What is the relationship between mobile health technology and meaningful use? According to Kevin Larsen, M.D., chief medical information officer and associate medical director of 420-bed Hennepin County Medical Center in Minnesota, “mobile is the cornerstone of true meaningful use.”
Speaking at the World Congress 3rd Annual Leadership Summit on mobile health in Cambridge, Mass., on July 28, Larsen described some of the groundbreaking work the public safety net hospital has done to push its Epic EHR implementation out to physicians’ mobile devices, to provider teams in the field, and to patients through a smartphone patient portal application. “The future of healthcare is convenience, integration, and connection with best evidence,” Larsen says. “To deliver financial value and efficiency, we need to get information and tools to where they are needed.”
Kevin Larsen, M.D., CMIO, Hennepin County Medical Center
One of the first steps Hennepin took in its mobile effort was to virtualize its Epic implementation using Citrix technology so the software became much more device-independent. Physicians started using Epic on their iPhones and tablets, even though the application wasn’t optimized for those devices.
Laptops with aircards are enabling Hennepin care teams to introduce new care models that take care and the Epic record to the patient. Physicians and nurse practitioners in Minneapolis are working with the homebound elderly and in 25 nursing homes. “Having the full medical record with them is a huge win for care coordination,” Larsen notes. “It is no longer a faxing game or a phone call game to troubleshoot issues. Now they have access to the full records and their chart notes are instantly made part of the record once they are entered.” (One issue, he said, is the spottiness of cellular data networks and the fact that most nursing homes haven’t invested in wireless technology.)
For the last six months, the medical center’s MyChart patient portal has been available as an app for the iPhone, iPod, and iPad that users download from iTures.
Patients can see appointments, health advisories, medication lists, and after-visit summaries. “Many of these features are part of Stage 1 and Stage 2 meaningful use requirements related to patient engagement, Larsen noted.
Hennepin is now working with Epic on an iPhone app for its providers that it plans to roll out in December. Stage 1 will include patient lists, lab results, and medications. Stage 2 will add e-prescribing, voice recognition, and a camera phone application. Photos taken with a camera phone of something like a patient’s rash will be added directly to the patient’s record. “That has huge potential, as does voice recognition on the smart phone for recording notes,” Larsen says.
Larsen envisions a physician watching a baseball game at the ballpark being able to respond to a request for help, review a patient’s record, and make a change to a prescription using her iPhone, all during the seventh-inning stretch.
Larsen also mentioned that Hennepin is ready to attest to Stage 1 of meaningful use for Medicaid providers but has been delayed for a few weeks by the state government shutdown.