University of Colorado College of Nursing Partners with cliexa to Launch a Mobile Application with Evidence-based Infographics

HIV disproportionately affects Latinos who experience higher prevalence, faster disease progression, more HIV-related deaths, and a marked delay in diagnosis and treatment than their white counterparts. This is a concern in geographic regions across the United States (US) as Latinos comprise the largest minority group in the US. Similar HIV-related health disparities exist in developing countries, such as the Dominican Republic (DR), where those with low socioeconomic status experience higher disease burdens and worse outcomes than those with higher socioeconomic status. These health disparities are exacerbated when affected individuals have low health literacy and are unable to understand the information needed for self-management, as inability to self-manage leads to less use of healthcare services and worse understanding of illness, health behaviors, and health outcomes.  Therefore, to improve health outcomes and reduce health disparities among Latino persons living with HIV (PLWH), clinicians must provide the health information needed for effective self-management to diverse Latino PLWH in a meaningful way.

In response to these concerns, Dr. Samantha Stonbraker, Assistant Professor at the University of Colorado College of Nursing, rigorously and iteratively developed the Info Viz for Health intervention to assist clinicians to provide this health information to PLWH through several NIH-funded studies. She first identified a need for this intervention (T32 NR013454).1-3 Then, she worked with an expert visualization team at Columbia University in New York and with health care providers and PLWH at a clinic in the Dominican Republic to develop a set of culturally relevant and evidence-based infographics to assist clinical communication (T32 NR007969).4, 5 She has since assessed the feasibility of using the Info Viz for Health intervention to improve clinical communication with, and outcomes of, PLWH in the DR.6, 7 She also adapted infographics to the cultural and clinical context of Latino PLWH living in New York (NY), who are mainly of Dominican origin/descent and also assessed their feasibility and acceptability at a clinic specializing in HIV care in Northern Manhattan (K99 NR017829).

Two critical next steps in this work were:

  • To adapt Info Viz for Health for relevance to heterogeneous Latino populations across the US by adapting them to Latinos of Mexican origin/descent as these individuals form the largest Latino group in the US and their inclusion is necessary to enhance generalizability and enable future scalability of the intervention. To do this, Dr. Stonbraker conducted a series of in-depth interviews with PLWH attending a clinic that specializes in HIV care in Denver, CO, and adapted the infographics accordingly.
  • To integrate the Info Viz for Health infographics into a mobile platform to enable ease of use and scalability. Dr. Stonbraker teamed up with cliexa, an innovative company that develops and creates digital health solutions. Together, they incorporated the Info Viz for Health into a mobile app that is now accessible on the App Stores both in Apple and Google in English and Spanish languages.

Currently, Dr. Stonbraker is conducting a multi-site randomized controlled trial (RCT) to evaluate the efficacy of using the Info Viz for Health app to improve clinical communication and treatment outcomes of Latino PLWH at clinical sites in CO and the DR. Seven providers at the two different clinical sites are using the Info Viz for Health app as a communication aid while they provide information to study participants.

The research aims of this project are to:

Aim 1 Assess the efficacy of the intervention as compared to standard care in improving treatment outcomes (CD4 count, viral load, self-efficacy to manage HIV, among others) of PLWH and determine how resultant effects vary over time (baseline to 9-months) and between sites.

Aim 2 Evaluate the feasibility, acceptability, and usability of the app among interdisciplinary and multi-cultural providers using the app.

Aim 3 Identify implementation factors of integrating the mobile app into electronic health records (HER) through in-depth interviews and leverage findings to ensure the app effectively interfaces with EHRs in the US and DR.

Next steps:

  • Health care providers at all sites where infographics have been used have requested additional infographics be incorporated into the app so that they can address additional topics with their patients. Dr. Stonbraker will conduct a needs assessment to identify the pertinent topics to include next and will create rigorously designed and culturally appropriate infographics in response to identified needs.
  • The Info Viz for Health app is provider-facing and would benefit from integration with EHRs. Therefore, the next step in app development is to integrate it with Fast Healthcare Interoperability Resources (FHIR)®, which is the standard for connecting mobile apps and electronic health records (EHR). This permits scalability, as the resultant app enables clinicians to easily access evidence-based infographics from diverse settings globally.

The final product will be an app that interfaces with EHRs in resourced and under-resourced areas globally, has been rigorously tested amongst diverse Latino PLWH in distinct geographic settings in multiple languages, and includes evidence-based infographics to facilitate the clinical communication that helps patients improve their self-management and obtain better health.

References

 

  1. Stonbraker S, Smaldone A, Luft H, et al. Associations between health literacy, HIV-related knowledge, and information behavior among persons living with HIV in the Dominican Republic. Public Health Nurs. 2017;35(3):166-175. doi:10.1111/phn.12382
  2. Stonbraker S, Befus M, Lerebours Nadal L, Halpern M, Larson E. Factors associated with health information seeking, processing, and use among HIV positive adults in the Dominican Republic. AIDS Behav. 2016;21(6):1588–1600. doi:10.1007/s10461-016-1569-5
  3. Stonbraker S, Larson E. Health-information needs of HIV-positive adults in Latin America and the Caribbean: an integrative review of the literature. AIDS Care. 2016;28(10):1223-1229. doi:10.1080/09540121.2016.1173645
  4. Stonbraker S, Halpern M, Bakken S, Schnall R. Special Section on Visual Analytics in Healthcare: Developing infographics to facilitate HIV-related patient-provider communication in a limited-resource setting. Appl Clin Inform. 2019;10:597-609. doi:10.1055/s-0039-1694001
  5. Stonbraker S, Richards SD, Halpern M, Bakken S, Schnall R. Priority topics for health education to support HIV self-management in limited-resource settings. J Nurs Scholarsh. 2019;51(2):168-177. doi:10.1111/jnu.12448
  6. Stonbraker S, Flynn G, George M, et al. Feasibility and acceptability of using information visualizations to improve HIV-related communication in a limited-resource setting: A short report. AIDS Care. In Press;doi:10.1080/09540121.2021.1883517
  7. Stonbraker S, Liu J, Sanabria G, et al. Clinician Use of HIV-Related Infographics During Clinic Visits in the Dominican Republic is Associated with Lower Viral Load and Other Improvements in Health Outcomes. AIDS Behav. In Press:1-13. doi:10.1007/s10461-021-03331-8

American College of Cardiology, cliexa Launch Innovative Health Monitoring Platform

The American College of Cardiology and cliexa, have collaborated through the ACC Innovation Program to launch a home health monitoring platform called cliexa-PULSE.

” cliexa-PULSE is a revolutionary app and platform that allows cardiovascular clinicians to gather information from their patients before and after visits to ensure well-being and help pivot care plans that are individually tailored to patient needs,” says Andrew M. Freeman, MD, FACC, a member of the ACC Innovation Program-cliexa Work Group. “Using the cliexa platform allows for easy EMR integration along with the ability to capture chronic care management codes resulting in efficient personalized care. Further, with the upcoming population health tool, I can follow my entire panel of patients and help those in need sooner.”

As a virtual health solution, cliexa-PULSE is designed for clinicians to track symptoms, medications, and daily activity for the management of atrial fibrillation (AFib), hypertension (HTN), congestive heart failure (CHF), and coronary artery disease (CAD). Along with remote check-in, cliexa-PULSE offers remote patient monitoring tailored to any clinical workflow and provides bulletproof compliance, documentation support and MIPS reporting metrics.

With ACC’s clinical guidance, cliexa focused on user experience, both from patient reporting and clinician population health perspectives, providing discrete data and reports real-time into the EMR systems.

Mehmet Kazgan, founder and CEO of cliexa, said, “With the clinical guidance from ACC we have been receiving while developing this platform, we have built a great foundation that can be iterated for other chronic conditions. The views and feedback from ACC’s experts in the design work group helped us further understand the real needs and challenges for cardiology patient monitoring.”

Learn more about improving care coordination and a strengthened clinician-patient partnership with ACC Innovation’s Co-developed Platform.

The American College of Cardiology envisions a world where innovation and knowledge optimize cardiovascular care and outcomes. As the professional home for the entire cardiovascular care team, the mission of the College and its 54,000 members is to transform cardiovascular care and to improve heart health. The ACC bestows credentials upon cardiovascular professionals who meet stringent qualifications and leads in the formation of health policy, standards and guidelines. The College also provides professional medical education, disseminates cardiovascular research through its world-renowned JACC Journals, operates national registries to measure and improve care, and offers cardiovascular accreditation to hospitals and institutions. For more, visit acc.org.

cliexa, a Colorado-based digital health company, acquired ProSkedge.com, an automated surgical scheduling platform. cliexa’s end-to-end virtual health platform offers integrated clinical intake, automated documentation and remote patient monitoring solutions tailored to practices in multiple-subspecialty settings. cliexa has partnered with American College of Cardiology co-developing cardiovascular home health monitoring solutions since 2018.

“With the acquisition of ProSkedge, cliexa’s focus on actionable, meaningful and impactful patient reported outcomes now extends to the pre-clinical care portion of healthcare delivery. The integration of scheduling care enhances the patient experience and removes historic hurdles.” – Dr. Gerald Maccioli, Chairman of Advisory Board at cliexa

ProSkedge has been designed and developed by Dr Lukasz Kowalczyk, practicing gastroenterologist with over 10 years of GI and procedure experience. ProSkedge simplifies, automates, and personalizes the scheduling process for clinics and patients. With this acquisition, cliexa-ProSkedge becomes a true end-to-end platform for clinics and health systems, offering solutions from onboarding to post-procedure monitoring to patients.

“Surgical care continues to grow at a high rate and COVID has pushed care out of hospitals and into higher value ASC’s. As cliexa enables the digital delivery of care across ambulatory clinic settings, ProSkedge adds that expertise into the ASC’s and the surgical space. cliexa now offers healthcare organizations a singular, comprehensive system for high value digital transformation across the entire patient journey.” said Dr. Kowalczyk, who is now a board member at cliexa and Chief Medical Officer for GI and Surgical Automation.

Dr. Kowalczyk added, “Colon cancer screening with colonoscopy is a great example of how we can improve the journey for the patient and practice.  New colon cancer screening guidelines drop the initial screening age to 45-49.  This patient demographic, consisting of about 20M people, has shown a higher demand to manage their healthcare through a digital medium like the cliexa-ProSkedge platform.”

Learn more at cliexa.com/ProSkedge

 

cliexa welcomes Dr Macciolli as chairman of advisory board

cliexa, Integrated Virtual Care Solutions, Announces the Appointment of Gerald Maccioli, MD, MBA, FCCM, FASA as Chairman of its Advisory Board.

Dr. Maccioli practiced anesthesiology and critical care medicine for over 27 years. He completed fellowship training in cardiothoracic anesthesiology and critical care medicine at Duke University following a residency in anesthesiology at the University of North Carolina at Chapel Hill and an internal medicine internship at the University of Oklahoma.

“We are honored to have Dr. Maccioli on board. There could not be a better time to engage with such a successful leader and clinician who will guide us to better develop cliexa focusing on quality and compliance.” said Mehmet Kazgan, Founder and CEO at cliexa.

Prior to joining Envision Healthcare, where he worked as Chief Quality Officer, Dr. Maccioli served as Director of the American Society of Anesthesiologists for North Carolina, President of the Society of Critical Care Anesthesiologists, and Chair of the ASA Section on Education and Research. He has served as the Chair of the American Medical Association (AMA) Committee of Innovators, playing an influential role in developing comprehensive, progressively responsible healthcare reform strategies. Dr. Maccioli also served as a member of the Quality Improvement Advisory Committee and the Committee on Practice Sustainability and Professional Satisfaction.

“Patient reported outcomes (PROMs) are now the ‘coin of the realm’.  Having been involved in healthcare quality reporting for nearly 30 years; cliexa brings not an evolutional product but a disruptive change to actionable, and meaningful PROMs.  I am both honored and excited to join the organization. “ said Dr. Maccioli.

Learn more about Dr. Maccioli’s vision for empowered patient data:

Link to blog: Quality Improvement during a Pandemic: How cliexa Empowers Actionable Data Delivery