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President's Message
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Pushing Mobile Apps to Reduce Acute Care Episodes
Clinical Integration: The Grand Vision for Succeeding Under Health Care Reform
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Pushing Mobile Apps to Reduce Acute Care Episodes
Sam Hopkins, Sr. Writer Johns Hopkins Carey Business School

Getting sick often happens suddenly. Getting better requires patience and a plan. As health care administrators look for more efficient ways to prevent relapses into illness and readmission to hospitals for acute cases, they are increasingly turning to mobile broadband technology.

The company Health Recovery Solutions was formed in response to the demand for easy-to-use information tools, with appropriate data-driven technology and a human element that makes everyone involved in patient recovery feel more informed and empowered.  Co-founder and CEO Jarrett Bauer worked as a health care industry consultant prior to completing the Global MBA program at the Johns Hopkins Carey Business School.  From his professional experience and education, he knew how to assess market opportunities and recommend strategies for growth to health care organizations, but it was a bout of illness suffered by his grandmother that clarified his entrepreneurial goals.

What Bauer’s grandmother and every other heart failure and COPD patient needed to avoid after hospitalization was passing through those emergency room doors again. Bauer spoke with CFOs of major health systems and hospitals to validate his hypothesis that readmission was a growing problem for them, too. Yes, they told him, the readmission rate is a problem, but they would tackle when penalties came into play.

That time has come, with the Affordable Care Act causing hospitals and accountable care organizations (ACOs) to take a closer look at ways to keep patients and their allies informed and proactive about preventive care that keeps them out of the ER or ICU.

Once Bauer saw the problem and validated the desire to solve it, he integrated a business launch into his second-year MBA curriculum. “I looked at it as a chance to learn as much as possible in the first semester,” he said, “then focus on the Johns Hopkins-wide business plan competition in the spring.” First, he recruited team members, and they prepared to compete. The competitions went well, so his team applied to several technology accelerators related to health care, landing at New York-based Blueprint Health.

The software that they built not only educates high-risk patients about their specific diseases in the hospital, but also serves as a guide to helping them manage when they are leave, reminding them to take medications on schedule, weigh themselves, monitor their blood pressure, and communicate with their medical teams.  The information collected on 4G tablets is then sent back to the discharging hospital and care givers. With key milestones to reach and quizzes testing comprehension, it’s like a class for elderly patients—one where passing or failing could mean the difference between health and illness.

After more than a year of conducting a 50-patient, randomized nurse-assisted study based at Hackensack University Medical Center and Holy Name Medical Center in New Jersey, researchers who examined the data found an 8% readmission rate among patients who went home with the Health Recovery Solutions platform. That contrasts with a 28% readmission rate for the control group of patients who received usual hospital care but did not receive the 4G tablets. 

Another health-related technology tool with a Johns Hopkins connection is the eMOCHA platform created by physicians and researchers at the university’s Center for Clinical Global Health Education. Entrepreneur Sebastian Seiguer licensed the mobile health platform from Johns Hopkins in August 2013 to meet the demand for mobile health solutions in clinical settings. Developed by Hopkins clinicians and researchers, 15 eMOCHA apps have been deployed in 10 countries.

Seiguer's new company, eMOCHA Solutions, builds mobile health products that will give healthcare providers mobile access to patient data, with a focus on easing communication between providers and remote patients. There are three practical settings for this technology: patient management for clinical trials, where patient engagement can bring attrition down from over 30% in some recent Phase II & III trials. In a clinical setting, eMHOCA lets care providers interact with patient data from their mobile devices. “Clinical care professionals simply do not have the sophisticated tools they need to manage the increasing volume of electronic data being produced,” Seiguer says. Finally, eMOCHA can aid researchers in quickly and efficiently testing patient pools and collecting data.

In a recently-agreed pilot program, health care workers in Baltimore will use eMOCHA to monitor tuberculosis patients remotely as they self-administer medication. Centers for Disease Control rules require direct observation of therapy (DOT), which is costly when done in-person, but recently video supervision has been tested in California. EMOCHA has teamed up with Dr. Maunank Shah, a tuberculosis expert, and the CCGHE, to develop and launch the Baltimore City Pilot. In addition to uploading video, the same software will schedule medication refills, changes to regimens, and capture assessments filled out by the patient after video upload.  

The intersection of mobile broadband technology and healthcare has attracted many entrepreneurs who recognize the potential for efficiency gains and cost savings when multiple health care stakeholders participate in patient-centric networks.