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mHealth Apps: Evidence-Based Analysis at the Point of Care

April 30, 2013
by Gabriel Perna
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In part two of a four-part interview series with mobile health (mHealth) app developers, Healthcare Informatics Associate Editor Gabriel Perna speaks with Jack Olexy, co-founder and vice president of information technology of eDoc4u.

The app, which was chosen by Allscripts (Chigaco, Ill.) as one of the 15 finalists for its open app challenge, provides evidence-based clinical analysis at the point of care for both patients and physicians. In a population health management environment, the information this app can provide is critical to closing the gaps in a patient’s care.

If eDoc4u wins the Allscripts’ app challenge, it will take home a $250,000 prize. The app will be judged on usability, integration, ease-of-installation, and other facets. Below are excerpts from the second interview in this series of four. Part 1 can be found here.

eDoc4u; Jack Olexy, co-founder and vice president of information technology


1) Explain what your app is and what it does?

The eDoc4u’s NCQA [National Committee for Quality Assurance] certified Automated Physician Extender aims to enhance clinical productivity, lower costs (at delivery and in the back office), and improve compliance among high-cost, chronically ill patients, and provide a personalized, automated follow-up programs for patients.  The app automates health risk assessments, and integrates this health risk assessment information with evidence-based clinical analysis at the point of care.  It gives patients measurements of their risks for preventable diseases, recommendations for preventing/managing chronic diseases, and personalized health programs with action plans.  It aims to help providers identify care gaps, and improve patient outreach by automatically tracking and managing a patient’s progress, participation, compliance, and satisfaction.  The app also can help providers transition to value-based care incentives, including P4P [pay for performance] reimbursements for quality and performance improvements.”
2) What was the inspiration behind this app?

Drawing from its success with employer population health management, eDoc4u wanted to provide clinicians with new services that extend beyond traditional EHR [electronic health record] functionality to engage patients in their ongoing health and behavior, and make an impact on the communications between patient and clinician in a closer, more trusting environment. We wanted to automate the Medicare health risk assessment; deliver new evidence-based solutions at point of care, save time in patient encounters and the back office, improve quality and efficiency of the encounter, better engage patients, increase patient compliance, and deploy mobile devices; reducing nurse visit calls. It’s an effort to improve patient satisfaction; and support patient-centered medical home [PCMH] initiatives.

 3) How do you envision clinicians using this? (Either directly or indirectly if it’s a consumer-based solution)

eDoc4u’s platform looks to extend the physician’s clinical, financial and quality capabilities with patient engagement and outreach, and integrates with Allscripts’ platform. For example, the platform will automatically identify top patient cost drivers (those with gaps in disease management care) within a practice and message / engage them in ongoing education and disease management tasks.  It will then notify clinicians of patient activity via the task notification process, as well as share patient specific disease prevention recommendations, Medicare health risk assessment conclusions for those over 65, health awareness program status to the EHR for clinician review.  This process reinforces the patient / clinician relationship leading to increased health outcomes, increased clinician revenue and decreased healthcare costs. 

4) If this data uses PHI, how does it safeguard data for HIPAA [Health Insurance Portability and Accountability Act] regs?

eDoc4u’s HIPAA-compliant SaaS [software as a service] application integrates with the Allscripts EHR by leveraging the UNITY framework over secure web services.  eDoc4u implements security techniques that safeguard data both at rest (Transparent Data Encryption (TDE) and in transit (256bit SSL).  All web service transactions between eDoc4u and Allscripts use REST [restructured text] syntax.  For example, eDoc4u establishes a secure Virtual Private Network (VPN) with the client’s Allscripts installation. All data is transacted between eDoc4u and the client’s Allscripts installation over this secure VPN.  With the VPN established, when eDoc4u requests data from the client’s Allscripts installation, we first acquire a security token from Allscripts. That token is then passed over SSL with each function call to Allscripts whether we are retrieving data or sending data to Allscripts. The token must be valid in order for data to be transacted between the two systems.

5) What would you do with the Phase 2 prize money if you won? How would you enhance the app?

We plan to invest the prize money in product enhancements that extend our vision and support future innovation objectives that have a measurable impact on patient care and outcomes.  We are just beginning to understand how to effectively influence positive healthcare behavior change in patients using new concepts such as gamefication, social networking and mobile technology.

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