Remote Monitoring Yields Healthier Patients – More EHR and PHR Integration In The Works And Privacy Issues Should Be Addressed
Posted Nov 22 2009 10:01pm
Earlier this year the company created a blue tooth chair scale for those who have problems standing on a scale. As mentioned in the article, many insurance companies are not reimbursing for the use of such devices that report data, but there are some, such as CareMore in California who are. With devices that report data, privacy is a big concern as well as knowing who gets to see your data and where it goes. The link below is a bit of a summary I wrote a short time back on what is happening in the world of devices that report data. Unfortunately when it comes to healthcare reform, this area seems to be non existent in the world of Congress when it comes to laws and guidelines, maybe nobody up there participates and has tried such devices.
In addition to collecting data, organizations such as CareMore are also investing heavily with business intelligence software to analyze and look at the cost side of all the data received and how to save money.
One item mentioned here is the fact that the doctors do not want additional sources of data to have to search on their patients, simply because they do not have time, so one potential solution here is giving this information to wellness coaches that work with insurers to gather and first hand create potential solutions so we have a bit of a tug a war going on here as the doctor will be looking for better healthcare outcomes, while insurers with business intelligence have a “cost” focus up front so with this in mind we have a few questions, is my health having a better outcome here? There are some gray areas with insurers being in control as the primary collector of the data.
The ultimate solution is to have the primary care physician as the recipient with an EHR, and also too possibly the patient with a PHR. Non participation here is scary as it will end up going somewhere for someone to evaluate, it is what it is. Certainly for seniors it can be very helpful for emergency response and again we come back to “who gets and analyzes this data”.
Is your health plan or your doctor the better judge? I see this area as potential conflict and legal cases if not implemented properly and privacy issues not adequately addressed. The company, Ideal Life has a real focus on IPAs and insurers too, after all they do have a product to market and want to drive sales as soon as possible, as any company functions this way from pharma to devices. Guidelines and approved practices need to be established to ensure proper execution and folks who may not need the services are not coerced into participation in order to either have a big brother approach or to simply drive sales.
I like technology and what it can do, but am also aware of how something good can go bad if policies and implementation in this area get skewed for profit, so I am just stating some reservations that need to be addressed in the planning stages so we are not just throwing devices out to consumers and expecting both patients and doctors to shoot from the hip without adequate training and education too. With the current trending of marketing today there seems to be a lot of that going around as well as those who are non-participants but rather spend a lot of time just talking about how good it is for you, but have never moved one inch to be a participant and try any of the technologies themselves, in other words more “Magpie Healthcare”. BD
As more healthcare providers deploy electronic medical records, they're also looking to tie them into remote monitoring systems used by homebound, chronically ill patients. Now faster access to information generated via remote monitoring devices is reducing medical complications and hospitalizations, and improving quality of care, according to one in-home nursing service that's using those devices.
The use of personal health devices will grow as more electronic health record systems incorporate and use that data. "Interfaces can be written for anything," said Bayada's Farber, including feeding the remote monitoring data into EHR systems. However many doctors don't want one more flood of information to monitor, he said.
Bayada, which has 140 offices in 17 states and the United Kingdom, in the last year has rolled out wireless, Internet-connected remote monitoring devices from Idea Life to about 200 U.S. housebound patients with limited mobility and conditions such as chronic obstructive pulmonary disease, hypertension, and congestive heart failure. During that time, hospitalizations of those patients have been reduced by 54%, said Brian Farber, director of telehealth at Bayada.
The remote monitoring system alerts Bayada's nurses as soon as a medical problem crops up with a patient, letting the nurses respond fast. The system also sends alerts to patients' doctors, allowing them to adjust medication quickly or otherwise intervene. If a patient with congestive heart failure shows a gain of 3 pounds or more over 24 hours that could indicate a fluid retention, a dangerous condition for someone with that illness. The system sends an alert, and the nurse receiving it might schedule a home visit or notify the patient's physician so medication can be adjusted or other treatment prescribed.
One obstacle to widespread use of remote monitoring is that insurers and other healthcare payers generally don't reimburse providers like Bayada for remote monitoring services. However, that's slowly changing, said Jason Goldberg, president and founder of Ideal Life.
Ideal Life recently announced its medical devices were part of a state-funded project in North Carolina to remotely monitor 400 rural Medicaid patients who have heart failure or cardiovascular disease. Some private healthcare companies, including CareMore, a health-maintenance organization in California, are paying for the remote monitoring of patients with chronic diseases, Goldberg said. Increasingly, there are new incentives "to reward for preventative care, rather than just reactive models," Goldberg said.