Thursday, July 25, 2013

Boston safety-net hospital adapting OneHealth behavioral platform to medical home

By: Neil Versel | Jul 25, 2013 
OneHealth Solutions, a company that largely has focused on employer groups, is for the first time applying its mobile and Web platform for patient behavior change to primary care, courtesy of a partnership with Boston Medical Center.
The safety-net hospital, an affiliate of Boston University School of Medicine, is adopting the OneHealth system, originally to treat substance abuse, depression and other behavioral issues, to its patient-centered medical home initiative. Boston Medical Center will offer low-income patients access to the OneHealth online and mobile platform to promote self-management of chronic diseases, offer peer support and engage them in between office visits.
“It will be an integral part of the medical home,” said psychologist Dr. Robert L. Sokolove, who is championing the rollout at the 496-bed hospital in Boston’s South End.
“BMC partnering with OneHealth was done to mitigate a very longstanding issue in disease management,” Sokolove told MobiHealthNews. Counseling patients on smoking cessation, obesity, stress reduction and depression is about teaching skills that lead to lifestyle changes. “After the skill sessions have stopped, maintaining the skills, especially a year out, becomes very, very difficult,” Sokolove said.
OneHealth, available through Android or Apple iOS apps or through the Web, is meant to provide patients with information and social support that leads to the maintenance of newly acquired skills, Sokolove explained. He said that upper-middle-class patients tend to have the social support they need, especially as they are treated for depression and diabetes, but the lower-income populations, including immigrants, that frequent BMC tend to lack such networks.
“This can be one small way for removing those barriers to access,” Sokolove said.
He called the social aspect of the mobile platform a “sort of Facebook for patients” that helps them self-manage chronic diseases and reduce anxiety that can lead to poor choices such as smoking or eating unhealthy foods. “Anxiety is reduced by two factors: attachment and mastery,” explained Sokolove. “We feel less anxious when things are predictable.”
What BMC patients do have are mobile phones, and many are starting to acquire smartphones as well, which makes a mobile platform a great means of outreach. “Many of our patients can’t use a desktop because they don’t have a desk, but they do have smartphones,” Sokolove reported.
Solana Beach, Calif.-based OneHealth, launched its OnTheGo native mobile apps, optimized for tablets, in February. “Our mobile has overtaken the Web experience,” according to CEO Bruce Springer.
The company, which was known as OneRecovery until a little more than a year ago, has its roots in treating substance abuse, but has since integrated medical resources with behavioral tools. Springer said that those with chronic medical issues such as diabetes are 50 percent more likely than others to have behavioral comorbidities like depression, and that can lead to poor lifestyle choices that exacerbate chronic conditions.
Springer said he is excited about working with an academic safety-net provider because he believes the OneHealth system works well with Medicaid and uninisured populations and because Boston University offers research opportunities to help validate the technology.
“It’s hard to reach them,” Springer said of patients BMC is trying to bring into medical homes. “It’s hard to get them activated in programs to improve their health.” With providers increasingly taking on financial risk, they have to manage patients outside the hospital or clinic, and mobile technology is an ideal way to do so, Springer added.
Sokolove said there will be a research element “eventually,” but for now, he wants to get the program launched by September for smoking cessation. “What I hope to do is build it out slowly,” Sokolove said, tailoring the language to the right health literacy levels and tweaking the interface so the OneHealth platform is easy to use.

Boston safety-net hospital adapting OneHealth behavioral platform to medical home

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