Realizing the Potential of Remote Monitoring and Patient-Generated Health Data
If you or a loved one has a chronic medical condition, such as diabetes or heart disease, you’re familiar with the ever present danger of a major medical episode. You’re also probably accustomed to frequent hospital visits. According to the U.S. Centers for Disease Control, almost 1 out of every 2 adults suffers from at least one chronic illness. As a nation, 75% of our health care dollars go to the treatment of chronic diseases, yet some chronic illnesses rank among the most preventable. Thus, as a nation we are quite sick with diseases that are preventable yet collectively cost us a significant amount of money. What’s wrong with this picture?
For a country that has employed the wonders of modern technology to fuel our individual obsessions for minute-by-minute information on our heroes, celebrities, pop-culture, sports and news – one would assume we would equally want to understand when something is about to go seriously wrong with our health and in our bodies. Particularly, those who are at highest risk. How can someone in the midst of diabetic shock be expected to take steps to seek emergency medical help? And even when needed supervision is present, you often have to rely upon visual indicators that appear too late. We can’t see a severe diabetic’s glucose levels begin to tumble/drop to dangerous levels by looking at a person.
Recognizing this need as an opportunity, the information and communications technology (ICT) and telecommunications sector is working to improve healthcare by enabling the real-time remote monitoring of patient-generated health data (PGHD) outside of the hospital room. Generally, PGHD is any health-related data created, recorded, or gathered by or from patients to help address a health concern. In the context of the example mentioned previously, a diabetic would wear a blood glucose monitoring device that transmits readings to a health care professional in real-time. Of course, this is only one example of countless others where remote monitoring of PGHD can improve the lives of tens of millions of Americans impacted by chronic medical conditions.
The benefits of remote monitoring solutions that transmit PGHD are well-known past the example of real-time notifications of medical emergencies to health care professionals. A recent technical expert panel formed by the National eHealth Collaborative recently concluded that the use of PGHD enhances patient care, raises accountability by healthcare providers, reduces return doctor visits, and can lead to improved lifestyle choices and improve overall health, among other benefits. There are also real cost savings that benefit our entire society – for example, a recent study has predicted that remote monitoring will result in savings of $36 billion globally by 2018, with North America accounting for 75% of those savings.
With all these projected benefits, you will be hard-pressed to find a person refuting the potential of remote monitoring and real-time access for health care professionals to PGHD. Despite near unanimous agreement on its benefits, however, we still don’t see the widespread deployment of these solutions. Meanwhile, cloud-based solutions utilize the same concept across countless other sectors of the economy, from smart utility meters to the entertainment industry. The capability has already been developed. So what’s the hold-up?
TIA members have found that a combination of policy and regulatory barriers take a lion’s share of the responsibility for preventing the adoption of these advanced solutions. For innovators looking to provide remote monitoring solutions to patients, a complicated quagmire of regulatory requirements and liabilities exist in multiple agencies within the Health and Human Services Department (HHS), as well as the Federal Trade Commission (FTC). Fortunately, patient-generated health data is on track be incentivized through the U.S. government’s multi-billion dollar electronic health record incentive program (known as “Meaningful Use” criteria), now in its second of three stages in implementation with HHS working to propose criteria for Meaningful Use Stage 3. It is still important that efforts within HHS ensure that the full potential of PGHD is realized through this incentive.
While it’s valuable to see the forest through the trees in recognizing the value of the remote monitoring concept, there are concrete steps that policy makers can take today to help modernize US healthcare by bringing remote monitoring and enhanced eCare to you in the very near future. As mentioned above, a key opportunity exists for HHS to include clear expectations in its Meaningful Use Stage 3 that support remote monitoring of patient-generated health data, and require open, voluntary, and consensus-based industry standards for interoperability with remote patient monitoring devices, services and systems. Another exists for the HHS’ Center for Medicare and Medicaid Services, or CMS, in extending support to remote monitoring solutions through their schedule for physician reimbursements.
Remote monitoring and PGHD should become elemental to the efficient delivery of healthcare. Right now, TIA is working with its members and other stakeholders to advance this cause, and we call on Congress and the Federal agencies to join us both in the short- and long-term. With this needed support, the U.S. healthcare system can pass the tipping point and move to a connected and enhanced system that will set the gold standard for the rest of the globe.