Electronic Health Reporter

Guest post by Kent Dicks, CEO, Alere Connect.

Mobile devices are completely ingrained in the fabric of our daily lives – from personal use to business – throughout the world.

The healthcare industry, usually resistant to the whims of technology trends, has been a fast and significant adopter of mobile devices. Apple’s introduction of the iPad appears to have been a watershed that brought healthcare IT into the 21^st century. Besides improved efficiency in communication and administrative functions, clinicians found the devices much more practical to incorporate to patient interactions – from consultation to education. Now mobile devices have become almost indispensable in the daily care of patients. Physicians use smart phones and tablets wherever they review patient records, receive updates or alerts by secure text messaging and coordinate care among other clinicians. Care professionals are connected to health information like never before.

Telehealth has “connected” patients and physicians for decades in an attempt to deliver proactive healthcare, but mobile devices and cloud-based technologies are making remote healthcare more practical. Still, we are just scratching the surface as to what a “connected healthcare system” can look like. Despite strides, we still need to tie it all together: patients, physicians, devices, data, analytics, decision support, monitoring services and education – to achieve the best outcomes for our patients.

A connected patient is more compliant with a better chance to attain better outcomes. A connected provider has access to better information to make better decisions. The common goal is to keep the patient out of the hospital, lower costs, reduce the strain on an already strained healthcare system and provide better outcomes. How we implement the goal of a connected healthcare system is the challenge.

In assessing how to best utilize mobile technology with patients and providers, my belief is that one solution doesn’t fit all. We must align the right technology with the right patients. Smart phones and tablets with complex apps and expensive data plans may be common in demographic groups that may skew younger, or those with higher technical literacy and dexterity and more disposable income. Simpler technology using month-to-month or prepaid service plans may better suit seniors and those with limited and fixed incomes. Meaningful change will come faster by focusing on the 15 percent of the population that consumes 80 percent of healthcare costs. This segment traditionally includes the elderly and indigent, Medicare/Medicaid population. This group doesn’t overwhelmingly consume the “latest and greatest” devices with the hottest apps and seamless connectivity – 4G, Bluetooth, WiFi and syncing to the cloud is not reality. We must be realistic when we propose solutions to address something as important as the delivery of patient care, providing the right technology to meet the needs of the people using it. Acquiring the right data, at the right time, and right cost, to achieve the right (better) outcome for the patient.

Mobile technology and cloud computing are the right vehicles to achieve the promises of telehealth: Proactively connecting remotely located patients with their care providers, enabling the timely exchange of health information, giving clinicians opportunity to detect changes in trending quicker, and allowing more timely intervention when needed – ultimately avoiding more costly care scenarios.

ACOs working off of capitated costs need effective technology to reach more patients, using fewer resources, to keep connected to patients and avoid expensive therapy or hospital admissions. Mobile health technology has produced impressive results in 30-day CHF re-hospitalization avoidance. CHF patients released from the hospital can be monitored on a daily basis to make sure their condition is in check and avoid an ER visit or readmission. CMS applies reimbursement penalties to organizations whose patients are readmitted to the hospital within 30 days of discharge having CHF, MI or Pneumonia (27 percent of patients with CHF readmit to the hospital within 30 days, 47 percent readmit within 60 to 90 days).

As previously mentioned, another approach is to use smart phones and tablets with health related apps. There are an estimated 100,000 apps for health and wellness in Apple’s App Store. Many are downloaded, used a handful of times and never used again. Even the most dedicated users admit to adherence gaps, having to manually enter vitals on a regular basis. Imagine trying to get less motivated individuals to use apps to consistently supply and track readings. Additionally, there are many questions when you shift this model from health and wellness to disease management: who pays for data plans? Which clinical systems can apps integrate to? What are the regulatory implications in using apps?

Another use of mobile healthcare technology is SMS text messaging. It’s used to communicate with patients on a regular basis with smart phones, tablets and more basic pre-paid cell phones. It’s one of the most economical ways to reach patients. A great example is Text4Babies, the first free mobile health service in the US. Text4Babies uses text messaging to support pregnant women and new mothers, especially among lower-income and underserved populations with health information and timely reminders regarding prenatal care and doctor appointments.

It’s notable that the market for MEMs (Micro-Electro-Mechanical Systems) sensors in home health is expected to explode over the next few years. These very small sensors are used in every major market from automotive and consumer electronics to medical devices. MEMS sensors are cost-effective with broad application for use. In home healthcare the technology is used in wearable sensors to monitor a variety of patient vital signs, including arrhythmia and glucose levels. The sensors communicate wirelessly with mobile devices to put information in the cloud.

The future for mobile health technology is bright. With initiatives to integrate EHRs into every hospital and doctor’s office, the data must be acquired from wherever the patient is – point-of-care, home and beyond – to wherever it is needed. The data will come from the old and young, rich and poor, healthy and sick. It will arrive from different flavors of mobile technology: smart phones, tablets, and dedicated cellular health hubs. It’s not a matter of “if” mobile technology will be used to integrate a truly connected healthcare system, but “how.”