I recently had an enlightening discussion with a senior executive at a three-million-patient health system. This health system has developed remote monitoring programs for patients with managed conditions such as hypertension and Type 2 diabetes. Surprisingly, their motivation for investing in preventative technology was not driven by reimbursement incentives, which many argue will be the stimulant of a value-based care shift. Instead, this health system was driven by a single, stark reality: Over the next three to five years, many physicians are retiring and even fewer are entering the workforce, while the number of patients is rising.
Addressing the imminent physician shortage will be a challenge for health systems that are already facing escalating regulatory pressures, an increasing number of patients in need of healthcare, and a growing elderly population being treated for one or more chronic conditions.
The only way to service an increasing patient population with a decreasing workforce is by implementing strategies that yield a magnitude of productivity. I can state confidently, as a technologist, that the only way to create ten times more output without ten times more human capital is with technology.
The burden of chronic disease
It’s important to understand and recognize the burden of chronic diseases on patients’ lives. These diseases impact their day-to-day or even minute-to-minute decision-making. They are expensive and cumbersome to treat for both patients and providers. Our systems are crippling under the financial implications associated with chronic diseases and the poor self-management of patients. Though financial models are not yet in place to cover the full spectrum of remote care, there are financial incentives, which health systems can help drive, that enable physicians to better manage, treat, and empower patients remotely.
Patient-generated health data is key to helping patients self-manage their condition, but the context around that data is essential. People who suffer from diabetes must learn how their dietary habits – when, what, and how much they eat – impact their a1c, blood sugar levels, weight, and insulin dosage. Similarly, this data provides physicians with insight into a patient’s lifestyle and health. Care teams can view sleep data, blood sugar data, fitness data, blood pressure data, and other values critical to better managing patients. Creating a dynamic in which patients receive their data back, contextualized, and in which physicians have an opportunity to treat patients holistically, creates a value-based system.
Patient-generated health data
Disease management programs are commonplace, but extant services are often comprised of regular in-person visits, weekly or monthly phone calls, and manually reported patient data. Challenges to this time- and resource-intensive, hands-on model are introduced within rural populations, where a patient’s medical institution may be two or more hours away, making routine face-to-face visits cumbersome and unrealistic. Also, when a patient is pre-chronic, full reimbursement is not available for the followup visits needed to help prevent the complete onset of a condition.
Technology solutions that produce and integrate patient-generated health data (PGHD) can be leveraged to address many of the challenges faced by patients and physicians today.
Brockton Hospital, part of the Signature Health System in Massachusetts, in partnership with iGetBetter, has started to leverage PGHD to reduce readmissions for patients with heart failure and COPD. These efforts have led to remarkably improved patient care and outcomes as well as a substantial cost savings.
A 2014 pilot involving 31 heart-failure patients aimed to reduce readmissions by utilizing connected blood pressure monitors and weight scales. Data from the devices fed directly into iGetBetter’s care management portal. Without this intervention strategy leveraging PGHD, Brockton typically sees a 28% readmission rate; however, in this study, no patients were readmitted, leading to an immediate savings of $216,000. Programs like this demonstrate the immediate value of PGHD and provide a useful incentive for helping clinicians and IT staff understand how to effectively capture and utilize patient data generated outside of the clinical setting.
Another example is the Validic and SAP partnership, in which patient-generated health data from more than 400 personal and in-home medical devices is pulled into the HANA Cloud Platform. Together, this joining of platforms enables data to be turned into actionable insights, allowing patients to improve their health and quality of life.
Engaging with patients in preventive care measures, whether through mobile or other means, and obtaining access to real-time status data is essential to improving clinical outcomes and controlling costs amidst the impending physician shortage. By capturing and integrating reliable PGHD with other EHR data to guide clinical interventions and care decisions, health systems will have an advantage that will pay off in care quality and financial returns.
To learn more about turning real-time data into actionable insights, visit SAP Booth #543 at #HIMSS17, February 19-23 and join the conversation with Drew Schiller at 2pm (ET) on Wednesday, February 22.Comments