Patient Data and the App Economy: What’s Next?
Close provider-patient communication gaps with health application solutions
In previous blogs, we’ve talked about how the “appification” of health care can better engage patients, including how health application solutions may better connect a patient’s team of family caregivers who often do not receive critical, life-saving information until it’s too late. And we’ve also explored three major advances that the app economy brings to health care organizations’ business decisions and data transparency, including population health enablement, care coordination, and streamlining the patient experience for better customer satisfaction.
It’s not just about having a slick health application offering for brands, however. As any good marketer can attest, customer engagement (patients, in this case) is about reaching your customers where they are — where they are already spending their time. And currently, at least 95 percent of all Americans own a cell phone, 77 percent of which are smartphones.
“Serious gaps in communication” have been blamed for a spike in hospital readmission rates, particularly in elderly patients being discharged into post-acute care settings. But according to a new study, even a majority of Medicare customers age 80 and older are in on the smartphone action, with 69 percent more Medicare enrollments happening online this year, many enrollments of which are likely occurring on these devices.
This year is already shaping up to be an exciting one where the next frontier of the health application economy is concerned — it’s all about the patient. And some of these new technologies force us to look at smartphones as not only vehicles for obtaining data and sharing more of it, but to also examine data’s usefulness in this process. Can healthcare application technology and data be used to narrow the communication gaps between patients and their providers, improving accountability and outcomes at the same time? Or are we simply inundating already overburdened physicians with mounds of interesting, but ultimately siloed and useless, data?
A glimpse into the future
The marketplace has exploded in the last couple of years with health care IoT and HIE devices and apps. And there is no grander world stage to unveil new tech gadgets than the Consumer Electronics Show (CES), held annually in Las Vegas.
A solar cow may have taken the 2019 CES Innovation Award (we’re not kidding), but it’s this year’s new health application and tech product announcements that get us most excited at Bridge Connector. And several devices/apps show great promise, in our opinion, to improve patient–provider communication and accountability:
- Omron’s Heartguide blood pressure smartwatch, the “first, clinically accurate, wearable blood pressure monitor,” which takes medical-grade measurements and night readings to test for hypertension and risk of stroke while sleeping; syncs with the HeartAdvisor app to communicate this data back to doctors
- IQcast, the Medtronic app collaboration with IBM Watson, which uses AI to help diabetics predict a low blood glucose episode within a one to four-hour window
- RxPense, the smart medication dispenser for seniors and care facilities, that lets providers and caregivers know if a patient missed a dose; additional capabilities to obtain and store patient vitals
- Imec, Belgian electronics company wearable device, which gauges stress levels with a variety of sensors, to assist with psychiatric and workplace stress assessments; long-term goals include increasing mental wellbeing without the use of antidepressant drugs
- BoneTag, an orthopedic implant tracking and evaluation tool, which enables communication with all brands of surgical orthopedic implants by connecting them and making them “smart”
- Valencell suite of 30 different wearable and hearable sensors, some of which draw on the co-morbidities of hearing loss and cardiovascular disease with solutions such as hearing aids that can measure vital signs, and other solutions which use biometric sensors in headsets to improve safety in the workplace, such as with aviation pilots and long-haul truckers
Present-day products, with brands we already know
Apple unveiled the Apple Watch Series 4 last fall with an FDA-cleared atrial fibrillation-detecting algorithm, electrocardiogram sensors, and fall detection which notifies emergency contacts.
Not to be outdone, one of the original fitness wearables and apps, Fitbit, has launched cheaper products to bring more customers into the fold, including a new model for children over the age of six, to reduce childhood obesity rates from their rebranded vantage point as not just a fitness device but a “digital health care company.”
Samsung combined most of the aforementioned app functionalities in the form of a robot “companion” with its Samsung Bot Care, also unveiled at CES 2019. It also supports video calls for real-time communication and greets users in the morning with a sleep analysis. “Good morning, Jessie, did you sleep well? You slept a total of eight hours.”
Hot off the presses even more recently from Amazon, their Amazon Echo device and Alexa voice assistant technology now allows for “Alexa” to act on HIPAA-compliant health-related requests, such as booking appointments at a nearby urgent care clinic, or checking the status of prescription refills. Or rather, select developers have received the invite-only call to create and launch solutions, aka “skills,” utilizing their technology. This, after a successful Amazon Echo pilot program at Los Angeles-based Cedars-Sinai, where an Alexa request by a patient is routed through the health care-specific Aiva voice assistant platform, to fetch medicine (the request goes to the nurse’s mobile phone) for example.
In related news, the FDA recently cleared Spry Health’s Loop System. Of many wearable devices, such as those already discussed, or dozens of others in the works, this remote wearable is specialized for Chronic Obstructive Pulmonary Disease and other chronic condition patients, however, and does seem to do a better job closing the “loop” of communication we are rallying for here — it continuously collects and analyzes patient health data with the intent to actually warn providers of potential deterioration, allowing them to focus their care on those patients who display the highest risks.
But what to do with all of this data?
With all of the devices and apps remotely monitoring patient vitals, you’d think that seamless patient–provider communication and health IT interoperability is farther along than it actually is. But the health care industry still has a long way to go in this arena.
The first issue to tackle is provider and physician access to all of this patient data. Many of these technologies rely on the patient to bring their device or mobile app into an appointment and remember to ask the doctor about an abnormal reading or downward trend their app has detected. Interoperability has not been universally achieved within singular health systems, even. So the idea that all of these wearables’ data is being connected to clinical EHRs is an far cry from reality.
“When Amazon knows more about you than your physician does, it’s time for health care to play catch up,” said Bridge Connector VP of Sales, Brian Cappy. “That’s why we are all about fixing this information-sharing gap for healthcare organizations, facilitating communication, and creating healthier communities.”
And higi, the network of over 10,000 health stations with blood pressure cuff and other capabilities in U.S. pharmacies and workplaces, is one Bridge Connector partner who has been successful at turning patient data into useful information. They give patients control over their own data, and the ability to share data directly with their providers. higi has termed the resulting, improved level of patient engagement “the 4th network of care,” because it allows consumers to measure, track and act on their health data while enabling the major three care networks — hospitals, outpatient provider clinics and urgent care centers — to deliver the highest quality care. Bridge connects higi’s rich, patient “data” into current care delivery systems, so providers are more empowered to act on “information.”
But how many health care companies are equipped with patient engagement tech or health application solutions similar to higi? And of those new wearable and other tech advances we’ve reviewed, how many of them are “connected,” enabling patient data to be turned into useful information — information that needs to be succinctly reviewed by providers who are already stretched too thin? Further, has that information been triggered with actionable prompts, at the point of care, to help them more easily do their jobs?
Karl Poterack, the Mayo Clinic’s medical director of applied clinical informatics, reiterated this theme when he pointed out some concerns about the clinical applicability of wearables’ data. He also identified reasons why physicians are afraid to use the data: with too little context (the lack of interoperability between systems), physicians cannot fairly interpret data, and thus do not want to be held legally liable for bad advice, or for not detecting an adverse condition early enough in the game.
BUT WAIT … THERE’S MORE
We would be remiss if we didn’t at least touch on another area that greatly affects patient outcomes but is barely being discussed with physicians at all. Despite 78 percent of Americans being affected by at least one social determinant(s) of health (SDOH) — where patient access to quality medical care is limited due to “social” factors, such as lack of affordable housing, transportation, education, adequate food, and other criteria — only about one in every five patients affected by SDOH are actually discussing these issues with their providers.
How to address the transportation SDOH in particular has led to recent advances in telehealth, with the U.S. leading innovation in this area, largely as a result of our senior population and high prevalence of patients suffering from comorbidities. Whether a combination of messaging and video apps, or a standalone device, telehealth and health application solutions not only close communication gaps but enable patients quicker access to actual provider care in rural areas, and in emergency situations.
As we continue to track how health care should best address SDOH as a recent trend, Bridge Connector will soon be able to reveal more about how we’re working with partners to address SDOH within the clinical setting, at the point of care. Because that’s where we’re most interested in affecting real change — changing how health care communicates to boost positive outcomes for patients, while make providers’ lives easier along the way.