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Using mobile technology to reduce hospital re-admissions

Using mobile technology to reduce hospital re-admissions

The U.S Healthcare Information and Management Systems Society (HiMSS) released a report titled “Leveraging mobile technology to reduce hospital readmissions.”

According to the Centres for Medicare and Medicaid Services (CMS), Medicare has been overwhelmed with excessive hospital re-admissions – with total costs up to $17.5 billion a year. [1]

From 2007 to 2010, the national re-admissions rate remained at 19.2%, with an average Medicare cost for a hospital readmission stay at $9,600.

Therefore, the Hospital Re-admissions Reduction Program (HRRP), under the Affordable Care Act (ACA), aims to reduce re-admissions for all acute-care hospitals receiving payment under the Medicare Inpatient Prospective Payment System. [1]

In 2012, more than 2,000 hospitals were penalized for having excessive re-admission rates. The Medicare Payment Advisory Committee (MedPAC) estimates that these hospitals paid an average penalty of $125,000. [1]


Mobile technology ripe for greater adoption

Hospitals and health care systems are looking into developing new strategies, redesigning discharge procedures, and hiring more staff to follow up with patients at home.

They also need to rely on health information technology to scale their programs since they are also required to meet meaningful use criteria.

Hospitals and health systems are being urged to include mobile technology such as remote monitoring devices to connect patients and clinicians and impact care outside of their organizations.

According to the Pew Mobile technology fact sheet, as of October 2014, 64% of American adults have a smartphone. [2]

According to the 2015 HIMSS Mobile Technology Survey, 90% of respondents uses at least one type of mobile device to engage patients. [3]

Mobile health technology has created a demand for the concept of care from any location, which includes being able to communicate, share patient information, and receive services remotely.

The acceptance of mobile technology in the care setting continues to grow. 52% of survey respondents believe that the use of mobile technology will “substantially impact the delivery of healthcare in the future.” An additional 16% noted that the use of mobile technology will “dramatically change the way healthcare is delivered in the future.” [1]

Respondents also ranked that medication reminders, remote patient monitoring and preventative support care are benefits that mobile technology can deliver on patient care.


Overcoming the barriers

While remote monitoring technology (RMT) and mobile technology improve the quality of care and outcomes overall, barriers still exist.

In the case of mental health, mobile technology solutions like the one offered by Monsenso can help reduce the number of hospital re-admissions as well as the health care spending.

For example, a patient is brought into the emergency room as a consequence of displaying severe symptoms of mental illness.

After a couple of weeks of hospitalisation, the patient is released into the care of a close relative. Even though things seem to be going well, the patient is readmitted to the hospital again after six months.

This scenario can be quite common for people suffering from severe mental illness. Patients receive the treatment they need while being hospitalised, however once they are released into the care of their relatives, they receive no support, which gradually deteriorates their mental health.

It is very seldom that patients suffering from mental illness are called in for follow-up appointments, and as a consequence patients remain “stable” for a short period and then hospitalised after relapses.

Monsenso mobile health solution

The Monsenso mHealth solution can help reduce the number of hospital re-admissions in psychiatric treatment. Once a patient is released from the hospital, clinicians can establish a remote care plan that includes monitoring and self-treatment.

Every day, patients will complete a self-assessment in their smartphone. The information on the self-assessment is synchronized in real-time with the clinical web portal.

With the information obtained from the self-assessments, the system can identify the triggers and early warning signs of all active patients. A clinician can access the system every morning and be informed on which patients may need urgent care.

After accessing the patient’s records and reviewing the patient’s behavioural patterns, the clinician can make an informed decision. He can determine if the patient needs to be called in for an emergency appointment or just monitored more closely.

The clinician can also send an encrypted message to the patient asking if everything is fine and encouraging the patient to reach out if he feels ill.

In addition, the Monsenso mHealth solution provides patients with personalised action plans that suggest certain activities in case the patient displays certain symptoms.

Sources:

[1] Leveraging mobile technology to reduce hospital readmissions. Healthcare Information and Management Systems Society (HiMSS). 2013 http://www.mhealthnews.com/resource/leveraging-mobile-technology-reduce-hospital-readmissions

[2] Mobile technology fact sheet. Pew Research Center. 2014 http://www.pewinternet.org/fact-sheets/mobile-technology-fact-sheet/

[3] Mobile technology survey. Healthcare Information and Management Systems Society (HiMSS). 2015 http://www.himss.org/ResourceLibrary/genResourceDetailPDF.aspx?ItemNumber=42595

Jeg tror virkelig at Monsenso kan hjælp andre med bipolar type 2

Jeg tror virkelig at Monsenso kan hjælp andre med bipolar type 2

Watch Peter Hagelund’s documentary series, ‘Jeg savner min sygdom’  on living with bipolar disorder type 2 here.

For fire år siden blev jeg diagnosticeret med bipolar lidelse type 2.

I hele mit liv har jeg vidst, at jeg var anderledes. Jeg har altid kæmpet med depression og angst, og hvad der viste sig at være hypomani. Da jeg var 22, havde jeg min første slemme depressive episode, og jeg blev nødt til at starte på antidepressiver. Alligevel tog det yderligere 6 år, før jeg officielt blev diagnosticeret med bipolar lidelse type 2.

Det sværeste, ved at have diagnosen bipolar lidelse type 2, er at man ikke oplever den typiske maniske episode, hvor man er over-energisk og på grænsen til psykotisk. I stedet er man hypomanisk, som betyder at man er socialt velfungerende. Man er ikke psykotisk. Man føler sig faktisk rigtig godt tilpas. Så problemet er, at man ikke ender med at tage til sin psykiater og sige, at man føler sig for godt tilpas. Det gjorde jeg i hvert fald ikke!

Årsagen til at min psykiater fandt ud af, at jeg var bipolar, skyldtes at han ikke kunne få mig ud af mine depressioner. Først diagnosticerede han mig med depression og ADD. Men disse diagnoser var ikke rigtige. Da jeg ikke havde den rette diagnose, fik jeg stadig mine store humørsvingninger og meget angst. Da jeg så blev diagnosticeret med den ’rigtige’ diagnose, bipolar lidelse type 2, føltes det faktisk rigtig godt. En masse ting gav mening. Pludselig kunne jeg se, hvorfor jeg havde følt, som jeg havde hele mit liv.

Jeg tror virkelig, at Monsenso kunne have hjulpet min psykiater med at diagnosticere min lidelse tidligere, fordi app’en hjælper mig med at tracke mit stemningsleje og med at blive mereopmærksom på, hvordan jeg har det. På grund af app’en skal jeg hver dag tage en pause og tænke på, hvordan jeg egentlig har haft det, før jeg taster svaret ind. Når jeg tager til psykiater, kan vi sammen se, hvordan jeg har haft det. En god ting ved app’en er, at mit svar ikke afhænger af min hukommelse, men af hvad jeg faktisk svarede den pågældende dag. At indsamle al den her information kan hjælpe mig, og derved min psykiater, præventativt med at undgå fremtidige depressive eller hypomaniske episoder, fordi vi tydeligt kan identificere, når jeg har humørsvingninger.

I august har min dokumentar, om at være bipolar, premiere på nationalt fjernsyn. Reaktionerne har været overvældende. Rigtig mange personer har skrevet til mig og takket mig for at snakke om sygdommen. Jeg havde oprindeligt tænkt mig, at lave dokumentaren således, at ingen personer ville blive flove over at have sygdommen. Jeg tror, det er lykkedes mig.

Mit håb for fremtiden er, at personer bliver diagnosticeret med lidelsen tidligere end jeg blev. Selvfølgelig kommer det til at afhænge af en masse forskellige faktorer, men jeg tror virkelig, at Monsenso kan gøre en forskel. Mit håb er, at andre psykiatere og patienter også begynder at bruge app’en.

I Truly Believe Monsenso Can Help Others with Bipolar Disorder Type 2

I Truly Believe Monsenso Can Help Others with Bipolar Disorder Type 2

Watch Peter Hagelund’s documentary series, ‘Jeg savner min sygdom’  on living with bipolar disorder type 2 here.

Click here to read this story in Danish.

Four years ago, I was diagnosed with bipolar disorder type 2.

For my whole life I had known that something was different about me. I had always struggled with depression and anxiety, and what eventually turned out to be hypomania. When I was 22 I had my first big depression episode and had to start taking anti depressant medications. However, it would take me six more years before I was officially diagnosed with bipolar disorder type 2.

The tricky thing about having the diagnosis of bipolar type 2 is that you are not experiencing the typical manic episode where you are over-energetic and nearly psychotic. Instead, you’re hypomanic, which means that you’re socially well functioning. You’re not psychotic. You actually feel really good. So the problem is that you don’t end up going to your psychiatrist saying that you feel too good. At least I didn’t.

The reason why my psychiatrist found out I was bipolar was because he couldn’t get me out of my depressions. At first, my psychiatrist diagnosed me with depression and ADD. But these diagnoses didn’t fit. When I didn’t have the right diagnosis, I still had my large mood swings, and a lot of anxiety. When I was diagnosed with the ‘right’ diagnosis, of bipolar disorder type 2, it actually felt really nice. A lot of things made sense. Suddenly I could see why I had felt how I had for most of my life.

I really believe that Monsenso could have helped my psychiatrist diagnose my disorder earlier, because the app  helps me to keep track of my mood and really helps me to become more aware of how I feel. Due to the app, every single day I have to pause and take a moment to think about how I’ve actually been doing before putting my answers in the app. After doing this, when I go to my psychiatrist we can together see how I’ve actually been. The good thing with the app is that my answer to how I’ve been is not only based on my memory but how I actually answered that day. Logging all of this information has helped my treatment. My psychiatrist and I can better plan how to avoid my future depressive or hypomanic episodes, because we can clearly identify when I am having mood swings.  

In August, my documentary about being bipolar aired on national danish television. The reactions have been overwhelming. So many people have messaged me, thanking me for talking about the disease. I had originally made the documentary so that people would not be ashamed about having the disease.  I think I have succeed.

My hope for the future is that people will be diagnosed earlier with the disease than me. Of course, that will take a lot of other factors, however I truly believe Monsenso is one of the things that can help. My hope is that other psychiatrists and patients alike will start using the app.

“mHealth for better mental health treatment” Kristoffer Södersten’s Customer Story

“mHealth for better mental health treatment” Kristoffer Södersten’s Customer Story

To turn on English subtitles, click on the ‘CC’ at the bottom of the video. 

Psychiatrist Kristoffer Södersten from PsykiatriResurs in Sweden shares his experience using the Monsenso mHealth solution.

How does the Monsenso mHealth solution encourage and empower better mental health treatment? 

Kristoffer explains how the Monsenso mHealth solution helps him to enhance and inform treatment. Specifically, the solution helps him to gain more relevant information about his patients, such as information that couldn’t have been obtained through the traditional method of verbal sessions. “It’s difficult to retrieve reliable and consistent data from each patient during a verbal consultation with them,” says Kristoffer.

Obtaining the right information is key for psychiatrists and psychologists to provide an accurate diagnosis 

“[The accuracy from a diagnosis obtained] from face-to-face consultation depends so much on factors like personal relations, how comfortable the patient is in the conversation, cultural background, etc. Therefore, [due to these factors] it can be very arbitrary about which diagnosis a patient receives. This diagnosis can depend on which clinician he meets, and these other factors.” says Kristoffer. The information gathered from the Monsenso Clinic can help to provide a consistent and clearer view of the patient’s mental health, to better inform a diagnosis.

Kristoffer finds the Monsenso mHealth solution to be particularly helpful in capturing relevant objective data. The solution provides a comprehensive and easily accessible overview of relevant patient data, such as day score, mood score, sleep and medication adherence. Moreover, overview of collected sensor data, such as physical activity, social activity, phone usage and voice features can also be provided. This objective data can help to supplement the subjective data provided during verbal therapy.

“The technology of Monsenso can help us to gather more objective data that – together with the subjective experience – provide a more holistic picture of the patient’s problems, to help provide a more accurate diagnosis and follow-up treatment in a totally different way,” says Kristoffer.

Monsenso mHealth solution is providing a visualization of a historical data, which in some cases can identify why the symptoms appear and help to prevent them.

“You can also use this tool to predict future psychological outcomes, which can help us intervene early and prevent relapse.”

“I wouldn’t be able to keep track of my mood before Monsenso.” Peter Hagelund’s Customer Story

“I wouldn’t be able to keep track of my mood before Monsenso.” Peter Hagelund’s Customer Story

In this video, Monsenso User Peter Hagelund speaks about his experience using our mobile health solution to support his bipolar disorder treatment, and how the solution has helped improve and inform his communication with his psychiatrist.

Prior to using the app, Peter & his psychiatrist followed the typical therapeutic setting, they would meet for an appointment every two-three weeks, and they would have a conversation regarding Peter’s past weeks.  Peter would usually say that he had been fine for each appointment, but he would sometimes forget important details regarding his previous weeks that he wanted to discuss.

“It can be pretty tricky to remember, two weeks later [between appointments] how you actually felt that day. With the app it’s really easy to go back and see if your mood has been pretty stable over the last two months, or if you had had some ups and downs over a period,” says Peter Hagelund.

With the app, instead of relying solely on their conversation and Peter’s memory during the appointment, Peter’s psychiatrist can now access his logged data and see how he has been doing, as it is happening. His psychiatrist can view how much he has been sleeping, how much he exercises, how much he drinks, how much anxiety he has, and other relevant aspects to his treatment and his disorder.

“By having the [Monsenso] app, my psychiatrist can actually go into it and see how I’ve been doing, as in, yeah, you say you’ve been doing fine, but I can actually see that you’ve had a bit of ups and a bit of downs, and I think [the app] helps your psychiatrist to get a really honest view of how we, as patients, have been.” says Peter Hagelund.

Big Data in Treating Mental Disorders

Big Data in Treating Mental Disorders

Big data is transforming the treatment of mental disorders and the overall life science industry. Monsenso’s mHealth solution shows how technology provides new ways to inform treatment and achieve scalability. This is a guest blog written by Mads Frost is the PhD, co-founder and Chief Product Officer of Monsenso

The challenge with mental health today

According to numerous analyses and forecasts conducted by several international organizations and authorities, mental health today is one of the biggest challenges for society and health budgets. In fact, the World Health Organization (WHO) has predicted that mental disorders will be the greatest health burden for society in the coming years. This emphasizes the need for solutions to remedy this. Presently, technology is the best bet.

An example of the utilisation of technology to help overcome the burden of mental health for society is Monsenso. Monsenso is an innovation leader in mHealth solutions for the treatment of mental disorders. Monsenso helps support the treatment of mental disorders by inspiring and strengthening cooperation between patients and therapists.

Based on continuous research with leading experts in psychiatry, pervasive healthcare and data science, Monsenso has designed an innovative solution that fits into each patient’s life and helps them to better manage their disease as well as increasing the quality and effectiveness of treatment. It has been developed in a user-centred design approach, with patients, clinicians and relatives, to ensure that the solution is easy to apply and fits into the patient’s life and treatment.

The mental x-ray

Through daily self-assessment, clinical questionnaires, and collection of behavioural data from both sensors in modern Smartphone, wearables, and even voice analyses of patients’ voices, Monsenso provides the patient and the therapist with a detailed insight into the user’s mental health state. Through the application of advanced data analysis, indicators such as behavioural patterns, contexts and even forecasting future conditions and risk levels can be demonstrated – all with the purpose of gaining better insight into the patient’s mental health and providing an improved basis for treatment.

Generally, many organizations are fighting to realize mHealth’s full potential. According to a study where clinicians have been asked: “What is your most pressing information technology problem”, the answer that received the highest percentage of responses was, “turning data into action.” [1]

Psychiatry has previously used paper schemes to collect information from patients. However, but current technology provides access to a wide range of information that has not previously been available. This technology can be called the mental x-ray, in that using this technology can be used to see and monitor mental functioning with x-ray like precision and detail. This allows for early interventions and to help patients when they are in need. An example of this at work is the Monsenso based research into using voice analysis as an objective state marker for bipolar disorder . [2]

Paradigm shift in treatment: How do we achieve scalability?

To achieve the benefits of technology, it is necessary to adapt the clinical workflows. Psychiatry has a very traditional form of treatment where the patient meets the therapist and receives face-to-face treatment. The future brings more patients and fewer therapists – how do we scale this?

One possible solution is to optimising treatment is to use monitoring systems. These systems can rapidly identify which patients are in need of help, and which ones are well. In this way, clinicians’ time can be focused on patients who are in need.  Likewise, the systems can be more treatment-supporting, taking over the trivial and automatable tasks of the clinician, allowing them to spend their time on those with the greatest needs – the complex cases that technology cannot help. The last perspective – a paradigm shift in treatment – is to go from a reactive to a proactive approach. The proactive approach comes from gathering more detailed information, to lead to more informed decisions and earlier interventions. More information can help immediately notify both patients and clinicians when things start to go in the wrong direction, and need help to prevent potential hospitalisations. And the patients, who are well, can focus on life and not illness. However, it is important to keep in mind that it is not a trivial task to realise this.

How should we realise the potential of ‘Big Data’

On an overall level, there are a number of points that companies that are active in data-driven health technology should think about to thrive in complex health environments:

  • Find applications and services that bring tangible value to identifiable stakeholders – it must provide meaning and value to end users
  • Think on a global scale
  • Focus on solutions, not technology
  • Identify potential partners to create greater impact and find new value

Most of all, those who come from the outside into the healthcare domain must avoid the trap of seeing technology as something different from healthcare. Its greatest value will be how it integrates with healthcare systems and allows clinicians to provide better care for patients.

In some cases, technology will appear illusory: Personal contact between patient and therapist will always have a place in treatment, but data driven approaches can revolutionise the basis on which treatment is given.

Where are we going?

There are many possibilities that presents itself when exploring data driven approaches. I have  particularly emphasised ‘Context Aware Computing’ as one of the perspectives that are important to pursue. The goal is to use the context of the patients to provide the right intervention, to the right patient, at the right time, at the right place. This is not a trivial task, but extremely important for solutions like Monsenso to really help patients. The present systems are still relatively unintelligent in terms of achieving this, based on the amount of data available. It is difficult to know the context of what the collected data in the system is based on – what experiences and thoughts the patients have.

[1]  Top 5 industry challenges of 2016 By Aubrey Westgate, November 30, 2015  http://managedhealthcareexecutive.modernmedicine.com/managed-healthcare-executive/news/top-5-industry-challenges-2016?page=0,0

[2]  VOICE ANALYSIS AS AN OBJECTIVE STATE MARKER IN BIPOLAR DISORDER. M Faurholt-Jepsen, J Busk, M Frost, M Vinberg, EM Christensen, O Winther, JE Bardram, and LV Kessing. Translational Psychiatry, 2016. (ISSN: 2158-3188) (DOI: http://dx.doi.org/10.1038/ tp.2016.123), vol: 6, issue: 7, 2016

Mads Frost will be speaking about Big Data & Life Science in Copenhagen on December 7th, Product Market Fit for Health Startups.  Entrance is free. Click on the link to register and attend.