March to digital healthcare

Digital Healthcare has emerged as an industry watchword and is more than a passing term when we see the multitude of 'wearable' healthcare related gifts being opened and used over the recent holidays.

Wearables have almost tripled according to analyst firm IDC that tracked the market between 2014 thru 20151. Far from being trendy or cool the wearables are part and parcel of the evolution towards the IoE (Internet of Everything) and will be an increasingly large component of healthcare's ability to cultivate behavior and wellness. Think of it as an expanded bridge between the physical and digital interactions between providers and patients.

Consider that these digital health technologies (fitness trackers, smartwatches, clothes, video chat apps, remote medical monitors, etc.) offer the consumer/patient/care giver a snapshot of clinically relevant data. This snippet of data is interesting, while it may not qualify as medical device data (FDA approved), it could serve to inform practitioners anecdotally as part of the patient health experience. As such, it makes sense that this information, while not necessarily qualified as PHI, should be tracked, managed and utilized within the entire range of clinically relevant data collected in the patient healthcare record.

Growing Benefits of Tracking Digital Health Data:

o Evaluate trends/symptoms/complications
o Identify the onset of a disease process and care options proactively
o Recommendations and preventative care activities
o Compliance and tracking to medical advice (alarm management)
o Responsibility for required health related next steps (prescriptions, exercise, sleep, reporting, etc.)
o Greater transparency to healthcare efficacy
o Routine health requirements accomplished via mobile devices
o Measurable results, etc.

As we engage value based care models and the technology that support results (value over volume) the industry must rethink and re-architect its enterprise systems to embrace and rapidly utilize the clinical data that digital healthcare provides. It has enormous potential in Telehealth, cybermedicine, patient monitoring and behavior modification. Digital Healthcare provides a firm and personal handshake between payer and the patient which has been forsaken in the volume based models.

When asking colleagues, friends and family how they are capturing and using their Digital Healthcare products in relation to their electronic healthcare records or patient portal you get the unfortunate answer "I'm not...not sure how I would incorporate". This is the opportunity and initiative that the provider community can take as they look to modernize and transform.

Digital Health in Practice

At Adventist Health, headquartered in Roseville, California, we have started using our wellness application to encourage improved health activities of employees. The employee benefit package includes a standard health plan package and an "engaged" health plan package, which includes a lower annual deductible and out-of-pocket expenses by being more proactive with our health. We earn points for various activities, and one way to get points is through the logging of exercise and activities. Many of us have our Fitbit pedometers synchronized to our health plan portal, where the data is logged each day and gives us points for meeting our annual goals for qualifying for the "engaged" plan level. This really helps to make the data meaningful. It includes a mobile application where additional data can be logged.

Per Kathleen Wilson, Vice President of Benefits of Administration for Adventist Health, they "use the information in the portal for clinical monitoring in partnership with the patient, and will be incorporating it into our wellness/health coaching workstream, with interest in moving toward integration with our provider software applications. This is, of course, based upon patient permissions and is a collaboration between caregivers and patients."

Adventist Health is also discussing ways in which we can have types of remote patient monitoring data uploaded to the patient portal that could then be made available to the EHR for provider review and potential inclusion into the medical record. Today the focus is on more medical grade remote monitoring devices, but the proliferation of wearables makes this a topic that could need to be broadened in the future.

Conclusion

As you consider your march to Digital Health, look beyond the immediate features above and think of building a technology infrastructure to manage future requirements and capabilities across the entire healthcare environment. Digital Health and remote monitoring technologies should be rapidly edging themselves to the forefront of your HIT strategy-mapping and discussions. But, there are many additional factors to consider when designing and developing your path to digital health. Utilize the best practices of other health systems forging the way and consider the capabilities of HIT consulting firms to assist in assessment and implementation.

Sheila Henriques is an Executive Director for Clinical Systems in IT at Adventist Health, a faith-based, nonprofit integrated health delivery system serving communities in California, Hawaii, Oregon and Washington.

Hjalmer Danielson is a VP at Ascendian Healthcare Consulting and a frequent contributor to the subject of Health Information Technology. You may contact him directly at hdanielson@ascendian.com or visit the Ascendian website for more information at www.ascendian.com.

1 March 2015, IDC Health Insights Perspective: IoT Outlook

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