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By Robin Jay, BHC Editorial Director

Today on Capitol Hill, the innovators of Life:Wire, a mobile, two-way, interactive health management solution, will be showcasing their provider-patient empowering tool at the Healthcare Information Technology Showcase in Washington, D.C., as part of National Health IT Week.

With Life:Wire, providers and case managers can send direct, text-message-based interactions to patients which can be customized to track, monitor and engage users to improve their health outcomes and empower them to achieve important health goals. Life:Wire is an off-the-shelf, HIPAA-compliant solution that uses a patient’s cell phone, along with a web-enabled interface, to program, monitor and analyze results.

Life:Wire is focused on providing its health management solution to medical management organizations and providers to address chronic health issues, addiction management, pharmaceutical compliance and adherence, and lifestyle issues such as appointment reminders.

The patent-pending system is a user-friendly wireless solution for case management, disease management, compliance and wellness services. Through Life:Wire’s interactive cell phone solution for patients with care management and medication-adherence needs, providers can deliver a wide variety of interactive text message reminders in any language personalized to each patient’s specific needs. For example, behavioral health care coordinators can use Life:Wire to enhance the provider/patient relationship by providing greater quality access to patients and providing patient support.

The system is designed to easily integrate into a user’s daily routine, and turn any cell phone into an interactive health management tool, without the need for patients to download or install software or purchase equipment. Through the two-way messaging and administrative management platform, patients will receive and respond to customized text messages on their existing cell phones. Messages include functional rating scales, reminders of appointments, wellness tips and reinforcement of educational information. Using the application, providers will be able to keep a private, digital record of patient responses for web-based trend analysis.

Life:Wire is an innovative, proprietary adherence education and interactive program designed to empower coordinating providers to improve health outcomes by increasing patient engagement.
Recently, Life:Wire announced its relationship with iLab researchers at Carnegie Mellon University’s Heinz College to improve health outcomes for patients suffering from life-altering diseases. Health and information technology researchers at Heinz College’s iLab are helping Life:Wire increase the effectiveness of these communications by investigating optimal message content and frequency, as well as the impact of peer influence in health management.

Today, as the innovators of Life:Wire present their technology on Capitol Hill, their goal is for policy makers to see how the unique technology could help improve outcomes and reduce costs as a tool integrated into healthcare reform. Joining us today on BHC to discuss how Life:Wire can help providers, patients and payors, is the inventor and proprietor of Life:Wire, Howard Rosen. We encourage you to listen to this compelling interview with Howard or read the written interview that follows…

BHC: Life:Wire, in a nutshell, is a mobile, two-way, interactive health management solution for both individuals and providers. Howard, give us a brief overview of the different ways the technology can be utilized.

Howard Rosen: Well, in terms of health and health management, as you suggested, it’s designed to be very personal to the individual. It’s not just pushing information to them, but it’s actually pushing information specific to them and actually designed to get responses from them, which in turn, could potentially create additional responses. So for example, it’s not a matter of just saying, “Don’t forget to take your medication.” It is, “Have you taken your medication?” And you either respond with a yes or no, and that goes onto the system. And depending how it may be set up, if you say “No,” that may trigger a case manager to give you a call or make sure there’s a message to remind you later on saying, “Don’t forget to take your medication,” just to help. So, it’s more interactive to help in the management of what an individual is doing.

Another way it’s being used quite a lot now is actually the motivational side, where case managers have been putting messages for their patients, in a motivational nature, that are specific to them. Let’s say they were in smoking cessation. There could be a message of just simply, “This is your second week, and I know it’s tough, but keep up the good work and keep on going.” So it can be very standardized that way or it can be more in-depth.

In one case, we had a situation up in Toronto where the case managers deal with a number of diabetics who had weight issues, and she just put together a series of messages — a message for all of her patients. At that moment, she wanted to tell them, “Look, it’s really nice outside. You should go for a walk.” So it can be very specific and you can preprogram these things to happen since it’s all automated to happen long in advance. Or, in that particular case, a spur-of-the-moment idea might work. She just wanted to let them know they can go for a walk and all the information itself is recorded not on the phone but in a central database, so it goes into an electronic health record.

BHC: Howard, you’ve had some studies done that show that interactive call messaging such as this has been very effective in compliance. Can you tell us about that?

HR: There have been a number of studies that have been done in this area around the world. Recently, there was a peer-reviewed study of studies published that talked about 18 or 19 situations marked with improvement and compliance — adherence with medication, and things such as blood glucose levels in the diabetic situation, depending on the circumstances. And the main thing the proposition offers behind how Life:Wire is working is because it’s accessing people in a means that is most attuned to their lifestyle, and particular to Life:Wire, we really designed it where it works with your existing cell phone. So you don’t have to go out and get another phone, you don’t have to program anything. Its design actually just works, and so it’s the least intrusive approach to the health management side because people are always finding excuses not to do things. We’ve tried to take away those excuses and just let it happen and let it work.

BHC: Now, how might an individual utilize this service if they were to go on directly to the site and program themselves reminders: “I have an appointment this afternoon?” Or how might an individual use this service?

HR: We’re working in a variety of ways in terms of either having a preprogrammed series of things — let’s say you are looking for weight management. But even [for] individuals who are part of the case management program, we have a program which we call ‘My Reminders,’ which lets individuals go on and create their own messages for themselves. That could be for anything. It doesn’t have to be specific to medication or a health management regime they’re on. It could be simply like, I have as a reminder myself to pick up my kids from piano [lessons], which they do seem to appreciate that I remember to pick them up.

BHC: With the model of the patient-centered Medical Home going to be tested and promoted in 2010, do you see an application for Life:Wire in that area?

HR: Well, absolutely, because what it does is a number of things. One is getting people attuned to using a variety of applications or tools, for a lack of a better term, to improve their health management, and being empowered to do part of their own health management regime. And where Life:Wire kicks in — and we’re not going confuse this and some nominal tools that are out there and things that they have for in-home monitoring — but where Life:Wire really takes over is where you go beyond some of those very sophisticated monitors. And what other kind of interactions that they can’t pick up, such as how are you feeling today? And other areas. And literally, the moment you leave your home, you leave those monitors, but Life:Wire is still there in terms of the kind of interaction where you’re looking for responses from people.

BHC: Let’s talk about a couple of your upcoming events and some recent announcements. You recently reported that Life:Wire now has a relationship with Carnegie-Mellon University. Tell us about that arrangement.

HR: It’s with Carnegie Mellon’s Hines College Eye Lab, which is their innovation and research arm for the university, and particularly what we’re looking at with them is research in the area of health management and interactions and using mobile approaches such as Life:Wire, but taking it a step further to say, “Okay here, how are the variety of ways we can help improve interactions?” And research in that area, including the use of social networking and peer networks, in the area of health management which is a particular area of interest of ours, again, because the idea is being as lifestyle-oriented as possible, and making things as simple and as easy and natural for people to do in health management, and not trying to do things that are foreign to them.

BHC: So are you talking about things like Facebook and Twitter, social networks like that?

HR: Yes, we go in those directions, absolutely. It’s a natural extension of the Life:Wire approach as it grows.

BHC: Just out of curiosity, how would HIPAA rights be involved with that? Would there be any sort of privacy issues that you’d have to overcome?

HR: Well, yes, it depends on the nature of the interactions on the social networking, versus on the straight, more traditional data management of the two. So, for example, maybe the social networking aspect — and this is something that we’re developing out — you have a variety of interactions, and people you’re sharing information with that may not necessarily be confidential information you’re sharing with them. Whereas, in the traditional case management use of Life:Wire, that would be much more specific to the individual and more confidential as to their needs.

BHC: And next week, you’re going to be presenting in Washington. Tell us about that event.

HR: That is part of the Health Reform Seminar on the Hill. It’s a week-long conference that’s taking place in Washington and we’ve been asked to be one of the presenters on the 24th of September for a particular showcase at the Senate.

BHC: What messages do you intend to distribute to the Senate as far as how your technology might be a proactive tool as they move forward in healthcare reform and other issues?

HR: Well, what we’re looking at is finding ways that are very patient-friendly. You want to find approaches, whether it’s Life:Wire or frankly, any other area, for people to do things. People naturally don’t want to do things. I’m sort of naturally lazy myself. And so, you want to find ways that are very user-friendly, or as we kept using the reference, ‘lifestyle-oriented.’

So, using approaches, using things people are already used to using as a means of getting involved and empowering them, because the more they’re empowered, the more they’re going to get involved. And another way of empowering is the personalization side. The more they feel whatever solution that they’re doing is for them specifically, the more they’re going to get involved.

A lot of the problems, just in general of approaches today. [have been that] it’s been very generic. So, here’s pushing information that applies to one person or another, and we actually, early on, did a lot of research in this area, [and] the one comment from virtually every patient we spoke to was, “I wish my doctor understood that I was an individual.” No matter how wonderful the doctor was — and we had some fantastic doctors — but each patient universally said the same thing: “I wish they understood I was an individual, not a number.”

And so I think the key message is to try to find solutions that are person-oriented, and frankly, a lot of those person-oriented solutions are very inexpensive, and frankly, a lot of those person-oriented solutions are also very inexpensive. Because ultimately, part of the solution to these things is to try to be very cost-effective as well.

BHC: And that’s of course very important in this day and age, and many of the facilities and providers and even consumers, as we get more technologically savvy, we’re finding the society speed up, and you find yourself busy, busy, busy. How easy is this technology to utilize? And is it going to be easy for case managers and providers to fit into their current routine?

HR: Well, yes. Life:Wire itself for the individuals as I mentioned, works off of their cell phone they happen to have, whether it’s an iPhone, a Blackberry, or if it’s a six-year-old Nokia. It’s going to work with any phone. There’s no software to upload. There’s no extra equipment required, because the base interaction really works off of text messaging, and every phone manufacturer in the past 10 years has text-messaging built into the phone already. So, in terms of the equipment side, if someone just spent 700 dollars for a piece of equipment or even 500 dollars for a new phone — whatever phone you already have, it’s already going to work, so the set-up, getting up and going, takes, like we said, about 90 seconds or less to get up and running for the individual.

For the case manager, it’s all managed off the Web, on an online platform that we’ve created that’s very intuitive to use. In fact, we’re using the 24th as also the release of a newer version of Life:Wire that’s as wonderful as the first version was. This one’s even more intuitive and easier to use for case managers, taking into account all the comments that we’ve received over the last year and a half from case managers, and incorporating that in the new design.

And because a lot of the interactions are automated for case managers, they just put the questions or the set-up that they want once, and then the system takes over. It’s designed such that they only get notified either when there are some things that are outliers, you’ll get responses that are out of the parameters that they accept. Or, they can just go online and see flagged responses, or what the responses have been from the various patient groups that they have.

Life:Wire’s really becoming a health management telecommunication platform, so not only can case managers use text messaging, but they can also use IBR if they wish, or they can go with e-mail, depending on the nature of the interaction they’re doing, or a combination of all three.

BHC: And as health plans and providers are coming into healthcare reform and working with employers and their members to increase utilization review and compliance and other cost-saving measures, is there any talk about health plans making this sort of service a benefit?

HR: We’re certainly in discussions with them on that. As you know, this is sort of a new era for everybody. So everyone starts sitting around going and thinking, “Does this make sense for what you want to do in terms of improving compliance and adherence?” And obviously, we feel that it does, and on that basis, we see it as something that they’re interested in, because at the end of the day, any way you can improve outcomes and reduce the costs is something that’s of interest across the board.

BHC: Howard, is there anything that I haven’t asked you that is important to mention about the technology about Life:Wire, and about upcoming events?

HR: Well, we mentioned the fact that as the information is collected it goes into a central database that’s collected for the patient. Obviously, everything is HIPAA-compliant and secure, but whatever information that we collect, we’re not seeing ourselves as an electronic health record company, per se. We do collect the records and we have a dashboard to see this information, but it’s also designed to port to third-party legacy health records, so if you’re a health management group and you already have your own electronic health records system, we just take the data that we’ve collected and we can port it into your existing system. So you don’t have to sit and work off of two databases. All the information can reside in one database.

BHC: That’s a great help.

HR: The idea is to simplify as much as possible and as we discussed earlier, we’ve already had extensive discussions with Microsoft in terms of making sure that we become compliant with the health regulations, and obviously talking with other groups as well. So the idea is to be as seamless as possible so it’s as easy for case managers and health management groups [to use] as it is for individuals to use.

BHC: Howard, if you would, give us the contact information. Where would individuals, providers, and health plans go for more information about the technology?

HR: Well, if you’re not going to be there on the 24th, you can always feel free to go to our website, which is, www.lifewire.ca, or the direct phone number is (416) 690-1516 in Canada, or in the United States, we have a sales office in Annapolis, and that’s at (410) 280-0025. The contact down there is Gary Carnile, and the best person to speak to probably up here, just for the time being, [it’s] probably best to contact me directly, and then I can determine where it goes, who to speak to specifically from there. Because we’re talking to different groups in different areas, and what we try to do is bring specialists in different areas to deal with pharmaceutical companies and health management groups and that type of thing.
 

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