Abstracts

Rationale: The purpose of this project is to understand if next-generation health information technology (HIT) wearables can contribute toward effective ambulatory-based care in under-served rural communities. Approximately 20% (66 million) of the U.S. population lives in rural areas. About 95% of U.S. land is rural in which 12% of U.S. physicians practice (MacQueen et al, 2017). A crucial component of population health management (PHM) in these remote areas includes development of technology solutions. Our hypothesis is that HIT can be leveraged to improve the co-morbidity patterns and healthcare use-behavior of rural residents diagnosed with epilepsy-related challenges. Methods: The following methodology combines the following five innovative components: (1) a proof-of-concept mixed-reality neurocognitive task to assess spatial short-term memory function (Corsi Block Task) custom-coded in the HoloLens environment (Microsoft), (2) whole body motion capture accelerometers (Xsens) for assessing precise body movements of patients with epilepsy, (3) an animated education series targeting epilepsy and mental health, and (4) a custom-built electronic health record (EHR; https://epilepsyhealth.org) to which data generated by the first three components were automatically imported. (5) Finally, an independent community-based PHM coordination hub within the Epilepsy Foundation of North Central Illinois (EFNCIL) has been established in McHenry County, IL, to facilitate the above components. Results: 1. The average time utilized to acquire Corsi Block data for 4 patients from each assessment and automatically import to the EHR was approximately 14 minutes +/- 2.22 seconds. 2. The use of 17 wireless body accelerometers provided accurate 3D-output measures of participating patients identifying nocturnal seizure-like spells. 3. The feasibility of the immersive web-based education was followed over a 4-month period using on-line trafficking statistics for the patients and caregivers accessing the on-line education series. Conclusions: Preliminary data demonstrate the ability of clinicians to easily implement an otherwise time-intensive complicated neurocognitive task as well as compile and follow novel biomechanical semiology data sets of spells. This project illustrates the ability to automatically import meaningful data to an EHR for near real-time decision-making in an ambulatory care setting. Such HIT can augment a novel PHM outreach delivery model overcoming barriers to providing comprehensive care in geographically remote rural communities. Funding: Mental Health Board of McHenry County Illinois Children's' Health Foundation Upsher-Smith Laboratories UCB