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This is week 4 and the theme is The Future of Connected Devices. We have engaged VisiQuate to share insights on this week’s theme.
When remote connected devices were first introduced into healthcare, they were seen as more of a novelty, or at best a point solution that was a supplement to care. For example, a device might help a physician keep abreast of a patient’s daily blood pressure or weight fluctuations while the patient was recovering at home after surgery, but those applications were often “in addition to” rather than an integral part of “regular” patient care.
In the past couple of years, this mindset began to shift as connected devices slowly gained acceptance as part of the mainstream of care. Then came the COVID-19 pandemic, and suddenly “regular” care (i.e., in-office clinical visits) was no longer an option for many – especially the sickest and most vulnerable among us who needed them the most. Practically overnight, the ability to monitor patient vital signs and other information outside of traditional clinical settings on a regular basis went from novelty to necessity. With it came a hockey stick-like increase in the desire for data-rich ecosystems that could facilitate remote patient care, turning the pandemic into a proving ground for the value these connected devices bring in improving health outcomes and patient satisfaction while reducing costs.
The question at this point is where do we go from here? It’s unlikely that healthcare will go back to the way things were, with connected devices being treated as a “nice to have.” That genie is already out of the bottle and isn’t going back in since many providers are either considering or have already adopted the technology.
Fortunately, even the Centers for Medicare and Medicaid Services (CMS) has acknowledged the value of remote care with changes in reimbursement that treat telehealth visits and remote patient monitoring (RPM) as a valid option for any patient rather than those in special circumstances (such as living in rural areas). While these changes were approved in response to the pandemic, it seems likely they will continue once COVID-19 is behind us because they just make so much sense.
The more likely (and better for everyone) scenario is not only that the use of connected devices continues, but that the data they are generating is shared with the entire care management team – with the patient at the center.
This approach will be a significant upgrade over the current standard, where individual providers gather data from connected devices strictly for their own segment of care. For example, a cardiologist may monitor heart rhythms and blood pressure post-surgery to watch for any changes that could lead to an emergency department visit. But that information often isn’t shared with the patient’s primary care physician, or the endocrinologist who is helping the patient manage his or her diabetes. It’s also not typically shared with the patient’s health plan that could use it to improve their case management approaches and benefits, or with medical device manufacturers that could use it to improve the performance of their devices.
By creating a connected care ecosystem centered around the patient, and feeding the data being generated by connected devices into advanced analytics, the quality of care could be improved significantly as part of a team effort while waste is eliminated or at least greatly reduced.
Aligning reimbursement and incentives
Of course, in order for that future to become a reality reimbursement and shared incentives must be more closely aligned with this collaborative approach to connected devices. It is likely this change will be driven by healthcare’s continued shift from fee-for-service to value-based care. Obviously, as providers see health outcomes improve they will want to expand the use. But health plans can also drive this expansion, because as they gather the data that shows their payments are being reduced by the use of connected devices, they will begin insisting on their use as well.
Device manufacturers will have concrete evidence to demonstrate the contributions their devices are making to health outcomes for specific conditions, giving their commercial effectiveness teams more ammunition to convince providers to incorporate their devices into patients’ plans of care. Additionally, the feedback loop created on the devices will help drive continuous product improvement that further stimulates use.
Course corrections – small and large
One area where better use of connected devices will make a difference is in how healthcare organizations help keep patients on track toward their health goals.
Currently, connected devices are primarily used as an early warning system that a negative event is about to occur that could lead to an outcome such as an ED visit or hospital stay. In some cases they are also giving patients a gentle nudge to encourage preventive behaviors, such as reminding them to drink more water or meet exercise goals for the day. Going forward, these devices and apps are increasingly integrated into the healthcare ecosystem, the early warning signals will hopefully not need to occur in the first place.
Personal, consumer-grade devices sometimes offer that capability, but most don’t generate much usable data around it. Moving forward, however, physician- or health plan-provided devices will not only offer the reminders but also log them so care managers can do a better job of assessing the patient’s level of engagement with the plan of care in addition to ensure actions were taking. These sorts of micro-interventions can help keep patients on-track so they avoid the need for larger interventions later.
This same data can also be used to determine when larger-scale, non-emergency interventions are required, such as bringing in a certified diabetes educator to work with a patient whose glucose levels are fluctuating or inconsistent, or suggesting a meeting with a behavioral therapist if the data indicates that a patient who used to be compliant is now deviating more frequently from his or her plan of care. By recognizing issues such as these early, and delivering the appropriate interventions, providers and health plans can avoid the larger, most costly events that lead to higher costs and poor health outcomes.
The explosion of data overall, and the relationships between traditional healthcare data and data coming from connected devices, offers even more opportunity for AI/ML-based analytics to provide relevant and timely insights about patients that can be used to optimize active and passive care pathways. Making all of this data-gathering a regular part of the healthcare ecosystem, rather than a case-by-case add-on, will certainly improve individual outcomes across the board. But it will also create the feedback loops that, when combined with artificial intelligence and machine learning-enabled analytics, help drive continuous improvement in care pathways to elevate population health as well.
The COVID-19 pandemic has demonstrated how connected devices can contribute to more effective healthcare. But we have only scratched the surface.
As they move from novelty to necessity in the eyes of providers, health plans and patients, the data they generate will ensure the whole value is greater than the sum of the parts.