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Apt app: Mobile phone program helps docs track patient info

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Dr. Andrew Pecora, chief innovation officer and vice president of cancer services at John Theurer Cancer Center at Hackensack University Medical Center.
Dr. Andrew Pecora, chief innovation officer and vice president of cancer services at John Theurer Cancer Center at Hackensack University Medical Center. - ()

A patient-doctor mobile app developed at Hackensack-Meridian Health has drawn praise during initial tests in advance of a rollout to health care providers and patients.

Developed by a team led by Dr. Andrew Pecora, chief innovation officer and vice president of cancer services at John Theurer Cancer Center at Hackensack University Medical Center, the app carries patient data across multiple mobile operating systems and platforms. A key difference between this app and others: Patient info isn’t limited to a specific health care provider.

The app is just the latest in a flurry of programs developed by many companies, including tech giant Apple, with its Health Record program that was released in March.

According to IDC Health Insights, digital mobile engagement will increase by 50 percent by 2019, and in 2020 one in four patients will use some form of an app to tote their health records and previous treatments with them when visiting a physician.

“It’s not that [doctors] don’t know what to do, they just need to be kept on course; it’s no different than a pilot landing a jet [plane] who knows what to do and could do it in their sleep,” Pecora said. “It’s nice to know that there is something to help to optimize the right decision.” 

“It’s not that [doctors] don’t know what to do, they just need to be kept on course.”

Dr. Andrew Pecora, founder and executive chairman, COTA.

Through Pecora’s app, a doctor can understand the prior treatments a patient has received for an issue, such as cancer and what has or has not worked. That information not only allows a doctor to provide the best possible options for continued treatment but also the most affordable care.

“We, like everyone else who are health care deliverers, have to pay attention to the cost of care because it is becoming unaffordable,” Pecora said. “To do that, and importantly to do that well, it is not going to happen by chance. It is not going to happen by saying to a doctor, ‘Your outcomes are not as good as they should be or your outcomes are fine, but you spend too much money.’ You have got to give them something more than that.”

The something more for Pecora is the patient’s treatment history, which doctors can access with a click of a few buttons on a tablet or other portable device, no matter the operating system.

“This [info] should be shared, this should be available to patients and doctors; this should follow the patients, it is their information, and we are going to work to share this information with the patient,” Pecora said. “It is our intent to make it available and go wherever the patient goes. This is something the patient can see.”

But sharing the information is not required, as federal laws regulate that process.

Since its pilot test phase, doctors have been providing feedback about the app to make it fit more easily into their daily workflow. One of the problems was the fact that information presented in the app was not easily understandable.

At this time, the app presents information to doctors in a numerical format. Each treatment or disease is identified by a number or series of numbers, which requires the treating physician to understand the numerical meanings.

Pecora said they have been working to improve that process and have made gains since this information is “being used in real time” at the John Theurer Cancer Center. “Doctors don’t want it to interfere with their workflow, so we made some changes. The information was not as clear as the doctors wanted it to be,” he said.

The app builds on Pecora’s previously developed CNA, or cota nodal address. The approach aggregates information from medical professions such as oncologists and presents that information numerically into specific categories, known as the CNAs.

“The cota nodal address tells the doctors about the patient’s history, age, sex and other important information about their disease in a numeric form,” Pecora said.

Ideally, each patient in a similar group should ultimately receive the similar treatment. Through that information, doctors and patients can determine the best and most affordable care.

Pecora likens this integration between CNA data and the app as “real-time decision support,” similar to what airplane pilots receive while flying.

“The basic premises is the vast, vast, vast majority of physicians want to do the right thing for their patients. But in the craziness of a busy workday, doctors make thousands of decisions, particularly hospital doctors, and they do this without any support,” Pecora said. “When you look at the airplane industry over the years, it’s nice to know that you have decision support. Doctors are not different. Doctors are people too, yet we expect them to do all this in their head, but it’s just not possible. We don’t have any real decision making support for doctors to keep them on the right glide path, so it’s time we give it to them.”

In the next several months, Pecora hopes the app will become available to a wider group in the patient-sphere, but more immediately he said it will be offered to a select group of users to test the interface.

He is optimistic about the app achieving its goals, especially on the cost front. The app will be free for patients to use, and he said based on its use by physicians it has resulted in “tens of thousands of dollars” in medical care cost savings.

“We’ve already seen people change behaviors resulting in substantial savings,” Pecora added. 

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