GOTHENBURG, Sweden – The number of remotely monitored patients grew by 44% to 7.1 million last year, according to a report from Berg Insight. The report also found that the number of remotely monitored patients will grow at a compound annual growth rate of 47.9% to reach 50.2 million by 2021. Monitoring patients with sleep therapy devices and monitoring patients with implantable cardiac rhythm management devices accounted for 80% of all connected home medical monitoring systems in 2016, according to Berg Insight. Leading vendors in this segment include ResMed, Philips Respironics and SRETT, it said. Telehealth is the third largest segment with 500,000 connections at the end of 2016, according to Berg Insight. Leading telehealth vendors include Tunstall Healthcare, Honeywell, Cardiocom, Philips and Qualcomm Life, it said.
WASHINGTON – For the first time since 2014, all Medicaid agencies cover some form of telemedicine, according to an updated report from the American Telemedicine Association.
In 2017, all states allow coverage of telemedicine to some degree, compared to 24 states in 2005, the ATA found.
“These reports show that insurers, state lawmakers and Medicaid agencies see telemedicine and other digital health platforms as affordable and convenient solutions to bridge the provider shortage gap and enhance access to quality health care service,” said Latoya Thomas, director of the State Policy Resource Center at the ATA, in a statement.
Furthermore, the report found that Connecticut, Florida, Hawaii, Idaho, Rhode Island, Utah and West Virginia have adopted policies that improved coverage and reimbursement of telemedicine-provided services since 2016. On the flip side, Delaware, South Carolina and Washington, D.C., have either lowered telemedicine coverage or adopted policies further restricting telemedicine coverage.
Collectively, however, states are removing unnecessary requirements and embracing telemedicine as an appropriate way to deliver medical services nationwide, according to another report from the ATA.
As a result of changing board guidance and regulation for telemedicine when compared to in-person practice, states like Arkansas, Florida and Louisiana have made significant improvements for health providers, while Texas continues to earn the lowest grade in the country.
CHARLESTON, W. Va. – Charleston Area Medical Center has documented reduced readmissions for congestive heart failure (CHF), COPD and other chronic conditions using the SmarTigr interactive patient engagement and education system from TeleHealth Services.
The four-hospital system reduced their readmissions for CHF by more than 22% and COPD by almost 30% in early 2016, compared to the previous year. Readmisisons were also reduced for pneumonia.
“Seeing this positive trend in reducing readmissions and improving satisfaction has led other units and departments to look at the patient engagement system as a way to improve delivery of education and better prepare patients for taking care of themselves after discharge,” said Beverly Thornton, Health Education and Research Institute education director, in a statement.
The SmarTigr system integrates smart TVs, hospital software platforms and mobile apps with a library of interactive videos designed to educate patients about their care and medications. Through electronic medical record automation, condition-specific curriculum available in multiple languages are prescribed and monitored. The system generates activity reports for staff to review, document and measure compliance and patient comprehension. Records of patients viewing the videos are tracked and become part of their medical record. Patients are also asked to complete quizzes to assess education comprehension.
CAMC and its Multidisciplinary Patient and Family Education Council launched an initiative to reduce readmissions for chronic diseases in 2015. CAMC added the SmarTigr solution to standardize patient education and increase patient engagement. The strategy included a detailed clinical assessment at admission and nurse navigators who coordinate care and a smooth transition after discharge to other facilities as appropriate. Patients and their families have recognized the value of video-based education, shown by increased HCAHPS satisfaction scores, spurring adoption of education strategies in other units across the health system.
“Patients use technology in all facets of their lives, and health care is using technology as a way to improve patient care and streamline clinical operations,” said Dan Nathan, vice president of TeleHealth Services, in a statement. “Empowering patients in their own care favorably impacts outcomes and helps hospitals meet service and quality expectations.”
Thornton said the success of the initiative has been a catalyst for other units in the system to adopt the strategy.
WASHINGTON – There is still a large gap in technology adoption and use by older U.S. adults, according to fact sheets recently released by Pew Research.
Health care may be moving increasingly online and experts predict that the telemedicine market will hit $36.2 billion in just three years, but adults age 50 and older are lagging behind their younger counterparts in technology adoption and use, and the divide is even larger among those over the age of 70.
“The divide definitely widens as the age goes up,” said Laurie Orlov, founder of Aging in Place Technology Watch. “Older adults are not buying into the trendiest tech.”
While 80% of the U.S. population age 65 and older own a cell phone, only 42% of those own a smartphone, according to Pew. Just 63% of this same age group said they use the Internet. The statistics are even lower for older adults with low income.
This is a problem because “so much of the useful advice for lower income seniors is online,” said Orlov.
This evidence of slow technology adoption by older adults could be troubling, Orlov said, if they are expected to be among the 7 million users of telehealth services by 2018, according to a report by IHS Markit.
Another survey conducted recently by AARP found that 70% of adults age 50 and up own some type of computing device, but a mere 20% of those people are confident that their data are kept private online. Even so, the survey respondents said they spend about half of their online time getting health and fitness information.
The same AARP survey found that only one in 10 adults over the age of 50 own a wearable device for health or fitness, and only 3% of those over the age of 70 own one.
“Newer technology like wearables have lower adoption rates,” said the researchers. “However, younger adults are more likely to own such devices than those over the age of 70.”
Orlov said it’s not likely that physicians or health care providers will help bring older adults along the technology wave.
“We keep hoping that doctors will help, but that’s not going to happen,” she said. “Handing a person a device and giving them training is a feasible solution if the incentives are there for the provider, but people won’t teach themselves.”
Orlov believes the best solution is for older adults to have a “proxy”—someone who can help an older adult with enough technology access to keep them engaged in taking care of their health.
LOS ANGELES – A second class of health-tech startups in the Cedars-Sinai Accelerator powered by Techstars program is off and running in an intensive three-month session designed to rapidly develop innovations and products that can transform the delivery of health care.
“We’re excited to pair these bright, motivated entrepreneurs with health care experts from Cedars-Sinai who together can rapidly accelerate the pace of innovation and transform health care in meaningful ways for our patients,” said Darren Dworkin, senior vice president and chief information officer at Cedars-Sinai, in a statement.
The startups will receive mentoring from Cedars-Sinai physicians and executives, as well as $120,00 in seed money to cultivate health-related ideas and inventions in artificial intelligence, mobile health, health care financing, wearable devices and more. They will also have access to Techstars’ network of entrepreneurs and corporate partners.
Eight startups were chosen for this year’s class from a field of 650. This round’s accelerator class includes: Cerebro Solutions, FIGS, Frame Health, Healthcare TTU, HealthTensor, Noteworth, ReferralMD and Enso.
Graduates of the first Accelerators class have raised more than $11 million in investments since graduating last spring.
BALTIMORE, Md. – All 15 physician practices involved in the CMS Independence at Home Demonstration improved performance in the second year of the program by incorporating technology into patient-centered care, a report by the agency has found.
“These results continue to support what most patients already want—the ability to have high quality care in the home setting,” said Dr. Patrick Conway, CMS acting deputy administrator for innovation and quality, and chief medical officer.
Participating practices use home health technology like remote monitoring platforms, mobile apps, tablets, mobile diagnostic devices and electronic health information systems to care for the 10,000 patients being served through the demonstration.
A report released by CMS in January found that in the second performance year of the demonstration, practices involved saved a total of $7.8 million, with an average of $746 per beneficiary. Seven participating practices earned incentive payments totaling more than $5,000.
The demonstration provides chronically ill patients with a complete range of primary care services in the home setting. Medical practices led by physicians or nurse practitioners provide primary care home visits tailored to the needs of beneficiaries with multiple chronic conditions and functional limitations.
The demonstration also tests whether home-based care can reduce the need for hospitalization, improve patient and caregiver satisfaction, and lead to better health outcomes for patients and lower costs to Medicare.
The IAHD began in 2012 and was originally authorized for three years as part of the Affordable Care Act. It was extended for two additional years through September 30 of this year by the Medicare Independence at Home Medical Practice Demonstration Improvement Act of 2015.
“The Independence at Home Demonstration is helping to improve the health care system by paying practitioners for what works, unlocking health care data, and finding new ways to coordinate and integrate care to improve quality,” said Conway.
STANFORD, Calif. – Stanford University has opened the doors on a Center for Digital Health and opened the pathway to collaboration with Silicon Valley technology companies to develop, test and implement new digital health tools.
“Companies were constantly reaching out to Stanford, looking for people to collaborate with,” said Dr. Lauren Cheung, senior director of strategy and operations for the center. “We also had faculty who wanted to collaborate with Silicon Valley but didn’t know how to find them. The Center provides a way to connect the outside with inside collaborators.”
Cheung said the new Center will provide a way to promote these partnerships, perform clinical research and educate the next generation of physicians and digital health care leaders.
“What we are striving to do at the Center is answer some of those big questions about what the future of health care will look like,” said Cheung.
Another health care system from an institution of higher education, Penn Medicine, also opened a Center for Digital Health recently, to promote partnerships and to perform clinical research.
The Penn Medicine center evolved from its Social Media Laboratory, and will operate from a strategy and process to systematically evaluate how social media platforms can affect health, then develop new ways for clinicians to improve health care delivery through those channels.
Ralph Muller, CEO of the University of Pennsylvania Health System, recognized that a large number of its patients engage with the world through digital channels.
The Penn Medicine Center hopes to “harness the power of this engagement to transform the way we deliver health care,” Muller said.
Cheung said the Stanford Center for Digital Health is focusing on research, education and advising. They will also focus on helping Silicon Valley companies design health care technology that is more user-friendly for both providers and patients.
“We will answer questions about how health care can be delivered in the home so it’s effective,” said Cheung. “We want to help advance the field of home health care and try to make a difference in what’s happening out there.”
WALTHAM, Mass. – Providers find a variety of patient engagement tools to be effective, but a majority feel payers should cover the cost of them, a recent survey by the NEJM Catalyst Council has found.
Just over half of respondents said patient engagement technology tools can create an ecosystem that allows for better predictive analytics around patient health and more timely intervention, the survey authors said.
The online survey was sent to members of the council, which include U.S. health care executives, clinical leaders and clinicians at organizations directly involved in health care delivery. A total of 595 completed surveys were included in the analysis.
The top two benefits of using technology tools for patient engagement, said the respondents, are to support patients in their efforts to be healthy and to provide input to providers on how patients are doing when not in clinic.
Biometric measurement devices, including wireless scales and glucometers, are the most effective tool, said 85% of respondents. Second were apps for smartphones (75%), followed by texting (70%).
More than half of survey respondents said the fact that patient engagement technologies are not covered by insurance is the top barrier to implementation. Other barriers are the lack of integration with electronic medical records, the cost to the patient, unclear benefits and complexity of use.
Sixty percent of respondents believe payers should cover the cost of patient engagement technology tools.
“Views about technology tools for patient engagement are evolving rapidly,” the survey authors wrote in their analysis. “The use and payment of these tools is changing, and there is more work to be done to understand the efficacy of using patient engagement technology to help manage chronic disease and improve health behaviors.”
‘This needs to be a living document’
WASHINGTON – The National Quality Forum has pulled together a panel of experts to study telehealth metrics and develop a framework around which quality and effectiveness measures can be based.
“Telehealth has grown over the past 15 years in a variety of health care settings, but there is not a set of measurements that prove its effectiveness,” said Jason Goldwater, NQF senior director. “To develop these metrics, to show its value and effectiveness would really help advance the field.”
Using electronic communications, information technology, devices and platforms, telehealth supports health care delivery by replicating the interaction of an in-person encounter with a health care provider. Goldwater said the panel will cover telehealth broadly, including remote patient monitoring, sensor-based technology, store-and-forward technology and video conferencing.
The project to develop a framework to support measurement calls for the multi-stakeholder panel to review existing and potential metrics, which will hopefully lead to the identification of gaps. From there, the panel will develop a framework and a set of guiding principles for future measurement.
“People want to see an objective assessment of telehealth,” said Goldwater. “If you can do that, you are aligning telehealth with other forms of health care, if used effectively.”
The NQF panel is comprised of medical officers, telehealth program directors, technology specialists, health researchers and others who have the right expertise and knowledge to conduct the project, Goldwater said. The framework they produce will need to be sustainable, he said, to allow for advances in technology.
“As modes shift, the framework needs to be relevant,” Goldwater said. “This needs to be a living document.”
Goldwater said that technology allows for quality measurement, and he envisions measures that are developed to relate specifically to the patient. Where patients in the past accepted what a physician said and followed instructions, he said technology has changed the dynamic between the provider and patient, and now extends to the family and caregiver.
“We need to find measurements the patient is interested in,” Goldwater said. “They’ll be more engaged if it’s important to them and they understand the bigger picture. The communication can extend beyond the office visit.”
AMSTERDAM, the Netherlands – Royal Philips and Banner Health have signed a 15-year agreement to expand on their joint connected health care programs.
“If we are to make a difference in patient’s lives, we need to work collaboratively with innovative technology partners such as Philips,” said Peter Fine, president and CEO of Banner Health, in a statement.
The agreement leverages Philips’ knowledge and research in connected care and population health management (PHM) and Banner’s deep clinical and operational insights to identify and deliver integrated solutions that are intended to improve the health of Banner’s patients. The partnership will look to create best practices that enable Banner to improve the patient experience and, ultimately, transform healthcare for patients across the Southwest.
As part of the agreement, Banner and Philips will create a governance structure that will allow both organizations to identify solution delivery projects and innovative technologies that can help improve the patient experience and outcomes. They intend to look at how the healthcare network can take a more connected approach to care, such as cardiology by incorporating advanced imaging and interventional technologies, genomics, digital pathology and data analytics.
In addition, as part of the agreement, they will evaluate innovative services and business models that may enable Banner to adopt the latest in healthcare technologies, regardless of vendor.
“We have always taken a long-term view of our business, and realized very early on that the current healthcare system was not sustainable,” said Fine. “With legislation driving reform, we knew that we needed to manage population health and essentially keep people healthy and out of the system to reduce costs, while ensuring better patient outcomes.”
Headquartered in Phoenix, Banner Health is one of the largest, nonprofit health care systems in the United States, managing 28 acute care hospitals, the Banner Health Network and Banner Medical Group, long-term care centers, outpatient surgery centers and an array of other facilities that offer family, home care and hospice, and nursing services. It operates in six states: Arizona, California, Colorado, Nebraska, Nevada and Wyoming.