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iVisit Wiki



Proposal Summary



Demo




iVisit Summary

We are interested in creating the process and best practices for a remote check-up/routine appointment service. The primary objective of our service would be to save time, money, and overall patient satisfaction and convenience. For now, our service's platform will be either a mobile application or web application (potentially both). iVisit will function as a scheduling and meeting environment for patients and physicians, so that they can quickly and easily perform routine check-ups and other minor appointments (e.g. physicals, checking on a cold, a sore throat, etc). The system will ideally include peripheral tools that the patient will use to provide physician's preliminary data prior to each appointment.


1. Problem statement

During an average doctors visit you go to the office and enter the waiting room. Once in the office you are greeted by a nurse behind a glass windows where she forces you to fill out a form. Now the true test begins as you must wait in a small room filled with other sick people, babies, probably a weird smell, and annoying florescent lighting that is definitely not helping your nausea. Finally, after waiting for what seems like a lifetime, the nurse calls you into the back room, but not to see the doctor--now you have some basic health checks to do (height, weight, eye test, asking questions). Once the nurse is done with you, now you find yourself in another small room this time with a bed and paper for sheets. After another thirty minutes of waiting, the doctor comes out and introduces himself to you, and probably doesn’t even remember who you are despite him being your lifetime doctor. After about a minute or two, your ailment is diagnosed as an upper respiratory infection and you are prescribed some antibiotics. As you are about to leave, the nurse at the glass window stop you and ask for money. You look at your watch and find out it’s been 3 hours of your life wasted just for some antibiotics. With the help of technology, doctor visits like this one can some become a thing of the past, or at least far more seldom. iVisit is our group’s solution to this common issue.


2. Evidence to support the problem

According to Becky Wai from an online video service called VSee said that 900 million doctor visits took place in the US last year. According to that number, 50 percent could have been done remotely. Additionally according to a 2008 National Ambulatory Medical Care Survey, 30 percent of the 900 million were unnecessary visits that never had to happen. Considering the 50 percent with 450 million doctor visits being done at home it would save considerable time and money. The first reason is with a self-check up tool patients can diagnose themselves and if there is no problem then they will not have to meet with a doctor saving the 30 percent from happening. Another reason is the patient will get the self-check up and then meet the doctor saving the initial time of a checkup. A third reason is with less people needing to come in; those who are sick will have shorter wait times at the doctor's office.
Source


3. Potential solutions (list 3-5)

- Potential: Creating web-based service which allows users to input symptoms to perform an e-checkup, which then directs them to setting up appointments with chosen doctors
- Potential: Develop a tablet application used in doctor's office waiting rooms allowing patients to do a self check up before meeting with the doctor.
- Potential: Create an app which allows self check-ups based off a DSS that subsequently informs the user that they are either not very sick, or directs users to links for 3rd party eVisit services.
- Potential: Develop application which uses DSS based off patient symptoms, performing a self check up which can determine if the user is not very sick and only has a common cold (i.e. something minor).
- Chosen Solution: Develop an iOS application allowing users to meet with doctors using video or text, saving them time in determining if a real doctor's visit is needed.


4. Research on existing/alternate solutions tried by others

There are several services that provide online care for patients. One such service is MedCareLive that charges 45 dollars for a session with a doctor. Patients then meet by video conferencing with the doctor and are diagnosed through talking/discussing the problems the patient is having.
Source


5. Feasibility of each solution

- PHR security issues in mobile application
- Insurance integration problems (what insurance can/will the application accept)
- Risks with reliability of mobile diagnosis
- Higher risk of missed appointments (mitigated with frequent in-app reminders)
- Largest obstacle: developing the application and getting it to function without 100% reliability
- Slow physician adoption
- Integration with Apple and different peripheral hardware (mitigated through marketing, promotions, and reliability of functionality)
- Unexplored niche of e-health law: risks with missed symptoms causing lawsuits (or other similar situations)


6. Your chosen approach (and reasons)

Our group chose iVisit because the days of visiting the doctor in person are becoming more time-consuming and generally annoying for patients. We developed iVisit to revolutionize how health is assessed. There is no longer a need to sit in a doctor’s office, wait for an hour, and then only be given antibiotics. iVisit will save money and time for doctors and patients by eliminating the unnecessary portions of typical trips to the doctor. The ability to execute routine check-ups, as well as talk face-to-face with your doctor all over your iOS device is simply amazing. iVisit has the opportunity to be used Globally on all personal iOS devices as well as in waiting rooms at the doctor’s office.


7. Your timeline for completion

Fully assimilating iVisit into the medical field will take time. The Healthcare industry is notorious for being laggards when it comes to implementing new technology. It is expected to take another 3 to 4 years to fully integrate iVisit into healthcare. It will be very difficult to break the “mold” of normal doctor visits because the public is comfortable will their normal routine. However, comfort does not mean efficiency. We will strive to make iVisit the future of everyday trips to the doctor by:

  • collaborating with EMR’s, EHR’s, and PHR’s and attempting to implement their technology into ours.
  • allowing the general public to use the app for free on their personal iOS device.
  • making sure it is the easiest, most efficient way of conducting healthcare services in the modern era.


8. Team workload and roles

Tyler Kalarchian: Project Outline, Prototype, Wiki Editor
Jon Gluesenkamp: Project Outline, Prototype, Wiki Editor
Josef Rainer: Project Outline, Prototype, Wiki Editor
Conner Widergren: Research, Wiki Editor
Rachael Deja: Research, Wiki Editor
Andrew Marks: Research, Wiki Editor

9. Meeting minutes


Meeting #1:
9/24/13 after class
Present: Tyler Kalarchian, Jon Gluesenkamp, Josef Rainer, Connor Widergren, Rachael Deja, Andrew Marks
Summary: Two page outline is due next class, must finish it by tomorrow so it can be turned in Thursday. Keep updating the wiki and research some possible prototypes or existing technology in relation to the project.

Next Meeting: The next meeting will be next Tuesday after class.

Meeting #2:
9/31/13 after class
Present: Tyler Kalarchian, Jon Gluesenkamp, Josef Rainer, Conner Widergren, Rachael Deja, Andrew Marks
Summary: Great work on the two page outline. Prototype will be an image demo showing all intricacies of iVisit software.

Next Meeting: In a couple weeks due to midterms

Meeting #3:
11/5/13 after class
Present: Tyler Kalarchian, Jon Gluesenkamp, Josef Rainer, Connor Widergren, Rachael Deja, Andrew Marks
Summary: Prototype is due on Thursday, it is looking good and exactly what we think iVisit should be. The powerpoint presentation with the prototype has been made and will be turned in before Thursday.

Next meeting: There will not be one, we can communicate through the group chat and just fully update the wiki. Connor, Andrew, and Rachael will take care of that.


10. Solution prototypes

Our group has been developing an application that allows multiple functions your everyday doctors visit would consist if. The app allows a remote check-up/routine appointment service through your iOS device. From the beginning of the semester, our group has researched and created a prototype application that features many functions including Doctor ratings/favorites, Scheduling appointments, virtual doctor appointments, text based services, check and update your personal health record (PHR), and support functions. Our app also can be integrated with peripheral devices to help record and track data such as Withings Blood Pressure Monitor, Smart Body Analyzer, QardioCore, and iBGStar Blood Glucose Meter.

Begin Prototype:

Favorite Doctors
This feature of the applications will allow a user to choose their favorite doctors to meet with and send messages via iVisit.


fav doc.JPG



Schedule an iVisit
When a user needs to schedule a virtual appointment for iVisit, she can choose from her favorite, preselected doctors to meet with, select a payment type for the appointment, and set a date from a list of available choices.

schedule visit.JPG



Virtual Doctor Appointment
Once a user has scheduled an appointment with the doctor of her choice, she can access the virtual appointment feature to perform a routine check up, ask a specificquestion, have a conversation, or give the doctor important updates.
Virtual doc appointment.JPG

Text Based Services
If the user wants to talk to a doctor personally with even more convenience (without an iVisit or in-person visit), she can pick the doctor to message, select a payment type, and ask the chosen physician any specific question.

These services will use text and allow attachment of images or other data when relevant.

text based.JPG


Check/Update PHR with iVisit
This will be the basis of the iVisit PHR which will be primarily checked and updated by iVisit users themselves. However, if users allow, physicians will be able to check and update these records too.

The primary purpose of the iVisit PHR will be to facilitate the efficieny of iVisits, so doctors can see:
- Images uploaded by patients
- Key data uploaded from peripheral tools
- General patient information such as height, weight, blood pressure schedules, glucose readings, etc.

check update.JPG


Support
This portion of the application provides a way for users to report problems and bugs or to ask for help with using iVisit.

support.JPG

11. Final solution

Our application is not designed or intended to replace in-office doctor visits, but to help limit spend less time traveling to an appointment to record data, or symptoms that could easily be done from the comfort of your own home.

Full solution here:


12. Next steps


The next steps we have for our application involve the quickly advancing health care technology. The integration of more Public Health Records and peripheral devices will enable this app to record more data and complete different tasks done at an in-office visit at your doctors office. In order for this application to be able to launch, we would need to continue to tweak the project and hire an app developer to further create and build the application for us. Interviewing doctors, nurses, and patients would be beneficial to our product so we could gather ideas and inputs from all sides of the healthcare industry. Trial versions should be run after the final product is completed so any bugs can be fixed, and we can gather a viewpoint on how many customers/patients would access and use this app,.

13. Resources & Research


Health Vault Stuff
https://www.healthvault.com/us/en

5 Reasons Why Remote Visits Might Be Better
http://mobihealthnews.com/22215/five-reasons-virtual-doctor-visits-might-be-better-than-in-person-ones/

This company sells iPhone heath accessories like a blood pressure reader
http://www.withings.com/

Doctors use iPad to reprogram cardiac devices
http://mobihealthnews.com/15199/doctor-uses-ipad-to-re-program-implanted-cardiac-devices/

HealthTap service. Basically doctors answer questions in their free time. Could also be implemented into an iVisit app.
http://www.forbes.com/sites/tomiogeron/2012/06/28/healthtap-adds-micro-transactions-for-remote-doctor-chat/

Just another article about how insurance companies love remote doctor visits and how it makes things convenient for individuals
http://usatoday30.usatoday.com/money/industries/health/story/2012-04-27/virtual-doctors-telemedicine/54791506/1

iPhone compatible blood glucose monitor for diabetics
http://www.ibgstar.us/

“ER Wait Times: More Transparency with iTriage”
https://www.itriagehealth.com/promote-er-wait-times

General article on e-visit services
http://articles.latimes.com/2013/aug/23/health/la-he-edocs-20130824

Article from 2012 of unnecessary doctor visits. Anyone find a more recent study?
http://www.brewercompany.com/BrewerCompany/Utility-Nav/News--Events/Brewer-Thursday-Trivia/Trivia-2012/Thursday-03-08-12-Many-Visits-Unnecessary.htm

ECG Monitor
http://techcrunch.com/2013/10/28/qardio/