How Technology-enabled Care Models Can Help Fix Healthcare’s Greatest Challenges
It is not a secret that serious challenges plague the U.S. healthcare system and technology-enabled care models are much needed. A perfect storm has been building for several years. It is the result of a convergence of multiple powerful forces including unprecedented growth in demand, growing awareness of serious quality and safety issues, unsustainable healthcare cost inflation, widespread waste, and an inadequate supply of physicians and nurses. These trends are exacerbated by widely acknowledged demographic and lifestyle issues, including an aging population and people’s tendency to live unhealthy lifestyles.
Evidence of the problem includes:
- Chronic diseases such as heart disease, stroke, cancer, and diabetes are among the most common, expensive, and preventable health problems Americans experience. Over 100 million people in the U.S. are living with chronic diseases, and spending on hospitalizations and chronic care management now represents over 75 percent of all healthcare costs.Over 50 percent of Medicaid and Medicare beneficiaries now live with one or more chronic diseases or other disabling conditions.
- 133 million American adults, or 66 percent of the adult population, are either overweight or obese. The prevalence of obesity has doubled since the 1960s, to an all-time high of 30 percent, and the rate of increase continues to trend upward.
- With average life expectancy at an all-time high of 78 years, the nation’s elderly population is drastically increasing. Globally, the number of persons 60 and older was 600 million in 2000. It is expected to double to 1.2 billion by 2025. Medicare spending is 12 percent of the entire U.S. Federal Government budget and is expected to increase by nearly eight percent every year between 2007 and 2016.
Left unchecked, these and other challenges will only add to this perfect storm and result in an unsustainable rise in the healthcare resource consumption rate. By 2022, the rate will be almost 20 percent of GDP, threatening the viability of the nation’s economy.
More Efficient Healthcare Delivery Is Needed
While these challenges are profound, there is a ray of sunshine peeking through the storm clouds in the form of technology-enabled innovations in care model design. A visit-based care delivery model has dominated healthcare for centuries. In this model, patients who experience illness or injury must find a way to physically interact with a care provider in clinics, emergency departments, or hospital rooms.
With the increasing emphasis on value production in healthcare, it is only a matter of time before additional, more efficient care models arise to complement the traditional encounter-based care model. The emerging emphasis on value production and population management will drive the adoption of new technology-enabled care delivery models that are more continuous (24X7), geographically dispersed, proactive, and patient- and ambulatory-centric. Of course, physicians will continue to actively see and treat sick patients every day, but new value-based payment models will drive the adoption of new, more efficient care delivery models that allow care providers to remotely manage health problems.
This emerging clinical and business need has stimulated the growth of a class of technology that is capable of connecting patients with physicians, hospitals, and other care providers. These technologies include wearable sensors for collecting information about a patient’s physiological condition, activity, behaviors, and environment. As data is collected, these devices are able to transmit information to a collection point in a smart phone, computer, or secure site in the cloud, ultimately making it available to care provider organizations.
Addressing the Shortage of Providers With Sensors
By making such data available to physicians and other care providers, it creates the opportunity for care to be far more proactive in nature by picking up elevated hypertension, weight gain, uncontrolled blood sugar, or other clinical concerns well before they become serious threats to health or life. Coupled with multi-disciplinary care teams, this approach can help address the shortage of physicians and nurses by allowing less-skilled clinical support personnel, operating under the guidance of a physician or nurse, to manage health issues at an earlier stage before they require the knowledge and expertise of more-skilled clinicians. In addition to redefining how and where patients receive care, these remote patient monitoring technologies also promise to effectively enlist the largest untapped healthcare workforce in the country—patients and their families—to become more actively involved in managing their health.
Whether the goal is to maintain medical stability among the chronically ill, prevent readmissions, improve compliance, change behaviors, or adjust a patient’s living situation, remote monitoring technologies offer the possibility of keeping patients more in touch with their care providers over time outside of the expensive acute-care setting. Neither patients nor providers need to wait for disasters to happen in order to bring a deteriorating condition to the provider’s attention.
Wireless biometric sensors are rapidly becoming more accurate, inexpensive, and ubiquitous. They range from simple one function devices like weight scales to wearable multi-modal devices that can capture multiple different physiologic parameters. Data collected by these devices offers the very real possibility of dramatically altering the way we understand and manage chronic disease. In addition to better chronic disease management, combining this remote monitoring data with other sources of clinical, environmental, and subjective data will provide healthcare providers vast new pools of data that will help us better understand and manage other important behavioral, environmental, and social determinants of health.
Improved Outcomes Through Patient Care Technologies
Early evidence suggests these technologies will be accepted by patients and improve outcomes. A 2012 eHealth patient survey found that 33 percent of patients want their physicians to have access to remote monitoring technologies.Older patients want these technologies even more. Forty percent of older patients want access to technology that can alert physicians and other caregivers if they are having a health emergency and allow them to live independently longer. Early studies also suggest that these technologies can lower the annualized costs of some chronic diseases by as much as 30 percent.If true, this would save roughly a trillion dollars in medical expenditures, freeing up valuable resources for other critical health needs.
These technologies are already proving to be economically viable. A report conducted by Kalorama Information placed the U.S. remote patient monitoring market at close to $4 billion in 2007, which more than doubled to $8.9 billion in 2011. For 2012, the market increased an additional 20 percent to $10.6 billion, and Kalorama predicts the market value will reach $20.9 billion by 2016.
As these trends unfold, healthcare is likely to experience revolutionary change. According to a detailed AHRQ report, technology-enabled care model designs promise to produce better care for patients, while improving clinical and financial performance for health systems. In the process, they will also dramatically impact how health systems view and provide care. These approaches shift the health system’s focus from reacting to the acute care needs of individuals to proactively engaging a population of patients and focusing on their health goals, needs, and abilities to achieve desired health outcomes. The models encourage the use of the expertise of all members of the care team, including patients and their families. Transforming the mass of data from wearable devices into actionable information will require sophisticated analytics capabilities and expertise on the part of health systems. The analysis of large datasets, so-called Big Data, will need to become a core competency among all healthcare providers.
In short, these forces have the potential to produce the type of fast paced, disruptive transformational change in healthcare that has revolutionized many other industries.
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