Can IoT Technology Improve Patient Outcomes and Drive Value-Based Care
Over the past ten years, the USA has been on a mission to improve the quality and efficiency of healthcare.
With the advent of the Affordable Care Act (ACA), the move was made to tie reimbursement to patient satisfaction and outcomes. This replaced paying for specific services rendered. This is a significant shift in the healthcare system that requires that every provider, provider network,
This replaced paying for specific services provided. This is a huge shift in the healthcare system that requires that every provider, provider network,
This is a huge shift in the healthcare system that requires that every provider, provider network, hospital and ancillary system to alter their approach to the care they deliver.
To receive full reimbursement, providers now have to meet quality standards.
Today 45 percent of healthcare systems are reimbursed on a value-based system, according to the 2016 HIMSS Cost Accounting Survey.
How IoT impacts the transition to Value-Based Care
If you were to ask any physician or administrator, they would tell you that they need data. Without access to data, they are unable to make the most informed and best healthcare decision on patients care.
Reporting requirements require data on clinical outcomes. Administrators must document improved patient care and reduced cost of care, where appropriate.
This has many healthcare systems turning to IoT technology and monitoring devices to provide needed information.
This should result in the healthcare IoT market swelling to $410 billion by 2022 according to Grand View Research. Grand View estimates that there will be a 30 percent increase in implantable IoT devices in the next 5-6 years. Today, 60 percent of IoT in healthcare is wearables.
Chronic disease states along with acute and post-operative care are being measured and documented with wearable and implantable devices today. These devices include fitness monitors and wearables that monitor heart rate, rhythm and blood pressure.
Home dialysis patients are using IoT devices through closed-loop feedback wearables to reduce infections according to Becker’s Health IT & CIO Review.
Some cardiac conditions are being monitored through ingestibles and patches. Proteus Digital Health received FDA approval in 2015 for their patch and IoT sensor. The patch is worn on the body with transmits a signal from a 1mm sensor-enabled pills to a back-end cloud service to provide real-time information on a users medication adherence.
Proteus is currently used with heart failure and hypertension patients and will expand to include Schizophrenia and Alzheimer’s and other therapeutic areas that have inherent difficult challenges in getting accurate patient information.
The “Smart Pills Technologies Market (2012-2017),” report estimates that “the global smart pills market is expected to reach $965 million by the year 2017.” Presently, the smart pill market is focused on two primary functions: wireless patient monitoring and diagnostic imaging.
Smart pill do not aid with the underlying disease state; their purpose is strictly monitoring. For example, the Proteus system monitors drug compliance.
Drug compliance is a multi-billion opportunity to control disease states and avoid unnecessary complications or slow the advancement of a disease or prevent rejections of transplanted organs.
Studies have shown that more than 50% of Canadian senior citizens take more than five different medications daily, and the CDC data shows that 11.9% of the USA population takes 5 or more different medications per day.
Long-term, ingestibles are a good step in the management of chronic diseases. They may improve patient compliance thereby reduce the number of physical checkups required, and lower costs while leading to an improved quality of life for patients.
Medical Monitoring is Going Through a Disruption
Scripps Health is researching nano-sensors that travel through the bloodstream transmitting messages to a smartphone with alerts of signs of infections, changes in cardiac enzymes that signal a pending heart attack or other cardiovascular events.
Smart pills and nano-sensors technologies will be dramatic changes to the healthcare system and should result in improved quality of care, improved clinical outcomes at a lower costs.
Taking snapshots of our systems
Today, a colonoscopy can be as simple as wallowing a disposable pill instead of having an invasive procedure. This has been possible for a few years now.
Given Imaging, an Israeli company developed a battery powered camera pill that takes high speed images of the intestinal tract. The patient wears a device around their waist which captures the images. The images are then reviewed by a gastroenterologist.
The PillCam COLON is used with patients who have abnormal anatomy, prior colon surgeries or various diseases of the colon that increases the risk of a standard standard colonoscopies. The PillCam is a painless, non-invasive test to visualize the gastrointestinal tract and colon remotely detecting polyps and identifying the early signs of colorectal cancer.
According to the American Cancer Society colorectal cancer is the third most common cancer diagnosed in both men and women in the United States. They estimate the number of colorectal cancer cases in the United States for 2017 are 95,520 new cases of colon cancer. The Canadian Cancer Society estimates that 26,800 people will be diagnosed with colon cancer.
The PillCam COLON allows more people to be screened in a safe, effective and convenient manner, with a lower costs of care and decreasing the economic impact on the health system. While increasing the survival rate of those diagnosed.
More devices are in the works including for glucose monitoring for diabetes using a contact lens as Reuters has reported.
Data is Valuable When its in Real Time
To be useful, data need to be communicated, aggregated, and analyzed in ways that enable new and more effective action – “The Information Value Loop”. The technologies that makeup the Internet of Things (IoT) is creating new ways to add value from information.1
The impact of IoT is tremendous in both terms of disease state management, patient quality scores and costs.
For example, atrial fibrillation patients can buy a $75 device avoiding the need for electrocardiograms done outside of the hospital, a necessary test for monitoring the disease states. This eliminates the need for a $1,000 machine and the time for the test freeing up staff and improving the patients quality of life. The device is paired with a subscriptions to cardiac monitoring services allowing for a lower-cost collection of data and enabling timely and rapid interventions in case of a cardiac event.
The use of IoT technology is creating inherent value as it is embedded it in a more inclusive healthcare ecosystem.
Access to data and data in real time, allows healthcare providers to intervene earlier in disease states. This saves costs and avoids complication as the underlying disease state is inhibited.
Using IoT allows for improved medical interventions.
As a result patients are treated earlier, are healthier, and treated with the right care with faster medical interventions. Patient outcomes are improved with a higher patient satisfaction.
Not only does this save costs, improve quality and outcomes, but healthcare providers maximize their reimbursements from payers.
Today, wearables are not compatible or interoperable with electronic medical records. As much as this data can and will improve the quality of care, reduce costs and save lives if it isn’t available to medical providers it serves little purpose.
To take full advantage of this critical data, it needs to be integrated into electronic medical records and in real time or near real time. This will allow for rapid medical interventions, improved patient outcomes patient satisfaction along with cost containment.
IoT will Determine the Monetary Value of Medical Services
Predictive analytics coupled with data analysis can be used to turn the data into actionable insights. Complied data from a representative set of patients allows for modeling that can demonstrate early disease state patterns and episodes earlier than we may be able to today.
IoT and the analysis of data will allow early markers of medical disease states o be detected far earlier in the onset of a disease state than today. This will afford earlier and best treatment options at a far lower cost of care and save lives.
One of the biggest results of the adoption of IoT is the devices are not the most critical aspect of the healthcare puzzle. The data is.
For example, if a healthcare provider can detect potential disease state markers or issues with a device or replacement joint before an event, this offers tremendous value to the patient, the provider and the payor.
The patient does not suffer a traumatic event, the provider can adjust treatments as needed in real time and the payor avoids costs resulting from a prolonged recovery from remedial treatments.
The question becomes a financial one, what types of monetization mechanisms can be enabled to drive the adoption of IoT and reduce the costs of care?
A second issue that must be addressed with the advancement and adoption of IoT in healthcare is who captures the value?
As medical technology (medtech) companies are working with and jockeying for position with major players in the healthcare ecosystem with each bringing unique to the table along with their respective and unique perspective and capabilities. Who captures the value becomes a question that remains.
Lastly, healthcare provider networks and hospitals grapple with the costs and revenue of IoT and need to understand the costs and reimbursements associated with services rendered.
IoT technology offers healthcare providers the ability to gather real-time data about a patients disease state and related conditions without the need to see the patient in their office. This allows the ability to track and monitor costs and payor reimbursements.
With an accurate, real-time database of patient profiles and disease states, healthcare systems can build algorithms to optimize patient care and control costs. From a providers standpoint, this is one of benefits of IoT. From a patients perspective, they receive earlier interventions, improved quality of care at a lower costs and potentially avoid a traumatic event.
Today, without the benefit IoT data, healthcare providers are in some ways, flying blind without the benefit of predictive analytics.
IoT will impact on all aspects of healthcare, from prevention and wellness, chronic care, acute care, and post-acute care.
The future of healthcare is value-based care; IoT technology coupled with data analytics, will result in improved patient care, better outcomes, increase patient satisfaction, lower costs of care and increase revenues — all at the same time.