Though technology advancements like telehealth and medical wearables are becoming increasingly popular, many physicians and patients have considered them a sideshow to the main event of a spate of doctor’s visits or a hospital stay. But, let’s take symptom monitoring devices; I now have three family members using them. It took months to make this happen, either because the physician or the patient was skeptical. And then there was getting insurers’ cooperation — another struggle. But skepticism and distrust of new healthcare technologies are clearly being replaced by appreciation of associated care enhancement, convenience, and cost-savings. And today’s new technologies..they’re just the beginning.
Yes, the healthcare industry’s focus on healthcare IT adoption has primarily been on electronic health records (EHRs) in the last few years, which are oriented around hospitals and physician offices. But moving forward, EHRs will increasingly morph into the anchor technology as real-time data from other devices and applications flows in and becomes easily available.
Healthcare is becoming a web of interconnected care-givers, devices and applications that can feed data to the EHR and beyond, e.g. HIEs and researchers. New technologies and devices are increasingly popular tools that both patients and providers can use to maintain and improve health. Even patient portals are playing a significant role in health self-management by patients. All these advancements can help control healthcare costs, and improve care and confidence in our healthcare system.
Hospital and emergency care are expensive. The average cost for a single inpatient day in the United States is more than $2,200. The average cost of an ER visit is about the same—$2,168—without being admitted. Physician visits are also costly, and like hospital care, not always necessary if telehealth and/or symptom-monitoring devices are part of the patient care arsenal.
Revenue from telehealth devices and services is projected at $4.5 billion next year worldwide, compared to $441 million in 2013 according to IHS Technology, a business analytics firm. The number of people using telehealth services each year is projected to grow from 350,000 to 7 million. These technology advancements are changing how both patients and care-givers are working together towards a more capable and responsive healthcare system.
The growth of telemedicine (video communication between patients and care-givers) and tools to track chronic diseases (e.g.wearable heart event monitors) is already enabling medical care and diagnoses to be accessed remotely, often reducing long trips to a physician’s office or a hospital by rural patients and urban patients with inadequate transportation.
How, specifically, can we use new IT technologies to better coordinate high quality with patients and cut costs? Here are just a few ways:
- Identifying at-risk patients. Age, ethnicity, health history, gender, geographic location and other population health data give healthcare professionals a pretty good idea of who will get sick, but only if they can share that data. Interoperable systems and data analytics are expected to be the wave of the future by greatly widening the scope of data collection, enabling population-wide analyses, and slicing and dicing the data to find answers to health management of entire groups as well as individuals. Obviously, primary care providers will continue to have a significant role in identifying potential health problems and engaging the patient in a plan to avoid them. We should expect a care management scenario that combines big data analytics, the collaboration of multiple providers, remote communications, device-based health monitoring and human insight.
- Monitoring at-risk patients to diagnose problems and prevent or catch emergencies. Wearable devices are no longer limited to cool wristbands that track our steps each day. They have expanded to enabling healthcare providers to track patients’ health and potential symptoms outside of the hospital and clinic. That tracked data can be relayed wirelessly back to the EHR and be made immediately available to physicians or other care-givers. Warning signals from devices enable patients to immediately seek help.The scope of new healthcare technologies is remarkable. Per HH&N Magazine, high-tech sensors soon will monitor the at-home cardiac patient’s heart minute by minute. A new chip will be embedded in a pill that will be activated as it reaches a patient’s stomach to confirm he’s taking his medications. New devices are emerging that will scan patients for a symptoms without invasiveness and make a diagnosis.
- Remote patient evaluation directly via telemedicine. Through remote consultations and evaluations, a physician can usually determine whether a patient should come to the hospital, needs special testing or is fine at home. Telehealth offers great potential in terms of treating patients in rural areas where hospitals and specialists are few. Through telemedicine, patients can have faster access to healthcare, which is a major factor in improved patient engagement.
- Using patient portals to support care. No-show rates for patients vary wildly—anywhere from 5 percent to 55 percent—with similarly varying impact on patient health and costs. A patient may miss a cardiac stress test and shortly thereafter suffer a heart attack. The point is that patient portals and regular communication provide essential support that improves healthcare and cost-savings. Regular communication in advance of a test can provide patients with reassurance and more information on the potential benefits of attending the appointment. Reporting test results to a patient through a portal offers needed information and the first step in a coordinated rationale for further care planning.
- Empowering patients to manage their own care. Especially regarding behavioral health, technology enables patients to learn self-management techniques that improve coping skills and ideally prevent incidents requiring hospitalization. Support for self-directed or self-managed care comes from Health and Human Services, the Centers for Disease Control and Stanford University Medical School, among others. For self-directed care objectives, mobile phone applications can remind people to take medications, track heart rates, help with stress and anxiety, and improve thinking skills, to name but a few benefits. It’s limiting, however, to think of self-managed care as essentially behavior health-related. All patients can benefit from technological assistance with taking medications regularly, improving dietary choices, monitoring blood pressure and getting some exercise.
- Providing individual support and the latest educational information. The internet is a jungle of content, some of it benign and some worse. Help patients cut through the weeds by directing patients toward reliable sites, using your portal as a foundation for information and support resources. You also can provide your own content via PDF documentation on the portal.
Moving ahead with caution. Not surprisingly, the healthcare community is struggling with purchasing decisions about emerging technologies, especially as they get more complex and expensive. Analyzing their value and projecting how they may impact clinical programs, processes, and operating costs is made even more challenging by the speed of development. Yes, improvement in hospital safety and quality and performance reporting are major priorities, but which investments will be the right ones? CMS has contributed to better understanding, but the industry needs an effective knowledge-oriented framework of stakeholders to help hospitals make the right decisions about technologies and their cost-effectiveness for their unique environments. Technology continues to be the biggest driver of higher costs in healthcare; let’s make sure our investments are worth it.