Many health systems are recognizing the impact of consumerism on healthcare delivery, and the need to respond to consumer demand for personalized care. At the same time, hospital and health system leaders also are seeing an opportunity to leverage digital tools to help patients manage chronic conditions with the overall goals of improving care and reducing hospital readmissions.
At Nemours Children’s Health System, senior executive leaders developed a new digital health strategy with an eye toward meeting consumers where they are, while also helping the health system in its transition to value-based care and reimbursement. Nemours is a pediatric health system that operates Nemours/Alfred I. duPont Hospital for Children in Wilmington, Delaware and Nemours Children’s Hospital in Orlando, Florida, along with major pediatric specialty clinics in Delaware, Florida, Pennsylvania and New Jersey. As part of a broad effort by the health system to put more digital tools in the hands of patients, particularly those with chronic conditions. Nemours Children’s Health System recently launched a new mobile app for pediatric asthma patients and their caregivers.
The asthma app is the first product to be released by the Nemours’ Center for Health Delivery Innovation, which opened in 2016, and will be the first of several disease-specific tools designed to help patients and families better manage their chronic conditions by integrating the patient and clinician experience into one platform. The asthma app is now being piloted and is scheduled to be released through the Apple store in early 2018. Next year, Nemours plans to roll out two more specialty apps for diabetes and cardiac care.
As part of Nemours’ digital health strategy, these disease-specific tools for chronic disease management integrate electronic health record (EHR) data, the health system’s homegrown CareConnect telehealth platform, data from an informational website run by the health system, called KidsHealth, and a suite of connected home monitoring tools. The asthma app is a first step in the health system’s efforts to centralize all of the health system’s digital programs in order to give patients a “one-stop shopping” experience, according to health system leaders.
“This app is a model for Nemours, demonstrating how digital health allows us to meet families wherever they are and fulfill our commitment to the medical home model,” Gina Altieri, senior vice president and chief of strategy integration at Nemours Children’s Health System, says. “Our goal is to better engage with families, understand what is happening between visits, help families manage chronic conditions, and improve outcomes of care” and reduce hospital readmissions.
Tackling Asthma through Digital Tools
Unlike average health apps that track fitness or eating habits, the Nemours’ digital asthma tool provides digital synchronization between self-care and the doctor’s office. The goal is to offer patients access to care, anytime or anywhere, and encourage them to participate in care whenever it is necessary, PJ Gorenc, operating officer at the Nemours Center for Health Delivery Innovation, says.
“The piece that makes this a little bit different than what we’ve seen in the marketplace, what we’re calling our special sauce, is that this digital experience is designed to sit in the space between the patient and the clinician and provide a two-way conduit. It’s not just putting tools into the pockets of patient families; it’s supporting that care plan and the relationship with the clinician, and getting that real-time data into the tool and sent back to the clinician, so the clinician has better insight into what is happening with their patient in between visits,” Gorenc says.
He adds, “The idea is that the clinician can modify the care plan appropriately based on objective data that’s real and reliable. We’re also providing patients with the tools that support that care plan, and helping them to adhere to it, and hopefully making it easy for them to do the things that are appropriate for their condition.”
The app is designed with a patient-facing, user-friendly interface in which patients or their caregivers can tap through a series of questions and quickly determine if they are in the green, yellow or red zone. “The whole thing is designed to take less than three seconds. That information is being fed back in to the clinician, on a daily basis,” Gorenc says. “We’re also correlating all that information with air quality indexes. We’re providing push notifications through the app, if air quality is at a level that someone with asthma should be worried about. We’re also storing that air quality information along with all that data so that the doctor knows what was going on in the atmosphere that day,” he says.
The asthma app supports the use of physician ordered home-monitoring tools, such as a breath-flow monitor and a digitally connected stethoscope, provides video instructions for inhaler use and allows families to keep a real-time digital journal of symptoms. In addition, the app enables better communication for telehealth visits with asthma specialists. This important feature, Gorenc says, is to enable telehealth to be a tap away for families and caregivers. “Just one tap to be able to see a Nemours clinician who can see and hear their child and help them understand whether this is serious and the child needs to go to the emergency room, or if they can just follow their asthma action plan at home,” he says.