September White Paper Series. Implementing a mobile health solution in the clinical setting

Transcription

1 September 2014 White Paper Series Implementing a mobile health solution in the clinical setting

2 Table of contents Introduction / 02 Step 1: Identify a clinical champion and project team / 03 Step 2: Engage key decision makers early / 04 Step 3: Develop a project outline / 05 Step 4: Workflow mapping & implementation planning / 07 Step 5: Gather patient feedback / 08 Step 6: Community building & staff training / 09 Step 7: Go live / 10 Step 8: Iterate and monitor your success / 11 Step 9: Transition to long term adoption / 12 Have a question? / 13

3 Introduction Despite significant growth in the digital health industry in recent years, adoption of mobile health in the hospital and clinic setting is still in its nascent stages. In contrast with other industries, the complexities of the clinical environment create unique challenges for clinicians and administrators looking to adopt and evaluate new mobile health solutions. For almost two years, SeamlessMD has been working closely with providers to implement our mobile health solution in various clinical settings. As we progressed, it became clear that many hospitals lack a process for implementing mobile health solutions. Since then, it has become a mandate of ours to help providers through that process. We have come to realize that technology alone is not the solution. An effective mobile health solution requires both excellent technology and effective implementation of that technology in the clinical setting. We believe that for technology companies, it s our job to deliver both. In this White Paper, we share the following 9 steps our team at SeamlessMD takes with providers from ideation to implementation. Whether you want to adopt a patient engagement platform, remote monitoring solution or any other mobile health platform, this is a relevant process for you. We have iterated this process over time, and we will continue to iterate as we develop best practices with our partner hospitals. We hope that by sharing this process, we will make it easier for providers to avoid key mistakes and have more successful adoptions of mobile health solutions. Key steps for mhealth adoption 1. Identify a clinical champion and project team 2. Engage key decision makers early 3. Develop a project outline 4. Workflow mapping & implementation planning 5. Gather patient feedback 6. Community building & staff training 7. Go live 8. Iterate and monitor your success 9. Transition to long term adoption Implementing a mobile health solution in the clinical setting 2

4 Step 1: Identify a clinical champion and project team Every successful implementation needs strong leadership and an effective core team. An effective clinical champion has the following 4 traits: Traits Details Vision This person has a vision for how the project will look and feel in its final state Drive This person is highly motivated for the project to succeed and has the passion to keep moving the project forward over time Authority This person has the authority to make key decisions for the implementation of the project Influence This person is respected inside the organization and is successful at getting buy-in from the leadership team and other key stakeholders It s not hard to identify the right clinical champion. This is usually someone in a combined clinical and administrative role, who is also very vocal and excited about the project. Of course, the clinical champion needs to be surrounded by an excellent team to help execute on his or her vision. The project team should include a mixture of key clinical and administrative leaders in the department where the solution is being implemented. Implementing a mobile health solution in the clinical setting 3

5 Step 2: Engage key decision makers early It is not uncommon for the project team to want to quickly get the project off the ground, review the data afterwards, and then submit a business case study to key decision makers for longer-term adoption of the solution. However, by not engaging key decision makers early (e.g. hospital leadership team), the project team runs the risk of designing a project with the wrong scope and metrics that are not important to the leadership team. The leadership team s guidance is important for the project team to understand the high priority problems for the organization and what success criteria to optimize for. While this can take a bit of time, it s an important investment for the longevity of the opportunity. Implementing a mobile health solution in the clinical setting 4

6 Step 3: Develop a project outline The project team should develop a project outline that addresses the following: Category Details Scope What is the size of the project and which patient population does it impact? You should be able to describe your target patient population (e.g. hip replacement surgery patients) and target patient volume for the project (e.g. 300 patients in the next 6 months). The scope of the project should be determined in consultation with the key decision makers. Often, they will highlight target populations and high-priority problems that the project team might not otherwise have considered. Key metrics & success criteria How will you know the project was successful and that the mobile health solution created value? Likewise, the metrics and success criteria should be determined upfront in consultation with the key decision makers. This will best position the project team for potential long-term adoption of the solution. Some example metrics and example success criteria for patient-oriented mobile health solutions include: 1. Patient satisfaction Metric = satisfaction survey scores Success = 80%+ satisfaction 2. Patient engagement Metric = % of patients using the solution daily Success = 75%+ daily active engagement 3. Patient outcomes Metric = 30-day readmission rate Success = 10% decrease in readmissions Implementing a mobile health solution in the clinical setting 5

7 Product requirements What requirements must the mobile health solution satisfy? The mobile health solution will often come with standard features. The project team should review the solution closely and, whenever possible, determine upfront if any additional changes need to be made. It is not uncommon for the clinical team to get excited the first time they see a mobile health solution, and realize a key feature they need months later. It is important for the project team to review the solution carefully, begin imagining how their patients and staff will interact with it, and identify any key issues or needs right away. Approval processes What approvals are needed before the project can go live? The project team should find out early what approvals are required before a project goes live. Depending on the site, potential approvals required may include: Ethics board review Privacy assessment IT assessment Legal contract review Because each of these processes vary in length, it is important to engage each of these departments early and simultaneously. Otherwise, you run the risk of project delays, which can hurt the momentum of the team. Timeline What are the high-level milestones moving forward? Together, the project team and technology company should outline upcoming key milestones and their estimated completion times. A tentative go-live date should be set so everyone has a goal to work towards. Implementing a mobile health solution in the clinical setting 6

8 Step 4: Workflow mapping & implementation planning Every clinical workflow and patient pathway is different depending on the hospital or clinic. It is important that the technology company and project team sit down and map out the entire patient pathway and the patient s interactions with various healthcare providers. What can be particularly helpful is to let the technology company observe some patients move through the pathway. They can often lend a fresh pair of eyes and draw some key insights about the patient experience. The project team can then better understand the impact of the technology on the patient pathway and clinical workflow. These new insights will help the team identify the appropriate touch points for introduction and reinforcement of the technology in the patient pathway. This also helps determine which clinicians and other stakeholders are impacted by implementation of the solution. Keep note of who those stakeholders are, as you will want to make sure they are well-informed of the project, you obtain their buy-in and you understand how they need to be trained before the project goes live. Finally, make sure you involve the technology company in this process. As they have done implementations before, their learnings from other clinical settings can be very useful for your own implementation. Implementing a mobile health solution in the clinical setting 7

9 Step 5: Gather patient feedback The characteristics of a patient population can change from site to site, and from region to region. A mobile health solution that is incredibly successful in one region may need to be tweaked to meet the needs of patients in another region. As a result, it helps to gather a focus group of patients to try the solution and provide feedback in a controlled setting. For example, you could hold a focus group and get feedback on usability, language, utility, etc. This allows any obvious changes to be made before the project goes live. Implementing a mobile health solution in the clinical setting 8

10 Step 6: Community building & staff training It is important to build momentum in your organization for the project and create excitement for the future. Large group information sessions should be held to educate the overall organization on this exciting new project. In addition, by communicating your efforts to the whole organization, the team is forced to be accountable for the success of the project. This is a good thing. In addition, the hospital or clinic staff who will be directly affected by the implementation must be trained well on their specific roles, why this project is important and the overall goals they are contributing to. You want them as excited and driven for this project as you. You want them to know the solution inside out the way you do, and be prepared to help patients through this implementation. Why does this matter? Your patients take the advice and recommendations of their healthcare team seriously. As a result, the hospital or clinic staff play a big role in encouraging their patients to use the solution. If the healthcare team does not believe in the solution, then their patients will not either! Implementing a mobile health solution in the clinical setting 9

11 Step 7: Go live Assuming everything is ready and you have hit all your milestones, it s time to flip the switch and go live! Of course, there s more to it than that. While implementations would ideally go off without a hitch, the reality is that there are always kinks to work through that you did not expect. That s perfectly okay, but it s important that you keep close tabs on the project for the first month or so and get regular updates so you can fix problems quickly. You should also keep representatives from the technology company on site for the first few weeks. This way they can fix any technical issues immediately, and they can help you work through any problems in the implementation process. Remember, since the technology company has done implementations before, you should look to them as a resource with the know-how for addressing common problems you may face early on. Implementing a mobile health solution in the clinical setting 10

12 Step 8: Iterate and monitor your success The project does not stop once the pilot goes live. In fact, you should approach the project as an iterative process, where your goal is to have an excellent program by the end of the pilot project, which can then be extended into a longer term program. The project team and the technology company should re-group on a regular basis to review project progress and make improvements to both the solution and the implementation. This should happen weekly for the first month or so, and then it can move to monthly for several months as the kinks get worked out. If the technology company is collecting data for you, you should ask for a monthly progress report so that your team stays informed and motivated on the success of the project. More importantly, if together you identify certain metrics that are not doing well, you know can begin working to find ways to improve those metrics. Your team, in turn, should use this data and your own internal reviews to send regular reports to the key decision makers. This allows you to keep your project in the leadership team s mind, maintains their excitement and supports a smoother transition from pilot project to long-term adoption. Implementing a mobile health solution in the clinical setting 11

13 Step 9: Transition to long term adoption As we mentioned earlier, it s not a good idea to first complete a pilot project, keep the results under wrap and then present your case study to the decision makers for longterm adoption. Why? Consider that you have just spent a significant amount of time training your staff and getting them used to a new solution in their workflow - and now you are going to end the project, disrupt the workflow and wait what could be months before the leadership team makes a decision? When the leadership team finally does decide to adopt the solution long-term, you may have to retrain your staff, rebuild momentum, etc. That s not a good use of resources and time. This is why we suggest keeping your decision makers updated with reports on a regular (e.g. monthly) basis. Furthermore, you should work with your decision maker to decide on whether you will adopt this solution long-term before your pilot project is over. For example, you can start the discussion with the leadership team ½ to ¾ of the way through the project. This way, if you ultimately want to keep using the solution, you can reach an agreement with the technology company and your program will continue after the project end date without any disruption in the staff workflow. Implementing a mobile health solution in the clinical setting 12

14 Have a question? We hope you found this primer on adopting a mobile health solution in the clinical setting helpful. At SeamlessMD, we are more than happy to share our experiences and the lessons that we have learned. We are incredibly passionate about working with others to build the digital health ecosystem and advance patient care forward. If you have a question, comment or thought, we would love to hear from you! Contact us info@seamless.md Implementing a mobile health solution in the clinical setting 13