hINF – convenient digital appointments instead of routine visits to the clinic

hINF enables patients with chronic diseases to replace many of their routine visits to the doctor with convenient digital appointments, which means that they don’t need to show up at a clinic to get their lab results or request necessary information.

“Solutions that allow digital consultations with doctors promote patient independence and strongly focus on prevention. Empowered patients, in control of their health, could make the right choices to improve treatment outcome, and in the long run minimise avoidable medical service use,” says Paula Kink, CEO and co-founder of hINF.

“hINF is a digital solution, currently targeted at HIV positive patients and their care teams,” explains Kink. hINF has set an ambitious goal to replace half of the routine visits, that patients with chronic conditions have, with digital appointments. Digital appointments are scheduled appointments by the patient to chat with their doctor. At the moment, solutions connecting patients and doctors through online consultations are quickly gaining ground. hINF differs from other similar solutions primarily as it is not only a platform for consultation with a medical specialist, it replaces routine visits to the clinic with digital appointments. While many competitors offer the possibility to consult with specialists online, patients with chronic diseases, who need regular monitoring, can use hINF to contact their treating physicians, who have access to patients’ medical history.

Digital appointments are an important step towards modernising the care provided to patients with chronic conditions. In addition to making digital appointments, patients can use hINF to get an overview of their health status. Test results are presented on self-educating graphs where the red zone stands for bad and the green zone for good results. Contrary to a telephone or face-to-face consultation, hINF helps make sure that patients remember what doctors have told them, or alternatively, they can revisit their digital appointment and test results at any time.

“The mobile application also provides patients with an overview of their antiretroviral treatment,” says Kink. The system includes a smart notification centre, which sends alert messages as to when patients need to make appointments, take their medication, or pick up refills.

In Estonia, HIV positive patients receive their antiretroviral treatment from a clinic, not a pharmacy, every 1 to 4 months, depending on the patients’ adherence.

At the moment, patients can use the app on their mobile phones and doctors have a web setup. A web-based platform for patients is under development. Initially, it is planned to test patient mobility, or make it possible for patients to have their digital appointment at any place convenient to them.

Users are identified by their RL-HIV code, an anonymous, unique ID code issued to all HIV positive patients in Estonia. The app stores a minimum amount of patients’ personal data, namely his/her name, year of birth, and the RL-HIV code. All of the data stored is encrypted and only visible to the patients and their care team.

The idea was born at the HIVdigital hackathon

The idea behind hINF was born at the HIVdigital hackathon, which took place in Tallinn, August 2016. The hackathon was organised to come up with digital solutions that would simplify the life of HIV positive patients and improve their treatment adherence. The hINF team, including MD Kersti Kink, Paula Kink, Tanel Teemusk, Katrin Charles, and MD Helen Mülle, participated in the event.

“At a brainstorming session we came up with an idea of a patient-doctor platform for digital appointments. Discussions with professionals in the field, mentors and patients only confirmed our assumption that the existing system is out-dated and that doctor-patient communication needs to be modernised to be more efficient,” Kink explains. “We saw that patients do not particularly like the idea of making frequent visits to the clinic – instead, they actively seek out alternative options for communicating with their doctors, for example, via telephone. After realising that their information will most likely to be passed to them unless they visit the clinic, they start to avoid appointments overall. That is why it is crucial to create a suitable medium that would enable parties to communicate with their doctor in a secure setting.”

The app is developed in close cooperation with professionals in the field as well as patients to get immediate feedback and a better grasp of user expectations.

“Patients and doctors have contributed to our effort with a number of great ideas,” says Kink. “It is their suggestions and recommendations that the app’s current functionality is based on. Our goal is not simply to develop a great product, but to create a solution that best meets the daily needs of its users.”

Feedback from doctors and patients has been positive. To assess the number of its potential users, a broad survey was conducted among patients.

“We found it highly encouraging that 94% of respondents had a smartphone and the majority were advanced users,” Kink comments. “The only ones currently not interested in hINF were primarily patients who didn’t use a smart device.”

The app’s initial version will be launched in June 2017. By then, the digital appointment functionality as well as that of accessing one’s lab results will be ready. What is more, it is planned to interface the app with hospitals’ registration desks so that in addition to making digital appointments, patients could book routine visits to the doctor’s office as well.  Long-term plans include connecting the app to hospitals’ health information systems, which means that doctors could send and receive necessary data through the patient health record system during a digital appointment – and with just a few clicks at that. This would make for faster, easier and securer information transfer.

According to Kink, the overall goal of the app is to revolutionise certain routine medical practices, because the existing system is out-dated and inconvenient for patients with chronic conditions and their care teams. In addition, the current system is very time-consuming and costly. “Eliminating the need for visiting the clinic at least a couple of times per patient within a year, helps save time and money for all of the parties included in the system of managing a patient with chronic disease,” says Kink.