Digital Health

Technology

Overview

Digital Health is the explosive collision of technology and healthcare. Arguably, digital health was born with the transition from paper to electronic medical records.  This key disruption started a chain reaction that would affect an entire industry and business model.  Public policy and regulations are being put in place to support healthcare systems improvement through digital innovation.  With the advancement of digital health, doctors, patients, innovators, and payors alike will be empowered to conduct the creative problem-solving required to overcome healthcare challenges.

The challenges in healthcare are ready for digital innovation.  Policies, regulations and organizational goals are starting to align, bringing together the informational silos that exist in healthcare.  Medicare and Congress have made the exchange of information a requirement for reimbursement and Sylvia Burwell (Secretary of HHS) and have made three key mandates:

  • Consumer Access: To help consumers easily and securely access their electronic health information, direct it to any desired location, learn how their information can be shared and used, and be assured that this information will be effectively and safely used to benefit their health and that of their community.
  • No Information Blocking: To help providers share individuals’ health information for care with other providers and their patients whenever permitted by law, and not block electronic health information (defined as knowingly and unreasonably interfering with information sharing).
  • Standards: To implement federally recognized, national interoperability standards, policies, guidance, and practices for electronic health information, and adopt best practices including those related to privacy and security.

With these mandates, the country will be better equipped to leverage health information and advance the delivery of healthcare.

Sources: HHS.gov press release from Feburary 29, 2016
RockHealth on Predictive-analytics
2016 Trends: Analytics Magazine Jan-Feb 2016
CDW 2016 whitepaper on Analytics in Healthcare

Impact

Digital health is the adjuvant to the organic creative problem-solving that takes place within organizations when confronted with challenges.  In a way, digital health is a thread in the fabric of the solution to healthcare’s challenges, where innovation is the creative weave of technologies and organic redesign.  Successful organizations are demonstrating the ability to marry the redesign with technological innovations.  

The shift from volume- to value- based care has put pressure on healthcare systems to reduce costs, deliver efficient care, and improve quality.  Approaching this challenge involves technologies aiding in population health, remote sensors/inputs, Health Information Exchange (HIE), Health Registries, interoperability and analytics along with an organic redesign of care delivery. With the ultimate purpose to serve patients and improve patient outcomes, the challenge has three technological areas of focus:

  • Integrating multiple data sources (integrated EHRs, centralized clinical data warehouse, HIE)
  • Leveraging the volume of personalized data (wearables, mobile apps, engaged patients)
  • Prescribing actions that impact patient outcomes (reduced readmissions, improved care coordination, higher quality)

In fact, these three areas of focus come with their own challenges, approaches and opportunities for bringing about improved health outcomes overall.

Mobile devices expand where care can be delivered

Mobile devices and apps have taken big strides in healthcare over the past 15 years.  A wall of textbooks that may have been a provider’s reference might now all be packed into a mobile device.  That same mobile device is supplying lay diagnoses for patients via the internet and may quite possibly be the tool for Artificial Intelligence in the healthcare of the future. Secure communication is no longer just faxes, pagers and phone calls, but now SMS and emails to team members and patients.  Patients are now empowered with their Patient Health Record which many be accessed via smartphones.  Smartphones will soon be the mobile computers to collect and transmit much of the information in healthcare, everything from EKG, chemistry, vital signs, billing, registration and secure communication.  These technological capabilities along with regulatory and business model changes are reshaping the future landscape of healthcare.  As a result, we will likely see a shift in care that traditionally occurred in the hospital setting now occur in the clinic setting and in turn more clinic-care shift to home settings.  

Digital health has enabled organizations to be creative about where and when care is most effective. Organizations like CareMore in Southern California, have reduced hospital readmissions for heart failure by 56%. Their success has been an innovative redesign of their care delivery after the hospital as well as implementation of technologies like "talking" pill boxes that remind patients to take their medications, telemonitoring and the use of wireless weight scales to track heart failure patients. Early detection and intervention of health status changes have made huge impacts on health outcomes and costs.

Having mobile devices and networked homes creates an environment where sensors and wearables can transmit real-time important health data to care teams. In effect, the home is being transformed into an extension of the monitored clinic or hospital environment. This mobility further decentralizes healthcare from the silo’d institutions, further empowering patients with their own health data.  At that point, care no longer has geographic limitations and market forces in healthcare will have more impact.

Digital connectivity requires the advancement of healthcare information security

The need for secure data exchange and security will only grow as we forge down a digital transformation path.  Cybercrime has long been known to haunt and target retail, financial and government institutions but now that healthcare is becoming more digitally connected, it is a target for hackers.  Threats coming from all angles on an ever-changing landscape by a more sophisticated, organized, financially-driven network of hackers is why security has become so much more complex than it was even a decade ago.  The future holds more interconnected networks, mobile devices, sensors and applications which create a tremendous vulnerability to the entire industry.  The solution is not simple and does not simply reside in individual  IT departments.   What are the best practices for healthcare security?  Do you need to know more about Blockchain applications? Do you have a culture and a set of enforced policies in your organization to help support digital security?  Do you know where your weak spots and vulnerabilities are in your organization?  What is your security strategy for adding new devices/systems to your network? Regardless of how your organization responds to some or all of these questions, you have one certainty, that is, cybersecurity is paramount for the deployment of any digital strategy.

Accessible data empowers healthcare decision-makers

The wealth of healthcare data starts with the patient themselves, who, through mobile devices and medical technology, are able to monitor, track, and share both physical and mental health-related information.  In addition, providers can leverage the explosion of healthcare data to improve patient care through better coordination (align medication lists, medical history, study population health trends, reduce medical errors, and identify unnecessary testing).  Better data also creates the potential for healthcare delivery organizations to improve operations and patient experience (reduce surgery cancellations, improve on-time starts, enhance patient safety, allocate staffing resources).  Payors also benefit from the availability of healthcare data by identifying cost-effective treatments, by predicting and matching patient segments with preventative actions that result in better outcomes, by measuring drug adherence and recommending population health initiatives, by mitigating fraud through advanced fraud detection.  Finally, by tying the efforts of these healthcare decision-makers, innovators are more empowered to introduce and advance digital products that ultimately help patients.

Overall, the seamless integration of healthcare information, the rapid explosion of personalized data, together with the prescriptive insights from data analytics, set the stage for the advancement of healthcare delivery.

References

 

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