Operations and Implementation

Oral Presentation

(OI4-1) Collaboration: The Key to Developing a Clinical Model for Mobile Health Integration in Ontario

Sunday, April 23
3:00 PM - 3:19 PM
Location: Tangerine Ballroom

There are an estimated 1.3 million people in Ontario, Canada with type 2 diabetes, with an annual health spend greater than $5.5 billion. Recent studies suggest mobile health solutions and telemedicine models result in significant improvements in diabetes management and patient care, ultimately resulting in improved clinical outcomes.

To explore the potential for technology to facilitate new models of patient care in diabetes, the Ontario Telemedicine Network, along with technology, clinical, and research partners, has launched a project to evaluate the use of mobile health technology for patients with type 2 diabetes. The project involves 300 patients and their clinicians from the Diabetes Education Centres and Complex Care Diabetes Centres of three care delivery organizations.

Patients are provided with a digital health solution consisting of a smartphone preconfigured with a self-management application. The solution provides diabetes-related education to the patient, helps the patient and provider identify blood glucose and medication adherence trends, uses algorithms driven by the patient's treatment plan, and delivers personalized guidance to the patient as needed.

In addition to supporting patients to better self-manage their condition, the solution can deliver analyzed between-visit patient self-management and metabolic data to the care provider on request, while also enabling cross-team communication and care management. It also enhances patient-provider communication and supports timely therapy changes.

Maximizing benefits to both patients and providers requires the effective integration of the solution into clinical practice. Project partners collaborated to develop a clinical model for patient identification and enrollment, app activation and configuration, and ongoing patient and health team engagement. To help promote adoption of the proposed model and implementation of best practices among providers and patients, guidelines to support the optimal use of the mobile application were developed.

By understanding the clinical model, the researchers were able to design for evaluation of the project in a real-world implementation. The pragmatic research approach is a) evaluating how the digital health tool is implemented in practice, (b) exploring patients' and providers' perspectives of the usability and acceptability of the tool, and (c) examining the key issues associated with scaling this type of mobile application across Ontario.

This presentation will focus on the strategies needed to effectively integrate a mobile health solution into a clinical practice. This includes activities designed to foster buy-in and engage patients who integrate self-management into their day-to-day activities, as well as inform providers who transform their practice and use patient-generated data to optimize treatment plans. Lessons learned and interim evaluation findings will be shared for the project, which runs until June 2017.

Learning Objectives:

Harriet Ekperigin

Senior Business Lead, Telehomecare
Ontario Telemedicine Network

Harriet Ekperigin is a Senior Business Lead with the Ontario Telemedicine Network. She has over 10 years experience leading health systems projects at both local and provincial levels. Currently she is leading the implementation of virtual innovative projects in the areas of Diabetes, Mental Health, wound care and palliative care which is supporting the public to access faster, quality healthcare in the community and at home.

Harriet holds a Bachelor's degree in Nursing and a Master's Degree in Business Administration and is PMP Certified. In previous roles, Harriet worked as a manager at the Centre for addictions and mental health where she redesigned the mood and anxiety program process flow and reduced patient wait times by 40%. She has also worked on various healthcare consulting roles, using her hands on healthcare experience to advice on projects and lead teams effectively. Harriet supports a number of community projects and sits on the Hamilton local school board council.


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Angela Nickoloff

Clinical Innovation Lead
Ontario Telemedicine Network

Angela Nickoloff, RN, BNSc, MHS, is a Clinical Innovation Lead at the Ontario Telemedicine Network. With over 20 years of telemedicine experience, Angela has proven expertise in systems thinking and health system transformation and is recognized for her unique experience in the adoption and integration of innovative virtual health care solutions into the health care community.


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Malinda Peeples

Vice-President, Clinical Advocacy

Malinda Peeples, RN, MS, CDE, serves as Vice President for Clinical Advocacy at WellDoc where she oversees the clinical outreach program, grant and research activities, and professional organization activities. WellDoc is a healthcare company leveraging the mobile technology platform to create clinical and behavioral solutions that impact health and economic outcomes for chronic disease management. Peeples also serves as Adjunct Assistant Faculty, Division of Healthcare Informatics, Johns Hopkins School of Medicine. Previously, Peeples served as president of the American Association of Diabetes Educators (AADE), a professional membership organization devoted to advancing the practice of diabetes education.


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(OI4-1) Collaboration: The Key to Developing a Clinical Model for Mobile Health Integration in Ontario

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