Conference Coverage

A unified app platform helps gastroenterologists achieve a digital transformation


 

EXPERT ANALYSIS FROM AGA PARTNERS IN VALUE 2019

– A gastroenterologist-founded tech firm is making big waves in digital health care as Rx.Health, a spinoff from Mount Sinai Hospitals, New York, partners with the American Gastroenterological Association and other professional societies to deliver health solutions to the palms of patients’ hands.

Ashish Atreja, MD, MPH, chief innovation officer of medicine at Mount Sinai Hospitals, New York Kari Oakes/MDedge News

Dr. Ashish Atreja

“I would make the argument that disruption doesn’t have to come from the West Coast. It can come from savvy East Coasters, as well as Midwesterners, as well as Southerners,” said Ashish Atreja, MD, MPH, chief innovation officer of medicine at Mount Sinai Hospitals, New York.

At his home institution, where Dr. Atreja also serves on the gastroenterology faculty at the Icahn School of Medicine, the discussion about digital health began as Mount Sinai experienced rapid expansion. “So that has been a learning ground for us – to say, ‘What is happening across different hospitals? How are we going to standardize care?’ ” he said, speaking at the AGA Partners in Value Meeting.

“We’re looking at digital health to do it,” and the digital initiative dovetails perfectly with the strong value-based health mission of Mount Sinai, he added. “We say that, if our hospital beds are filled, then we are failing,” although the institution’s biggest revenue stream is from inpatient care. “We really have to look beyond the four walls of the hospital to provide care.”

The digital innovation laboratory at Mount Sinai was set up about 6 years ago, making it one of the first such centers in the country. It took about a year to build a team that had the technical skills to build apps in house, but once the ball got rolling, “it has been a fascinating journey,” said Dr. Atreja.

Innovation doesn’t always mean adoption

When Dr. Atreja and his colleagues took apps that were powerful data collection tools and put them out for general patient use, “We only saw 6% adoption ... because the patients forgot the names. They mistyped the names. They got lost in 60,000 apps. They forgot the activation code.

“And even if they got all of this, 20% of patients didn’t have space in their smartphones anyway.”

That’s when Dr. Atreja and his collaborators realized they didn’t really have an innovation problem, but rather a transformation problem – they needed to change the existing digital patchwork into a clinically meaningful intervention.

At this turning point, the Mount Sinai digital innovation team realized physicians could use evidence-based apps “and actually prescribe them – much the same way that you prescribe medication. ... So this was our ‘aha’ moment 3 years ago,” said Dr. Atreja.

Now, at Mount Sinai, apps are integrated with the electronic health record and can be prescribed with a few clicks. With the integrated digital prescription platform, patient activation of the apps has increased to 92%, said Dr. Atreja.

Currently, about 25 projects using this integrated system are being initiated within the Mount Sinai health system, and 35-50 external projects are underway in association with Rx.Health, a spin-off of the Mount Sinai efforts. Dr. Atreja serves as chief strategy officer for Rx.Health.

In all, 22 health systems are using the app platform at present, which bundles many facets of digital health – health education, remote monitoring, telehealth, secure messaging, to name a few.

The unified platform, said Dr. Atreja, “allows all of us – clinicians, business drivers, tech, researchers – to become creators and digital practitioners.”

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