November 4, 2013 Issue
The Most Powerful Name In Corporate News and Information
Displaying Targeted Multimedia Patient Education
About Health Mirror
displays targeted multimedia patient education, specific to the patient’s
demographics, diagnoses and symptoms, in the exam room within the existing
workflow of the office, and at other points of patient care. This
subscription-based service reinforces patient education measures, improves
clinical outcomes, according to physician and organizational preferences,
utilizing tablet and stand-alone touch screen interfaces. Our patent pending
process enables scalable comprehensive and consistent patient education
throughout an ambulatory healthcare enterprise, all managed from one
President/CEO, Health Mirror, L.L.C.
Interview conducted by: Lynn Fosse, Senior Editor, CEOCFO Magazine, Published – November 4, 2013
CEOCFO: Dr. Weidner, what is the vision at Health Mirror?
Dr. Weidner: We are building, developing and now offering subscriptions to a targeted patient education device that sits in the exam room to enable improved patient education and engagement in the ambulatory healthcare setting.
CEOCFO: How does it work?
Dr. Weidner: The device has a patient interface that works when patients are sitting in the examination room utilizing their time after being roomed by office staff. The time waiting there is spent viewing displayed multimedia patient education that is targeted to their diagnoses, symptoms and demographics. The engaged patient can make a selection of content; an unengaged patient who is not interested is also presented targeted educational material as well. This helps fuel the patient-physician encounter that is about to occur. Typically, this waiting time in the examination room is about 12-20 minutes on average. As physicians are being measured on how much patient education they provide, Health Mirror provides this without additional effort by the physician. We have also shown some improved clinical quality measures with the application of this device in a primary care setting.
CEOCFO: What is the device?
Dr. Weidner: Health Mirror is a process that primarily displays multimedia content on a touch screen monitor such an All-in-One PC or an iPad, or on the patient’s own device such as a smartphone. The process is driven by a routine data query of the ambulatory practice’s electronic medical records on entries from a browser based staff interface, at or soon prior to the point of care encounter. Additional browser based administrative interfaces allow addition and management of content, application demographic and diagnosis codes, generation of practice and physician preferences, and generation of utilization reports.
CEOCFO: So, a doctor’s office knowing your previous history would have this preset so that when you went in to your office, the content would come up that fits your prior conditions?
Dr. Weidner: Yes. A patient already established with a physician’s practice has their existing demographic and clinical information queried by Health Mirror easily through an EHR integration. This information is then matched to the patient education videos according to that patient’s demographics, diagnosis, and physician and practice preferences. This allows the patient to receive targeted patient education at the time they are there waiting for a clinical encounter. Without that integration, or perhaps with a patient new to the practice, our browser-based interface allows the nursing staff or medical assistant that is rooming the patient to enter this information, allowing this content to be targeted to the patient. As that information changes – the patient gets older or develops additional medical problems, the content changes with future patient-physician encounters.
CEOCFO: Are you developing the content as well?
Dr. Weidner: While we develop when we see the need, we have some partners who are content developers who provide some high quality content covering a wide array of primary care topics. We are also utilizing content that is in the public domain on the internet, essentially utilizing our patient interface as a viewer, but applying tags to the content to ensure that it is targeted to each patient. It is not uncommon that physicians have favorite YouTube videos that they want to show patients. So we look at a lot of content and find a lot of good content available around the internet. Health Mirror also allows individual physicians to add content so that it can be viewed on the patient’s device as well.
CEOCFO: Where are you in the development process?
Dr. Weidner: We just came out of beta site testing and we opened up for subscriptions several weeks ago.
CEOCFO: What surprised you about the feedback during the testing?
Dr. Weidner: We are continually learning ways to make this better. We just got done exhibiting this at two shows. Even after talking with many groups of physicians, and demonstrating this product to about 500 physicians and other care providers recently, there are still ideas that come up that we have not thought of in the past couple years of development that we think would be great enhancements. We are also understanding different settings of care where this would be beneficial. It is lovely when you have a clinician or physician you are demonstrating it to who initially does not seem particularly interested in it, then starts to gain some interest. Within about a few minutes of showing this, they start asking a lot of questions. Pretty soon you can’t shut them up, they’re still talking about this. It is a process we see happen again and again when we demonstrate Health Mirror to health professionals.
CEOCFO: Why are you certain that you will be able to engage the patient?
Dr. Weidner: Our beta site experience and reporting fields within Health Mirror support this. Now certainly not every patient is engaged in this process. A certain percentage do not want to look at this. I am still in practice in medicine and I test this out three and a half days a week, and as I see patients, I get to ask people on a regular basis what their level of interaction is with Health Mirror and verify how reports of their interaction appear as well. There are some patients who are feeling so lousy or too anxious and they will not engage with the product. But that is the minority. Our data shows that 50-75% of patients are engaged with Health Mirror in the examination room. In comparison to other patient education materials, when you talk to other physicians about what type of engagement they have with the patient education that they offer now, they understand there is no ability to really measure what happens to that paper handout that you handed the patient on the way out. Many of them say they think their patients just throw them in the trashcan. Our reports show how Health Mirror is being utilized, what educational information has been displayed to the patient, and what information they have interacted with. And Health Mirror utilizes time that would otherwise be wasted and allows that to fuel the impending encounter with the physician. But for some patients who just do not want or can’t handle an educational video, so we also have categories of content that are just relaxing videos or cartoons or other entertainment. I hope that this enables them to be more receptive of the targeted content at future visits, although we don’t have the data to support that yet.
CEOCFO: Is this a replacement of the informational posters on doctor’s walls?
Dr. Weidner: Yes. Definitely. On our brochures, the first page has a picture of one of the backs of the exam room doors in my clinic where there were several posters hanging. The visual noise created by multiple non-targeted messages in the exam room is what drove the development of Health Mirror. I will regularly receive plenty of well intentioned placards from nonprofits and other healthcare organizations developed as part of an initiative to promote a certain health issues. You end up hanging these up, but you are not able to really characterize how that education affects somebody, and it certainly is not targeted specifically to the patient who needs it. At least in a family medicine setting, there is a broad spectrum of patients of all different ages and diagnosis categories. So I could hang up information regarding smoking cessation and osteoporosis screening in each exam room, but the minority of patients in my office need these messages, despite these being major health concerns. Before Health Mirror, I attempted to offer patient education utilizing digital picture frames offering slideshows from one of five thumbdrives that were somewhat targeted. The way Health Mirror developed was when Vince Sammons, my co-founder, came in as a patient and he was looking at one of these slideshows. The slideshow was starting to show some content about osteoporosis, so we started talking about this and he asked why that stuff was up there for him. He saw how I was trying to make it specific on a digital picture frame. That was where his IT expertise and my clinical expertise combined to create Health Mirror.
CEOCFO: I would imagine that a lot of the patient interest would depend on how engaging the content is?
Dr. Weidner: I agree. A good example is a short video about suicide prevention that was disturbing to people. It is an important message in a way, but when you’re a patient hearing about the risks of suicide, in an exam room minding your own business, it can hit you over the head too hard. We had a few complaints and took that piece of content out. What I see more and more—about five times yesterday walking in the exam room—is that a patient will say (without me asking) the content is very good. That tells me they are watching it and engaged in it, and that is where they actually give me some unsolicited, positive feedback.
CEOCFO: Are they just watching out of boredom?
Dr. Weidner: Have you ever tried to take a five year old and sit them in an exam room for 20 minutes? Yes, it can be out of boredom. Exam rooms are typically boring places. What we find we are competing against more and what we are evaluating still on an ongoing basis is how engaging Health Mirror is compared to magazines and other messages in the exam room. Does it truly compete against the posters that are hanging up? We are evaluating the type of engagement and amount of interaction with the content that patients select in various settings with competing interests. While we cannot control patients bringing their iPad or cell phone and looking at their email, we are hopeful with future development to push the content to their own devices, sending a link to the patients email or smartphone 20 minutes prior to the appointment.
CEOCFO: What happens in a situation where you have engaged a patient right when the doctor comes in?
Dr. Weidner: What is beautiful about Health Mirror is that they can take it home with them. Right on the interface, they can scan a QR code that will give them a link to all of the content that is there, or they can put their email address in a text field and it will send them a link. They can view that outside the office setting, but for the device, we have a type of control feature on the interface that a doctor can hit to pause in order to have an interaction and encounter with a patient. Then suppose the patient needs an EKG or a nurse needs to come in and give them a shot. I can just turn it back on and select a piece of content that is more appropriate for that type of encounter. They can learn about the vaccine before they get it through multimedia content I selected on the Health Mirror patient interface.
CEOCFO: I would think that viewing it after would be a better time if you had just given them a possibility of what is wrong with them.
Dr. Weidner: Having that content sent to them can be an important reinforcement of what they already saw or what they did not see to reinforce the discussion that occurred at that encounter.
CEOCFO: Have similar concepts been tried in the patient room?
Dr. Weidner: Yes, several variations of this are currently in use. There are other companies that we have talked with about various degrees of collaboration. Many content providers and developers are interested in pursuing the application of their tools in the outpatient environment and are evaluating this as some pieces of content that sit on various platforms such as an iPad. This is still a developing field and I do not think it is one that has a broad application or acceptance. What is unique with our product is that with a patent pending process, we are able to truly display targeted patient education in a way that can be changed routinely during the workflow of the office. I do not know of any better way that can target content to the patients across gender, demographics, diagnoses, languages and symptoms that occur. There are some other content providers that have a library of content and they present content very well in their settings. However, I do not know of any of them who has shown some improved clinical quality measures with the application of a patient education device in the ambulatory setting as we have.
CEOCFO: What is your rollout plan to reach a good sampling of physicians?
Dr. Weidner: We want to get the word out through different content venues that physicians are engaged in. We will certainly continue to evaluate the use of contacting people in such venues as social media, but I think we want to pursue contacts that we presently have, and hopefully we will continue to establish word of mouth.
CEOCFO: With everything that is on a physician’s plate regarding the changes that are happening today, how can you grab their attention?
Dr. Weidner: For starters, after being a physician for twenty years I understand that there are some venues where physicians do rely on some information. I think that can be tough because physicians are busy people. I think that physicians are at various types of employment or practice ownership, and they have various levels of engagement with the purchasing process in their practice as well. More and more – at least in our area - physicians are electing to be employed instead of being practice owners. It may actually be the practice administrators who are reviewing types of devices, applications and tasks that need to be pursued. Different physicians have different levels of engagement with the purchasing process. We are finding more that this is a type of device may appeal to a practice administrator of a type of group that has many employed physicians where there is a compelling need to manage content from one desktop for the entire practice and have one centralized set of messages. There are plenty of systems competing out there to show some level of improvement in patient care, most in the inpatient area. I think the products that rise above the rest will be the ones that show some better clinical outcomes or at least improve clinical quality measures as well as reinforce the tasks that physicians have while not increasing the amount of work for physicians. I am glad to see how Health Mirror can provide patient education. We have estimated up to 75% of patients are engaged with this device in certain settings; engagement with traditional paper based patient education is much lower.
CEOCFO: Are you funded for the rollout or will you be seeking partnerships or funding?
Dr. Weidner: We are currently evaluating that. We have been bootstrapping this process so far and continue to. I think what we need to understand more as we just rolled out our subscriptions several weeks ago is what a sales cycle looks like and understanding expenses of that. We understand any partners would like to see some information regarding that as well, but I suspect we will need some partners in order to allow Health Mirror to be more scalable.
CEOCFO: Why should people in the business and investment community pay attention to Health Mirror?
provides patient education in an engaging way targeted to the patient’s
demographics and diagnoses. Physicians and health care organizations find
this valuable, as it also reinforces meaningful use measures for patient
education, improves clinical quality measures, and does so on multiple
operating systems. It is tailored to the practices needs, requirements and
capacity, all with less work for the physician. With a subscription-based
model, and as we’ve been able to minimize expenses on our end for our
content development, I think we can have a financially viable company as we
scale and add more subscriptions.
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