CASE STUDY Intel® Core® i5 Processor Mobile Computing Healthcare MOBILE DEVICES: SUPPORTING THE SHIFT TO VALUE-BASED HEALTHCARE From provider productivity to shared decision making, Intel® 2 in 1 devices with Windows* 8.1 show broad benefits for healthcare r. Christopher Bise is a long-time Apple aficionado. His dad owned an Apple store, and Chris earned his chops on an Apple DIIe* in high school. He was quick to adopt the iPad* and start taking it to work with him when Apple introduced it. Then, an Intel representative offered Bise the chance to see if a Microsoft Surface* Pro tablet/laptop 2 in 1 with Windows* 8.1 and 3D4Medical’s Essential Anatomy* for Windows would add value to his work as a physical therapy professor, clinician, and researcher. When the proof of concept was over, Bise was reluctant to switch back. Today, he relies on a Surface Pro tablet with the Intel® Core™ i5 processor inside throughout his workday and beyond. Four of his colleagues have gotten their own Intel® based 2 in 1s devices. Bise sees Intel based tablets and 2 in 1s with Windows 8.1 and higher as valuable enabling technologies for healthcare’s transition from fee-for-service to value-based care—and for large-scale deployment of tablet computers throughout health institutions. 2 | Mobile Devices: Supporting the Shift to Value-Based Healthcare Diverse Workload and Settings Bise is a thought leader who wears multiple hats. He’s an Assistant Professor of Physical Therapy in the University of Pittsburgh’s School of Health and Rehabilitation Sciences, and an adjunct instructor in the school’s Department of Occupational Therapy. He holds a Doctor of Physical Therapy degree, is certified as an orthopedic clinical specialist, and is working on a Ph.D. in Clinical and Translational Science—the study of turning lab and clinical insights into practical treatments. Bise’s workday extends well beyond the standard 9 to 5. In a typical week, Bise sees patients and teaches students. He lectures on musculoskeletal disorders and evidence-based ways of treating them. He leads student labs, collaborates with other health professionals, conducts sophisticated analysis of research data, prepares presentations, and works on papers for publication. He also consults with organizations designing next-generation programs to Dr. Christopher Bise deliver integrated rehabilitation and recovery services. He uses a diverse set of applications, ranging from processing-intensive statistical analysis packages to visual solutions such as Essential Anatomy, developed by medical imaging innovator 3D4Medical. Instant Convenience and Productivity Bise had been using a desktop workstation and carrying his laptop, iPad, and paper documents as he moved among his clinic, office, lab, lecture hall, and home environments. He saw instant improvements in productivity and convenience when he started using the Surface Pro tablet—a 2 in 1 device that can be used as a tablet on the go or docked with a full keyboard for use as a laptop. The device also comes with the Surface Pen* for writing, drawing, and painting. Amplifying the versatility, the Surface Pro enables users to move easily between mobile apps using the Windows 8.1 touch and tile interface and traditional applications developed for Windows 7. Bise still uses his high-end desktop system with its large, dual monitors for his heaviest statistical work. But for everything else, the Surface Pro has become his go-everywhere, do-everything platform. “With the Surface, I can access all my work everywhere I go, from a single device,” he explains. “There’s no need to carry a laptop or to drag around a binder with all my notes. Having a single mobile device that can do everything is huge in terms of the productivity benefits. Now, my Surface goes everywhere I go. I use it in the office and at home. I lecture from the Essential Anatomy app instead of a PowerPoint slide. When I’m seeing patients, I use it to help them understand what’s causing their pain and what their treatment options are.” Great Graphics and Performance, Plus Enhanced Security Bise says the Intel Core i5 processor in the Surface Pro provides outstanding graphics and performance for his more demanding applications. He also likes the robust, enterprise- proven applications in the Windows environment. “What platforms do I use all the time?” he asks rhetorically. “I use Word and Excel constantly. They’re built specifically for the Microsoft programming environment, so they run great on the tablet, and they’re not going to be quirky or introduce formatting problems. They sync seamlessly, so I can move easily between different platforms. The graphics are great on the Surface, and the Windows 8 touch interface is very smooth. You feel like, ‘This is how touch Mobile Devices: Supporting the Shift to Value-Based Healthcare | 3 and swiping are supposed to work.’ They let you move very smoothly among all the applications. Even the comms interface with our network seems to be more reliable.” AT A GLANCE Bise uses Microsoft’s BitLocker* software on the Surface Pro to keep his data encrypted. BitLocker improves Project performance by taking advantage of Intel® Advanced • Explore use cases for an Intel based tablet Encryption Standard New Instructions1 (Intel® AES-NI)— running Windows* 8.1 hardware-based instructions that speed the work of encrypting and decrypting data on computers based on Accomplishments the Intel Core or Intel® Xeon® processors. • Used the tablet in clinic, office, classroom, lab, Inspiring Patients for Better Outcomes and home settings • Identified benefits including greater support for Bise often consults with patients who are on the verge of research, data integration, patient education, and sliding into a debilitating pattern of long-term pain. Instead shared decision making of recovering from their condition or injury, patients can become increasingly overwhelmed by and obsessed with their pain. If they slip into a chronic pain syndrome, their quality of life suffers, and they’re at increasing risk of becoming high consumers of costly healthcare services. Biopsychosocial interventions can be crucial for such patients, and Bise has found his Intel based tablet with Windows tablet helps him intervene effectively. “When a patient is dealing with chronic pain, we need to take a biobehavioral approach so we can help them avoid a chronic pain cycle and pain catastrophization, where they’re unable to think about anything but their pain,” he says. “Using the Surface and the Essential Anatomy app and being able to show a patient what’s going on can help you get them to the point that they’re willing to try something new. It becomes a method to almost intervene psychologically and let them see and understand what’s happening and why the approach Essential Anatomy, by 3D4Medical you’re recommending makes sense.” Bise had a recent patient with long-term low-back pain who had given up on exercise, a step that in the long run was anatomy on the screen right next to his MRI,” says Bise. “I almost guaranteed to worsen his pain—and his overall could show him that from a structural standpoint there was health. “I was the fifth or sixth provider he’d seen,” Bise very little in the way of him exercising—that he wouldn’t do recalls. “He reported that providers had told him he had more damage to his back.” everything from a slipped disk to chronic pain syndrome. He wasn’t a good candidate for surgery, and no one was The patient followed through with the treatment plan and really sure how to treat him. He was afraid any sort of has resumed his normal activities—including golf. “Being activity might make things worse, and had come to a point able to show him the injury along with the underlying of thinking ‘The less I do, the less pain I’ll be in. He’d really anatomy helped me talk him back from the ledge,” Bise says. shut himself down.’” “He was able to see that exercise was not going to harm him and that even if it caused some short-term muscle soreness, Bise developed a comprehensive treatment plan that it didn’t mean his low-back pain was going to worsen.” included graduated activities. Then, he pulled out his Surface Pro tablet and pulled up the Essential Anatomy software. “I was able to use the app and show the patient the 4 | Mobile Devices: Supporting the Shift to Value-Based Healthcare Visual Support for Shared Decision us a better understanding of when to intervene and with what combination of interventions to improve health and Making and Evidence-Based Care outcomes. Patients will have a personalized dashboard that Bise expects tablet computers and applications like Essential shows them where they have room to improve. They’ll also Anatomy to be increasingly important as healthcare shifts to have the performance data to choose a doctor who has the value-based compensation. “When we talk broadly about best record at dealing with their particular condition. It’s very changing healthcare, one of the things we’re talking about is empowering, both from a provider and a consumer standpoint.” shared decision making,” Bise explains. “Engaging patients in Using tablets as part of the patient experience can improve their own care is one of the big initiatives of the Affordable both the quality of care and patient satisfaction. “You can Care Act. The goal is to create consumers who are much more create a HIPAA-compliant portal and give a tablet to fill in educated about their diagnosis and able to make informed their data when they check in or at the end of the visit,” Bise decisions about their treatment plan.