Monday, March 21, 2011

Mobile Tools and YoMamaCare

For all the talk about the damage social media does to our ability to communicate face to face, one thing remains true. There’s a group who was already isolated before the rise of the smartphone. This chronically ill, homebound population could benefit from expanded social interaction with the right mix of mobile devices, existing apps, and engaged stakeholders.

So raise your hand if you’ve got a family member or friend living too far away to easily visit. And you know they’re just sitting there most of each day with only some sporadic nurse, physician, or assisted living staff interaction. The all important human interaction needs to be spread across a few more people so that it happens several times in every day; the improvement in mental and physical wellness would be measurable. If the constraints of time and distance were removed, all of these patients already have some broader community of willing stakeholders that could help. For some family members, Gramma may be the one person in the world who would actually appreciate and benefit from the stream of trivial “what I’m doing now” tweets they’re already spraying into the void. The opportunity for physicians and home visit nurses to quickly send either patient specific reminders via txt, or more general information to whole patient groups via twitter would give them some presence in between live visits. The additional community of other online patients with similar conditions and issues provides even more reason to stay engaged.

Now before you roll your eyes at the thought of your not-so-mobile Gramma using Twitter, just consider the simple and engaging interfaces we’re seeing on the iPad and android devices. I saw a story today about a 2 year old mastering an iPad. Even if that’s a stretch, it is true that just a swipe or tap for an incoming notification is not an obstacle. What if Gramma had a lightweight, bright screened, large text and button display device kept beside her or in her lap? Shortcuts, text to speech, Skype? Who knows?

We can worry about exactly which device and whether it’s wifi or 3g/4g later. What we need to come up with now is a process to bring some structure and consistency and outreach to this approach to long term care.

Wednesday, March 9, 2011

Another interesting case for mLearning in Healthcare

Another interesting case for mLearning in Healthcare recently hit my desk. I’ve been asked to help devise a transitional care solution using technology. The specific directions are “maybe something with iPads”.
They’re looking for a way to change a consistent and troubling fact about a particular group of patients. The fact is that these individuals return to the hospital like clockwork after being discharged. The nurses that work with these “frequent flyers” can predict, with uncanny accuracy, saying “He’ll be back in three days...we’ll see her again in a week”, etc. This group all have one or more of a limited set of conditions like COPD. These various lung/heart/diabetes/other related health problems all have self-manageable actions, that if followed, prevent frequent hospitalization. That’s how the nurses predict who will return soon. They know which individuals won’t take their meds, or check their blood sugar, or exercise, or eat right, or monitor anything.

The mLearning solution that my colleague and I are developing centers around helping these patients increase their use of these self-manageable practices. It’s an evolution of the home care nurse visit model. We want to magnify it’s efficacy by adding a nurse’s virtual presence to fill the void of all the days and hours between physical nurse visits. Any tech solution for this patient group has to be really simple and convenient. They’re older, and limited in mobility, tech proficiency, and motivation. The iPad or android tablet might be exactly the tool.

Here’s the logline--a likely patient is profiled while in the hospital. The patient is trained, and given the use of, a tablet device to take home. Their “edu-care” nurse will not only show them how to use it, but also be their virtual coach after they return home. A simple to use, always-on app can be set to handle reminders for taking meds or checking blood sugar. It should have at least a minimal attempt at fun, like the Wii Fit Plus comments about how many days it’s been since you last exercised, or the “Ooooh!” when you step on the balance board sometimes. Simple touch answers to prompts, or sliders for measures, just tidbits at a time, just in time. The edu-nurse, at his/her office in the hospital, or anywhere with a PC, can set or change the scheduled reminders or check the results using the care giver's web interface. The virtual nurse can provide as much of a ticker tape as he/she wants, using twitter, targeting tips, encouragement, or news to similar groups of patients all at once. These nurses might share their various expertise with each other’s patients. Anyone with a COPD patient could for example, set that patient’s iPad to follow on twitter the account of whichever care giver is the COPD expert. The greatest improvement in patient outcome will come from the one-to-one, front-camera to front-camera Skype(or similar) interaction between a patient and their coach. If we provide a semi-constant interaction and invoke any of the smartphone obsessive behavior (i.e. feeling naked without it) that some of us have, these folks will stay out of the hospital longer.

In most cases, one visit would more than pay for the iPad/tablet, and possibly the virtual nurse/coach/educator’s time as well.

Saturday, March 5, 2011

A Case for mLearning in Healthcare

The community hospital where I work isn't ready for mobile learning yet; but, the potential is exciting. Every twist in hardware innovation and usage appears to offer a new educational tool.

This week, what caught my eye was the blurb for a content creation program that now includes a location trigger. So, potentially, when one of our staff approaches a patient room where airborne precautions
are in place, their smartphone or other mobile device(i.e. tablet) will notify them. The notification then links to a mini-course or checklist of required actions before entering that room. They could be notified upon entering or leaving any patient room as a reminder for handwashing, the single most important (and ignored) patient safety rule that exists.

These scenarios could be listed for pages. There are obstacles--is the GPS accurate enough to within 15 feet? What about the Infection control concerns around the phones themselves. It going to be handled before and after hand-washing. Do we use voice command and bluetooth headset? Tougher questions than that will arise.

Even before debates over the use of social tools in a healthcare setting wane, mLearning projects will crop up to explore the growing potential.