| Date post: | 15-Jul-2015 |
| Category: |
Healthcare |
| Upload: | clickmedix |
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ClickMedixConnected mHealth platform to enable healthcare
organizations to serve more patients better, faster,
and at lower costs.
Ting Shih - Founder & CEO
http://clickmedix.com
ClickMedix has been deployed in 16 countries, through
90+ sites addressing different diseases
7
1
2
43
3
3
1
2
4
5 1
2
9
2 4
2
Medical
Government
Technology
Mexico IMSS
Corporate
ClickMedix Built a Strong Network of Customers and Partners
2008: Mobile Application for Tele-Consultation (HIV/AIDS,
cervical cancer, pre/post oral surgery)
• >$1M USD saved from transportations per year
• >90 women treated for cervical cancer (in 3 months) through mid-wives screening for
cancer
• Thousands of patients with increased access to care per year
• Transitioned process and service model to Botswana government
In the past 18 months, ClickMedix enabled
Medtronic to screen 70,000+ patients with
just 9 health workers. They have also
doubled the number of treatments
performed in partner hospitals. Service
extending to in-hospital and patient
counselor follow-up care.
Health Worker Using ClickMedix to Capture Patient
Symptoms Information
1,000+ Cases Per Week
Most patients complains of diminished hearing
or itching
Images of CSOM (perforation of the middle-ear
causing diminished hearing, and deaf if untreated)
1. Serve more patients while lowering costs
through task-shifting
2. Connect healthcare providers
and community caregivers to enable
efficient care collaboration
3. Develop revenue model and
demonstrate ROI
ClickMedix Model to Scale Healthcare
Innovations
Diagnose Treat Follow
Up
Customize Patient Symptoms Collection Process to Enable
Screen-Triage-Tele-Consult Fitting Provider Workflow
Screen
&
Triage
Diagnose Treat Follow
Up
Engage,
Educate, and
Monitor
Task-Shift to Community Nurses / Health Workers to Collect Data
via Provider-Designated or Evidence-Based Protocols
Virtual Specialists
rural
rural
rural
urban
rural
Semi-rural
rural
urban
semi-ruralrural
semi-rural
Connect Healthcare Providers and Enable
Collaboration to Manage Patients
Clinics
Medical Centers
What We Learned and Applied to Achieve
Repeatable Outcomes
Repeatable Outcomes:
• Improve clinic efficiency: < 5 minutes per patient
• Increased patient access: < 3 days
• Improved quality of care through maximized right-referrals
• Improved patient experience
• <1 hour of training regardless of health worker education level
• Reduced costs of care: eliminate unnecessary procedures, delays, and travel costs
Overcame First-World Challenges
• Regulation: HIPAA-compliant, bank-level secure, on-device security
• Adoption: Customizable workflow, extensible to multiple diseases, easy to use for
providers and patients
• Scalability: one-click referral to additional patients or other providers and payors
• Sustainable payment models: additional patient referrals, private-pay or
reimbursement
Case Study 1: Tele-dermatology
• 5 published studies on efficacy from emerging markets
• Transitioned to the US through American Academy of
Dermatology and implemented in 27 clinics across 6
states (with UCLA, UPenn, Univ of Washington,
Harvard, etc.)
• 10-20 cases per week per clinic for patients who
otherwise wait 6-12 months to see a dermatologist
• Hospital system-wide implementation saw ~900
patients in 6 months; 500 from patient backlog resolved
in 4 months; captured reimbursement ~900*80 =
72,000
• Commercially replicated into private-pay and
reimbursable services
200+ health
assessments
in one day
Deployed to
20+ medical
personnel on
iPhone, iPad
Android
Healthcare &
education for
Grameen
America
borrowers
Launched in
NY,
September
2013
Case Study 2: Grameen PrimaCare, Community-Based
Comprehensive Care for Low-Income Latin Population
Developing US-Based Community Health Program for
Underserved, Low-Income, Uninsured Population
$49/month
Effective Community Engagement, Increases
Membership and Financial Sustainability
Case Study 3: Scaling Multi-Specialists Services to Collaboratively
Manage Diabetic Patients
Pharmacist Patient Education
Nutritionist
Nephrologist and Endocrinologist
• 25% growth annually
• Contracted by Insurers
• Collaborate with primary care physicians
• 25% growth annually
• Contracted by Insurers
• Collaborate with primary care physicians
• Doubled number of patients seen per day
• Task-shifted to care coordinator and medical
students for longitudinal patient follow-up
• Scaling model to medical schools in Mexico and
India
In 3 Months: Average A1C Drop of 1.66
(from 10.11 to 8.48)
Chronic Disease Management Requires Comprehensive Risk-
Assessment and Multiple Specialists
Complications
1<7.0
(<53
mmol/mol)
SBP < 130
DBP < 80
<100 or <70
with CVD
No
Symptoms
& No
Structural
Heart
Disease
At risk;
chronic
cough,
sputum
production;
normal
spirometry
No
Nephropath
y
No
Retinopathy
No Dental
Infection
No
Neuropathy
&
No PAD
18.5-24.9
No
Depressio
n
PHQ-9
score 0
27.0-7.9
(53-63
mmol/mol)
SBP 130-
139
DBP < 90
101-130
No
Symptoms
&
+Structural
Heart
Disease
GOLD 1 or 2
& 0-1
exacerbation
s/yr &
mMRC 0-1 &
CAT<10
Albuminuri
a
30-299 mg/g
Non-
Proliferative
Mild
Mild
Gingival
Inflammatio
n
Neuropathy 25-29.9
Minimal
Depressio
n
PHQ-9
score 1-4
38.0-8.9
(64-74
mmol/mol)
SBP 140-
149
DBP < 90
131-160
Symptomati
c
&
+ Structural
Heart
Disease
GOLD 1 or 2
& 0-1
exacerbation
s/yr &
mMRC ≥2 &
CAT≥10
Albuminuri
a
300-999
or
eGFR 30-
60
Non-
Proliferative
Moderate
Moderate
Gingival
Inflammatio
n
+PAD
&
+/-
Neuropathy30-34.9
Mild
Depressio
n
PHQ-9
score 5-9
49.0-9.9
(75-85
mmol/mol)
SBP <150
DBP 90-99161-190
Symptomati
c
w/
Heart
Failure
GOLD 3 or 4
& ≥2 exacerbation
s/yr &
mMRC 0-1 &
CAT<10
Albuminuri
a
1000-2999
or
eGFR 15-29
Non-
Proliferative
Severe/
Inactive
Proliferative
Severe
Gingival
Inflammatio
n
+ Ulcer
History35-39.9
Moderate
Depressio
n
PHQ-9
score 10-
14
5 > 10.0
(≥86
mmol/mol)
SBP > 150
-or-
DBP > 100
>191
Refractor
y Heart
Failure
GOLD 3 or 4
& ≥2 exacerbation
s/yr &
mMRC ≥2 &
CAT≥10
Albuminuri
a
>3,000
or
eGFR ≤15
Active
Proliferative
Acute
Dental
Infection
Previous
Amputation
≥40 or
<18.5
Severe
Depressio
n
PHQ-9
score ≥15
Patient Receives Health Score Card, along with Care
Plans and Service Referrals
BMI
1<7.0
(<53
mmol/mol)
SBP < 130
DBP < 80
<100 or <70
with CVD
No
Symptoms
& No
Structural
Heart
Disease
At risk;
chronic
cough,
sputum
production;
normal
spirometry
No
Nephropath
y
No
Retinopathy
No Dental
Infection
No
Neuropathy
&
No PAD
18.5-24.9
No
Depressio
n
PHQ-9
score 0
27.0-7.9
(53-63
mmol/mol)
SBP 130-
139
DBP < 90
101-130
No
Symptoms
&
+Structural
Heart
Disease
GOLD 1 or 2
& 0-1
exacerbation
s/yr &
mMRC 0-1 &
CAT<10
Albuminuri
a
30-299 mg/g
Non-
Proliferative
Mild
Mild
Gingival
Inflammatio
n
Neuropathy 25-29.9
Minimal
Depressio
n
PHQ-9
score 1-4
38.0-8.9
(64-74
mmol/mol)
SBP 140-
149
DBP < 90
131-160
Symptomati
c
&
+ Structural
Heart
Disease
GOLD 1 or 2
& 0-1
exacerbation
s/yr &
mMRC ≥2 &
CAT≥10
Albuminuri
a
300-999
or
eGFR 30-
60
Non-
Proliferative
Moderate
Moderate
Gingival
Inflammatio
n
+PAD
&
+/-
Neuropathy30-34.9
Mild
Depressio
n
PHQ-9
score 5-9
49.0-9.9
(75-85
mmol/mol)
SBP <150
DBP 90-99161-190
Symptomati
c
w/
Heart
Failure
GOLD 3 or 4
& ≥2 exacerbation
s/yr &
mMRC 0-1 &
CAT<10
Albuminuri
a
1000-2999
or
eGFR 15-29
Non-
Proliferative
Severe/
Inactive
Proliferative
Severe
Gingival
Inflammatio
n
+ Ulcer
History35-39.9
Moderate
Depressio
n
PHQ-9
score 10-
14
5 > 10.0
(≥86
mmol/mol)
SBP > 150
-or-
DBP > 100
>191
Refractor
y Heart
Failure
GOLD 3 or 4
& ≥2 exacerbation
s/yr &
mMRC ≥2 &
CAT≥10
Albuminuri
a
>3,000
or
eGFR ≤15
Active
Proliferative
Acute
Dental
Infection
Previous
Amputation
≥40 or
<18.5
Severe
Depressio
n
PHQ-9
score ≥15
Patient Receives Health Score Card, along with Care
Plans and Service Referrals
BMI
10,83
1
Case Study 4: Pharmacist-Driven Care Coordination
and Referrals
Pharmacy-facilitated disease management and expanding
to 500 pharmacy stores, affiliated insurer and hospitals
ClickPharmacy Application
Application to US: CA Senate Bill 493 Authorized Clinical
Pharmacists to Manage Patients and Coordinate Care
Nurse, pharmacist, or case manager helps patient
with assessments
Remote specialists
responds with diagnosis and
treatment advice
Advises on medications, educate patients, recommend products and services (MTM
Reimbursement potential)
Schedules for follow-up visits and reminders
ePrescriptionHome monitoring
(glucose meter,
blood pressure
cuff, etc.)OTC and
Prescription Drugs
Community Pharmacist-Facilitated Chronic Disease Management
Aggregate Proven Solutions to Improve Care While Lowering Costs
for Patients with Diabetes, CHF, COPD, Mental diseases
Existing
Patients
(claims
data, etc)
Communit
y Clinics
Home care,
patients,
and their
care givers
StratifyScreen Triage
60%
20%
20%
Intervene
Specialist
consultation
Case Management
Programs
Wellness Programs
Follow-up periodically
Pharmacies
Pharmacies/
Clinics
Easy to Deploy: Chronic Disease Management Application to
Community Clinics, Pharmacies, and Patient Homes
1. Configure Mobile Applications to Enable Patients
to Fill Out Self Assessments
2. Capture Comprehensive Data for Remote
Management by Specialists Via Mobile Devices
3. Decision Supported Assessments to Ensure Best-
Practice Protocols are Followed
4. Tele-Refer to Specialists
5. Doctor in Call-Center Can Also Help Triage
and Tele-Consult
6. Contact Patient to Provide Results and
Schedule Follow-Ups
1<7.0
(<53
mmol/mol)
SBP < 130
DBP < 80
<100 or <70
with CVD
No
Symptoms
& No
Structural
Heart
Disease
At risk;
chronic
cough,
sputum
production;
normal
spirometry
No
Nephropath
y
No
Retinopathy
No Dental
Infection
No
Neuropathy
&
No PAD
18.5-24.9
No
Depressio
n
PHQ-9
score 0
27.0-7.9
(53-63
mmol/mol)
SBP 130-
139
DBP < 90
101-130
No
Symptoms
&
+Structural
Heart
Disease
GOLD 1 or 2
& 0-1
exacerbation
s/yr &
mMRC 0-1 &
CAT<10
Albuminuri
a
30-299 mg/g
Non-
Proliferative
Mild
Mild
Gingival
Inflammatio
n
Neuropathy 25-29.9
Minimal
Depressio
n
PHQ-9
score 1-4
38.0-8.9
(64-74
mmol/mol)
SBP 140-
149
DBP < 90
131-160
Symptomati
c
&
+ Structural
Heart
Disease
GOLD 1 or 2
& 0-1
exacerbation
s/yr &
mMRC ≥2 &
CAT≥10
Albuminuri
a
300-999
or
eGFR 30-
60
Non-
Proliferative
Moderate
Moderate
Gingival
Inflammatio
n
+PAD
&
+/-
Neuropathy30-34.9
Mild
Depressio
n
PHQ-9
score 5-9
49.0-9.9
(75-85
mmol/mol)
SBP <150
DBP 90-99161-190
Symptomati
c
w/
Heart
Failure
GOLD 3 or 4
& ≥2 exacerbation
s/yr &
mMRC 0-1 &
CAT<10
Albuminuri
a
1000-2999
or
eGFR 15-29
Non-
Proliferative
Severe/
Inactive
Proliferative
Severe
Gingival
Inflammatio
n
+ Ulcer
History35-39.9
Moderate
Depressio
n
PHQ-9
score 10-
14
5 > 10.0
(≥86
mmol/mol)
SBP > 150
-or-
DBP > 100
>191
Refractor
y Heart
Failure
GOLD 3 or 4
& ≥2 exacerbation
s/yr &
mMRC ≥2 &
CAT≥10
Albuminuri
a
>3,000
or
eGFR ≤15
Active
Proliferative
Acute
Dental
Infection
Previous
Amputation
≥40 or
<18.5
Severe
Depressio
n
PHQ-9
score ≥15
7. Patient Receives Health Score Card, along with Care
Plans and Service Referrals
BMI
Expected Outcomes for Health Organizations
Improved patient care (outcome metrics for patients)
• Decreased time to access doctors and treatment (< 3 days)
• Decreased number of unnecessary hospitalizations (up to 55%)
• Increased patient education
• Increased patient satisfaction
• Improved CMS Star Rating and HEDIS Measures (diabetes example)
o Increased number of patients with improved Hb1Ac
o Increased number of patients with improved blood pressure
o Increased number of patients with improved cholesterol (LDL)
o Increased patients screened for diabetes retinopathy
o Increased patients with neuropathy assessment
o Increased patients with foot examination
Process Metrics
• Increased number of patients screened for health risks
• Increased number of patients managed
• Decreased time to obtain treatment advice from multiple specialists
ClickMedix
Medical
Experts
Hub
Phar-
macies
Clinics
HomesPhar-
macies
Clinics
Homes
Phar-
macies
Homes
Clinics
Payors &
Third-
Party
Data
Systems
BMI
Full Scale-Up: Aggregate Population Health Data and
Deliver Right Treatments to Improve Health Outcomes
ClickMedix
mHealth Innovations in Disease Management
Ting Shih - Founder & CEO
@clickmedix
http://clickmedix.com
Products Features
•ClickDiabetes mHealth Training•Tele-Dermatology Training
•Tele-Geriatric Care Certification Training
•Tele-Cardiology Training
ClickMedix Solution Summary: Ready-to-Use mHealth and mTraining Programs
HIPAA-compliant system with all features accessible on mobile phones or web browsers Remote diagnosis with store-and-
forward Real-time video consultation Triage protocols Customizable patient forms Patient portal, education & adherence
monitoring Electronic health record system ePrescription
•Diabetes•Primary Care•Geriatric Care
•Maternal & Pediatric Care
Multi-media (image, video, slideshow) training materials
Self-assessment quizzes Remote consultation with instructors Continuous updates of training
materials Online examinations/certifications
Click-Health
Hospitals & Health
Programs
Click-Training
Click-Specialists
•Tele-ENT (ear, nose, throat)•Tele-Dermatology•Tele-Radiology•Tele-Cardiology•Pre/Post Surgery
