73
 A starting point
When patient needs to track symptoms,
treatments, medications….
Assess their technology adoption and
suggest they find an app or suggest one
you or staff are familiar with
Have them bring printout of data from
online?
What works for you?
See VA App Prescription Pad
74
 ‫مقومات نجاح التثقيف والتعلم الصحي الذكي‬
‫‪Criteria for Having Successful Smart Health Education and‬‬
‫‪Learning‬‬
‫المشاركةًً‬ ‫•ًالحوكمة الذكية‪Smart Governance‬‬
‫• العمليات الديمقراطية المشاركة لكل الفئات وعدم التهمي‬
‫• الشفافية وسهولة الوصول للمعلومات‬
‫• الترابط البيني الحكومي‪(.‬الحكومة المتعدد المستويات)‬
‫• المنظمات واإلدارات‬
‫• تحسين وصول المجتم لى الخدمات االجتماعية والعامة‬

‫المنافسة‬ ‫•ًاال تصاد الذكي• ‪Smart Economy‬‬

‫• التنافسية العالمية اإل ليمية‪.‬‬
‫• االبتكار‪.‬‬
‫•الشرو بتنفيذ المشاري الريادية ‪.‬‬
‫• نطا واس لوصول جمي المواطنين وا عمال للفرص التجارية‬
‫• استقاللية المكان والمساعد على الحفاظ على السكان في المناط الريفية‬
‫• الوسائل اإللكترونية في العمليات التجارية بجمي أنواعها (كالخدمات المصرفية اإللكترونية والتسو‬
‫اإللكتروني والمنا صات)‬

‫‪75‬‬
 ‫مقومات نجاح التثقيف والتعلم الصحي الذكي‬
‫‪Criteria for Having Successful Smart Health Education and‬‬
‫‪Learning‬‬
‫االتصالية‬ ‫•ًالتنقل الذكي• ‪:Smart Mobility‬‬
‫• أنظمة النقل أكثر كفاء وذكاء‬
‫• شبكات باالستفاد للكفاء حركة المركبات وا شخاص والسل للحد من الجمود‬
‫• السلوكيات االجتماعية الجديد "مثل تقاسم موا ف السيار وتجمي السيارات والتواف بين السيارات‬
‫الدراجة‬
‫• ادار النقل بما يحق سهولة الوصول وخدمات لوجستية‬
‫• تعددية النماذ ‪.‬‬

‫االستدامة‬ ‫•ًالبيئة الذكية ‪Smart Environment‬‬

‫• االستدامة البيئية ‪ /‬كفاء استهالك الطا ة‬
‫• الحد من استهالك الطا ة من خالل االبتكارات التكنولوجية‬
‫‪ .‬تعزيز الحفاظ و عاد استخدام المواد‬
‫• الشبكات والمر ابة البيئية‬
‫• ادار الموارد وحماية البيئة ‪.‬‬

‫‪76‬‬
 ‫مقومات نجاح التثقيف والتعلم الصحي الذكي‬
‫‪Criteria for Having Successful Smart Health Education and‬‬
‫‪Learning‬‬

‫‪ Smart People‬المعرفة‬ ‫•ًالمجتم الذكي•‬

‫•ايصال الخبر التعليمية بصور متسقة في كل من المناط الحضرية والريفية‬
‫•حلول التعليم اإللكتروني (التعلم عن بعد والتعليم والتعليم بطريقة تعاونية) ليكون المواطن على مستو تعلم‬
‫أفضل‪.‬‬
‫• التعليم الر مي والتمكين من العمل على تكنولوجيا التصاالت والمعلومات‪.‬‬
‫• بناء المجتم القائم على ادار الحيا الحضرية ‪.‬‬

‫نوعية الحيا‬ ‫•ًالمعيشة الذكية• ‪Smart Living‬‬

‫‪-‬الرعاية الصحية الوصول لى خدمات الرعاية الصحية عالية الجود (بما في ذلك الصحة اإللكترونية أو عن‬
‫بعد‬
‫ومرا بة الرعاية الصحية)‬
‫• دار السجالت الصحية اإللكترونيا •‬
‫• أتمتة المنزل المنزل الذكي و البناء الذكي " خدمات المبنى الذكي "‬
‫• الوصول الى كافة انوا الخدمات االجتماعية من بل جمي الفئات‪.‬‬
‫• السياحة‬
‫• ادار الفضاء الحضر ‪.‬‬
‫‪77‬‬ ‫• الثقافة والترفي‬
What will healthcare look like
in 20 Years?
The Doctor's Office of the Future
Bloomberg Technology
January 18, 2017
Headlines: January 30, 2018
Amazon, Berkshire, JPMorgan Chase
partner to build healthcare company with
focus on tech
.Nicholson, D. and Jeffries, A. The doctors office of the future. Bloomberg News .
1/18/17. https://www.bloomberg.com/news/videos/2017-01-18/the-doctor-s-office-of-
the-future-video
https://www.thenational.ae/uae/health/health-pods-installed-in-dubai-government-offices-
will-collect-workers-data-1.732843
78
Dr.Mazen Maswady 79 9/26/2018
 Q&A

Dr.Mazen Maswady 80 9/26/2018