How to survive the deluge of patient-contributed data with a predictable, clinically relevant approach
With great fanfare and national promotion, the latest version of the Apple Watch was released last month featuring an electrocardiogram sensor that, with an accompanying app, will tell users if their heart rate shows signs of atrial fibrillation. However, this product is just one of the hundreds of wearable monitoring devices and countless apps (AKA “gizmos”) already on the market. These gizmos measure a growing list of health indicators such as heart rate, stress, blood pressure, blood sugar, respiratory factors, and even potential early signs of breast cancer.
Most of these gizmos are marketed to consumers with claims that they will be able to share their health data with their physicians. However, as useful as this might seem on the surface, an avalanche of repetitive or clinically irrelevant data is not what physicians need to improve care. What they need is meaningful and actionable data tied to patients’ medical conditions and treatment plans.
Patient-contributed data and outcomes can be highly useful, but how will physicians and health systems transform this data deluge from patient gizmos into a stream of meaningful and actionable insights? The answer lies in capturing condition-specific data on a disciplined, clinically relevant schedule integrated into a prescribed care plan.
Easy-to-use mobile-enabled remote patient monitoring (mRPM) is now available to enable physicians to harness the flow of patient-reported data and outcomes. Not just biometric data either: objective and subjective data, as well as social determinants of health information, can be collected based on clinically validated and relevant questionnaires that patients answer on their smartphone when it is convenient for them.
Thanks to the near-ubiquitous adoption rate of mobile devices, mRPM stimulates patient engagement and helps them take more responsibility for their own health. The technology also gives providers a contextually meaningful way to use gizmos to receive actionable information, which enables them to better manage chronic conditions and care transitions in between face-to-face appointments.
Effective remote monitoring: Biometrics plus real-world context
Gizmo-reported biometric data, such as blood pressure, blood sugar or weight, is helpful for patient monitoring, and the high adoption rate of smartphones now expands the number and types of additional objective and subjective data that can also be captured. These other information sets offer context and help providers understand much more about their patients’ health conditions and social determinant factors than the biometric data alone can provide.
For example, a patient reports an out-of-range blood pressure measurement. That metric indicates a problem but offers no context to help guide clinical decision-making. Is the patient’s medication ineffective? Are they experiencing pain from some recent injury? Has the patient recently visited another provider who prescribed a different medication that is affecting the efficacy of the medication?
By using a mRPM solution, the patient can respond to these queries and more. In this instance, the patient could respond that he has not been refilling his prescription because he has not been able to get to the pharmacy due to lack of transportation. The provider’s office staff could then either help the patient arrange for delivery of the medication or locate available transportation services.
This type of simple, highly automated encounter could prevent the worsening of a chronic condition as well as comorbid conditions while avoiding a needless visit to the physician’s office or a costly emergency department (ED) visit.
Patient-provider communication scenarios such as these are part of the reason why the National Quality Forum has stated: “Patients remain an untapped resource in assessing the quality of healthcare and of long-term support services. Patients are a valuable and, arguably, the authoritative source of information on outcomes beyond experience with care.”
Likewise, collecting this feedback and data from patients can have the ancillary benefit of driving stronger awareness and engagement of each patient with their care plan. As discovered in a recent report from the Chronic Care Management (CCM) service from the Centers for Medicare & Medicaid Services, many patients receiving the CCM service reported that they did not realize they should be concerned about their multiple chronic conditions until they received the additional associated monitoring.
The path towards clinical relevance
Valuable patient-reported data can seem overwhelming when a countless number of gizmos are inundating physicians and other clinicians with sporadic, often irrelevant metrics. Dismissing patients’ active interest in monitoring their health, however, would be a missed opportunity to improve their outcomes, especially for patients with chronic conditions.
Instead, physicians can harness patients’ gizmo enthusiasm through a mRPM platform that provides a structure for capturing clinically relevant outcomes on a disciplined schedule that makes sense for the patient’s health conditions. For example, in most cases, a patient with hypertension needs only to report their measurements once a week. That means an inexpensive home blood-pressure cuff can be provided as part of a mRPM care plan that gathers this data only that often.
It works like this: A patient is enrolled in a mRPM “care journey” specific to their chronic condition, recovery or general health. On a pre-determined schedule, patients are prompted to enter biometric, objective and subjective data and questionnaire responses. These entries are automatically forwarded to clinicians and reviewed at the practice or health system to assess risk and possibly follow up with a live intervention.
This is an automated process that activates and engages patients to participate in their care while delivering gizmo data surrounded in context to providers on a measured schedule appropriate to the situation. A process such as this is much more efficient and relevant than receiving a flood of non-actionable data 20 times a day, or whenever the patient happens to remember.
Leveraging mobile’s high adoption rate
Smartphones and other mobile devices are essential tools for data-transmission efficiency, but are also the most convenient and accessible means of connection for most adults today. The average U.S. consumer now spends anywhere from three to five hours a day on their mobile device, the vast majority of the time using apps. Granted, younger populations skew these study results, but Pew Research Center reported this year that 46 percent of seniors own a smartphone, while 73 percent of Americans aged 50 to 64 own such a mobile device.
Today, mRPM can leverage this technology since it is already widely adopted and heavily used among patients of all ages. Patients do not need to acquire or learn any new device or specialized equipment. This familiarity, and preexisting lifestyle integration, offers positive adherence momentum for physicians in launching a mRPM program for their patients.
mRPM technology works well for patients, who can answer a few short condition-specific questions using their phone or tablet on a schedule and at a moment that is convenient for them. It fits with providers’ workflows since it delivers a concise summary of clinically meaningful information that helps them determine if early or immediate intervention is warranted.
Leveraging mRPM makes gizmo data predictable, relevant and actionable — instead of a deluge — and an essential tool for population health management and value-based payment.
About the author:
Harry Soza is president and CEO of CAREMINDr, a Silicon Valley tech company that partners with health plans and providers to advance population health management by enabling physicians to leverage the power of mobile-enabled remote patient monitoring that engages patients and leads to improved outcomes and lower costs. He can be reached at hsoza@caremindr.com.