Just as digital technology has transformed every aspect of our lives, the introduction of digital health devices will provide an opportunity to solve two of the hardest problems in medical care delivery—patient-oriented and individualized, timely and convenient service and seamless communication.
These connected devices—running the gamut from smartphones to wearable technology to metabolic sensors to implantable devices—offer new capabilities that providers can use to expand care delivery in ways that new reimbursement plans are enabling.
The single biggest driver may surprise you: the Affordable Care Act (ACA)—or whatever rises to replace it in the months ahead—has forced changes in how medical payments are structured, and moved the industry further away from a fee-for-service model. Today, medical service payments are linked to measures of performance, and providers are rewarded for managing more patients outside of the walls of costly hospital stays and clinics.
Unfortunately, many of the compliance mandates of the ACA have fallen to the doctor, and this has dramatically decreased the time they have for patients. Connected medical devices are a logical way to care for more patients without compromising quality of care and to free up physicians to treat and spend more time with those patients who are in the greatest need of their particular expertise. This represents a real cultural shift for people who work in healthcare and presents an enormous opportunity.
A lot of this change to billing and compliance metrics is decidedly unsexy stuff, but it has significantly increased interest in many quarters in digital healthcare. In fact, among the early connected health products on the market are ones that help hospital systems document that they’re meeting these new compliance metrics.
These ACA mandates are not the only drivers for the use of connected devices in healthcare. There’s widespread, unmet need for access to healthcare and massive inefficiencies in our current approach. The use of connected healthcare devices in healthcare, as in other fields, is already underway, and it offers improved access to healthcare, efficiencies and better outcomes. Those better outcomes will result from continuously monitoring patients, leading to more informative face-to-face, doctor-patient interactions, and more engaged patients empowered to increasingly understand and participate in their own health and medical needs.
This effort is currently in utero, not even born. But connected healthcare through the emerging use of devices is evolving. The shift is likely to develop quite rapidly, for several reasons.
Technology’s role. A crucial driver of connected healthcare is the simple fact that more connected medical devices are being developed for this purpose. More sophisticated, specialized sensors are in development or reaching the market for monitoring various aspects of a patient’s health, including established conditions. This advancement serves to enable access to healthcare wherever the patient may live or be at the time of need.
The proliferation of sensors that can serve as diagnostic devices will likely serve myriad medical needs, from cardiac care to metabolic care, from diabetes to screenings for cancer to OB/GYN services for pregnant women.
The fundamental prerequisites to make this work are already out there: a smart mobile device and an Internet connection, both nearly ubiquitous in developed economies. In developing nations, there’s an opportunity to leapfrog over a lack of legacy communications infrastructure with standalone units that provide power and connectivity to entire villages.
In either a developed or developing nation, the patient data transmitted to a doctor at a facility would be used to devise a treatment strategy. Then the patient’s journey to a brick-and-mortar facility would be streamlined and targeted at specific treatment.
In fact, this scenario is unfolding today, ad hoc, as smart mobile devices become ubiquitous, as those devices are equipped with the sensors and specialized apps.
The patient’s role. Studies show that patients with knowledge, rather than fear, of their health issues exhibit more rational behavior in terms of aligning their lifestyle and medication compliance with their physician’s recommendations.
But connected healthcare goes beyond conditioning patients to take care of themselves. Over time, it gives patients the potential to educate themselves, thus creating widespread medical literacy.
Then there are aggregate benefits. If a physician seeing a certain number of patients realizes that one-third of them suffer from the same disease, there are huge efficiencies in treating them. Ultimately, aggregated, anonymized data from patients around the world will provide insights into environmental and behavioral factors that lead to discovering the incidence of various conditions and diseases. This will improve our ability to provide education, preventive measures, early detection and treatment.
Digital concerns and hurdles. As in every domain touched by digitization, the privacy and security of healthcare data remains a perennial concern. Although the privacy and security of patient data has been addressed to a degree by existing policies and regulations, it will undoubtedly draw further scrutiny as connected healthcare becomes a pervasive practice.
Clearly, the fate of the ACA remains to be determined. If it is repealed, the shape of its replacement is also currently unknown. So the widespread advent of connected healthcare may well require new business, insurance and legal models to make it work. Many unknowns remain.
A path to commercialization. While I believe connected healthcare through widespread use of medical devices will rapidly grow, the industry is early in discovering the potential, and it’s yet to discover the so-called “killer app” that will give connected health immediate traction in the marketplace, and a warm embrace by physicians and patients. As with digitization in other domains, however, I fully expect killer apps to arise, opening the door to a broad array of applications.
Our efforts at the University of California’s Keck School of Medicine are but one among many around the world. We have partnerships that are pursuing the medical, technological, cultural and regulatory challenges facing digitized healthcare. Although we clearly face many such challenges, the promise of digitized healthcare would appear, in my view, to make its adoption inevitable.
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