Let’s Keep You Out of the Hospital May, 2015 Presented to: Insert relevant presenter information Calibri 16pt Presented on: Month day, Year Presented by: Insert relevant presenter information here
My Girls 2
Stay Off the Couch 3
Golf 5
Dr. Kevin Most Experience • Convenient Care Physician • Medical Site Director • Convenient Care Medical Director • Senior Medical Director • Vice President of Medical Affairs • Chief Medical Officer, Northwestern Medicine, Central DuPage Hospital Education • University of Kansas, BS, Medical Technology • Midwestern University Medical School • Lutheran General Hospital – Family Practice Residency • University of Notre Dame – MBA 6
Thank You
Thanks for Watching WGN Channel 9
Be Safe at Home • Home is the one place you should be the safest. • Clean floors; no throw rugs - they cause falls and hip fractures. • Have bars added to your bathroom walls and shower. • Keep your cell phone within arms reach. • Change doorknobs to lever handles • Get good outdoor lighting, motion controlled • Have your electrical outlets raised • Laundry room on main floor, avoid stairs with laundry 9
Stay Active E XERCISE Y OUR B RAIN Read the Newspaper Sudoku Crossword Puzzles Join a Book Club 10
Stay Active E XERCISE Y OUR B ODY • Exercise 3-4 times a week • Walk, swim, bike - wear a helmet • Be aware of the weather - walk in the mall. • Exercise with friends - peer pressure - watch out for each other. • Keep your cell phone with you while you exercise • Stretch ! Know when to stop exercising. 11
Stay Out of the Hospital Medication Management T HE G OAL IS TO K EEP Y OU O UT OF THE H OSPITAL Do Don’t • • Take medication as directed Skip doses or cut pills in half • Keep a list of your meds • • Ask your doctor about Share medications or save options if medication is too medications expensive • • Use caution when Assume the new purchasing medication from medication is the same as outside the country the old medication 12
Medication Management Smart Phones • Use your cell phone to manage medical history. • Don’t know how to use a smart phone? Have your kids load it for you! • Store information such as: List of your medications List of your doctors, phone numbers List of your allergies and what happens List of previous surgeries • Consider also having it on paper. 13
Medication Management Multiple Doctors-Multiple Medication-No Communication • Drug Interactions Drug from one doctor may interfere with the drug from another doctor. • Smart Phone Applications (Apps) can help you to manage medications safely. Download an app for drug integrations Download an app for pill identification 14
Communication with Your Doctor Can we keep you out of the hospital if your doctor had info sooner? • What if you could do this with your What if you could send your health data to your doctor every day? smart phone and the data automatically went to your doctor? • Weight → signs of heart failure, signs • Your doctor could review it every day of depression, signs of cancer and look for trends or changes. • Blood pressure → impact on kidneys, • Could this help prevent hospital visits? heart disease, stroke - is your medication working? • Blood sugar → impact on diabetes • Pulse oxygenation → signs of pneumonia, heart failure, COPD, asthma • EKG → showing your heart activity • Lung sounds→ heart failure, pneumonia 15
Smartphones, Watches The future of medical information tracking 16
Medical Apps Will these impact physicians and hospitals? • Venture Capital investments are pushing billions into health related apps. • Cost comparison applications are skyrocketing. • Patients now want to make appointments on their smartphone app. • Patients now want virtual visits-access and convenience. • Clinical Apps that monitor and manage illness. • We have apps now that let us do an EKG on a smartphone. • We have apps that allow us to take our blood pressure with a smartphone. • Favorite of mine – Breathalyzer App • Will these drive down costs? 17
Who Will Support This? Insurance Companies and Medicare • Goal is to identify problems before they become expensive. • Allow doctors to practice wellness, not treating illness. • Lower cost of care. • Engage the patient in their health. • Engage and inform family members for support. • Allow us to track compliance with medication and change medications sooner if we see they are not working. • Save everyone money. • Extend life. • Increase quality of life as well as quantity of life. 18
Medical Apps 19
What You Deserve from Us Patient Safety Experience Quality Service Outcomes VALUE = Price 20
Exciting Changes in Medicine • Stroke • Cancer Screening and Treatment • Parkinson's Disease 21
Stroke Stroke Signs to Look for • Essentially a heart attack in the brain • Numbness or weakness • Clot – often from your neck will travel • Sudden confusion into the brain, and stop the blood • Vision changes flow to a portion of your brain. • Balance issues • Just like a heart attack; the sooner we • Headache identify it, the sooner the treatment , the better the outcome. 22
FAST Diagnosis F Facial Drooping- Numb A Arm Weakness S Speech Difficulty T Time 23
Stroke/CVA Interventional Let the stroke Neuroradiology – progress, work on remove clot, place rehab after stroke stent, coil is complete. aneurysm. 1990 2000 2005 TPA – dissolves clots if given in a timely manner. Inconsistent results. 24
Cancer Screening and Treatment Many changes coming • Screening • Treatment • New blood tests to • Proton Therapy identify tumors and • Nanotechnology monitor treatment • Vaccine Therapy • Genetic testing to • Immunotherapy identify who is at a higher risk for specific cancers
Neuro Movement Disorder – Parkinson’s History Treatment • Degenerative disease of the central • Medication – levodopa given, nervous system. however as cells die, more and more levodopa is needed. • First described by Dr. James • 5-10% crosses the BB barrier. Parkinson in 1817. • Symptoms include an at rest tremor; • Side effects – nausea, drowsiness, this tremor goes away with stiff joints. voluntary movement. 26
DBS Surgery for Parkinson’s Disease 27
Could This Be Your Next Office Visit? 28
Venture Capital…Follow the Money F UTURE OF M EDICINE ?? • Wake up, feel terrible • Log in at 6 am, to Skype Doctor, MD. • He is in North Carolina, sitting in his home. Shirt and tie on, white coat and golf shorts, he accesses your electronic medical record. • He does an interview, uses your computer or phone to examine you, blood pressure, pulse, oxygenation level, glucose, (strep and influenza testing). • Makes his diagnosis and immediately and sends you patient info on his diagnosis including what to look for and expect. • He also sends the same info to your primary care doctor for his records. • He sends your prescription to the local pharmacy, which fills it and delivers it to your home, along with Gatorade, Tylenol, a gallon of milk and a loaf of bread. 29
Expectations of the New Generation 30
Tyto Care • Handheld communication device designed to allow seamless and secure interaction between patients and clinicians. • Supports online examination remotely by a clinician and also store-and- forward examination guided by the device. Source: Tyto Care website 31
Tyto Care • Performs a variety of examinations at-home and shares information with clinician for remote review. Mouth & Throat Heart Lung Ear Eye Skin Temperature 32
Medical Apps Walgreens testing mobile app for virtual doctor visits • A Walgreens store in Manhattan, Sept. 30, 2014. SPENCER PLATT/GETTY IMAGES Source: MDlive website 33
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