of U.S. hospitals currently use three or more connected health technologies.
Connected health and telemedicine solutions
The growing acceptance of technology-enabled health and wellness was a focal point at HIMSS17.
In fact, according to the 2016 HIMSS Connected Health Survey,
Joseph C. Kvedar
More sophisticated and portable telemedicine technology is leading to imaginative new uses.
Professor, Emergency Medicine and Informatics, The University of Texas Health Science Center
Associate Medical Director, Houston Fire Department, Asst. Professor, Emergency Medicine, Baylor College of Medicine
In most places, calling an ambulance almost always ends with a trip to the emergency department (ED), but in Houston they’re trying something new thanks to ETHAN (Emergency Tele-Health and Navigation).
Michael Gonzalez, MD
"Essential conversation: mobile innovations and telehealth in emergency care" described a two-year-old program that allows emergency responders and physicians to do joint patient evaluations via video, and determine whether patients need to go to the ED (either in the ambulance or via a taxi, if their condition doesn't need ambulance support) or be referred to a clinic. The program frees up ambulances for patients who really need them, helps connect patients with primary care and has saved more than $900,000 from averting unnecessary ED visits.
A number of presentations, panel discussions and exhibitors also demonstrated how the industry can close the gap between today’s early adopters and widespread, mainstream adoption. Anytime, anywhere care is possible – and it is the future of care delivery.
The complete connected health ecosystem was highlighted throughout the week, including wireless medical devices, sensors, mobile apps, EMR integration and back-end analytics. There were dozens of sessions, special events and presentations on technologies that enable the collection of patient-generated health data, tools to better connect patients with their providers, and devices and apps that help individuals manage chronic conditions, as well as virtual visits.
The Connected Health Experience exhibition space showcased more than 50 health tech vendors and a theatre featuring presentations on remote patient monitoring, the Internet of Things, telemedicine and next-generation technologies.
At HIMSS17, it was clear just how far advances like telemedicine and remote patient monitoring have come. There is growing evidence that connected health and telemedicine have become cost-effective solutions for care delivery, particularly in light of value-based care.
MD, Inova Translational
J. Patrick Bewley
Vice President, Information Technology, Benchmark Senior Living
“I think the possibilities are endless now. The main impediment was cost. Ten years ago, when the human genome project was done, it cost about a billion dollars to genetically test one patient. This year it’s about a thousand dollars, and we expect over the next five years for it to become $100.”
Chief Executive Officer, Big Cloud Analytics
John Deeken, MD, discusses the mission of Inova Translational Medicine Institute and how genomic sequencing is changing the culture of patient care
One hot topic was remote patient monitoring (RPM), which allows providers to collect a wealth of data in between office visits.
Senior Care Trending:
Tech case study for pop health
On future innovations in genomic testing
In "Connecting senior care: wearables and analytics drive results," Ken Smith presented new research that looked at the potential of wearables to capture the effects of sedentary time and light activity, not just heavy exercise and sleep.
Smith looked ahead to the near future when wearables will go beyond exercise and sleep monitors and collect data on glucose, hydration, the stress hormone cortisol and even mood.
Managing Director, Spyglass Consulting Group
Senior Research Scholar, Stanford Center on Longevity
The skeptics had their say with "RPM: Is it all it is cracked up to be?" Gregg Malkary surveyed 100 providers and found that while they think their patients are ready for RPM to help treat diabetes, asthma, congestive heart failure and chronic obstructive pulmonary disease, 78 percent of hospitals aren’t ready to integrate the data into their electronic health records (EHRs), and 68 percent of them say their physicians would be uncomfortable using the data.
Connecting Senior Care: Wearables and analytics drive results
Is it all it's cracked up
"Senior care trending: tech case study for pop health" described how wearables that measure sleep and physical activity can predict the future for patients in retirement communities and nursing homes. Sleep disruptions and declines in activity signaled impending hospitalization, and some types of data fluctuations were associated with increase fall risk, blood clots in the lungs and urinary tract infections.
Some of the challenges? Collecting reliable baseline data, making sure devices are charged, and finding a way to measure activity that doesn't depend on steps.
The HIMSS17 education program included 47 education sessions tagged as connected health.
It’s easy to get excited about the latest #Connect2Health innovation, but maybe not so easy to integrate it into your institution and get measurable value out. HIMSS17 presenters had plenty of tips, though.
“Our new hospital that will open this spring in San Diego will feature a host of new technologies, including a digital, interactive map of the facility, a large interactive monitor in the patient’s room to access information, dining options and entertainment, and mobile digital devices that enable care teams to quickly access the information and equipment they need to provide high-quality care.”
Susan M. Kapraun
The Mayo Clinic has been using telehealth in one form or another for 30 years, and still faces formidable challenges getting it to work effectively across its three locations in Minnesota, Florida and Arizona.
Health Systems Engineer, Mayo Clinic
IT Service Delivery Manager, Mayo Clinic
COO, Avera eCare
Telehealth workforce – unique competencies and opportunities
Jay Weems presented its secrets of developing a solid telehealth support staff in Telehealth workforce – unique competencies and opportunities.
Telehealth technology is great, but it still needs people behind it – not just the clinicians providing the care, but the tech workforce to keep things running smoothly. South Dakota-based Avera Health started doing specialty e-consults in 1993. By 2009 it was supporting 330 telehealth locations in 100 communities in multiple rural states.
Jenna A. Beck
Create and scale an enterprise telehealth support model
Kaiser Permanente’s digital patient engagement strategy is an industry role model, and in "Transforming care through a consumer-driven model," Dick Daniels outlined how the organization puts the pieces together.
Transforming care through a consumer-driven model
In "Create and scale an enterprise telehealth support model," members of the Mayo team described how they developed a centralized support structure to standardize and streamline the telehealth program across all three locations, and made sure everyone in the organization understands where to turn when they have telehealth-related technology issues.
CIO, Kaiser Permanente
Greg Orr presented an ingenious connected-health strategy that the company is using to help customers adhere to their medications and track their activity through the company’s Balance Rewards program.
View Greg Orr Article
Vice President, Digital Division, Walgreens
Director, Health Services Research, Cedars-Sinai
View Brennan Spiegel Article
Brennan Spiegel talked about the hospital's use of virtual reality to treat pain: a small controlled study showed that virtual reality was able to drop patients’ average self-reported pain scores from a 5.4 to a 4.1. Older patients were more likely to turn down the treatment, but those who did use it found it to be a more transformative, profound experience than the younger users.
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HIMSS is a global voice, advisor, convener, and thought leader of health transformation through the best use of IT with a unique breadth and depth of expertise and capabilities to improve the quality, safety, and cost-effectiveness of health and healthcare. Through its network of over 1 million professionals, including 64,000-plus members, HIMSS advises leaders, stakeholders and influencers globally on IT best practices to ensure decision-makers have the right information at the right time to make the right decisions. HIMSS North America, HIMSS Analytics, Personal Connected Health Alliance, HIMSS Media and HIMSS International (HIMSS Europe, HIMSS Asia and HIMSS Middle East) are the five business units of HIMSS. A not-for-profit headquartered in Chicago, Illinois, HIMSS has additional offices in North America, Europe, United Kingdom, and Asia.
ABOUT HIMSS MEDIAHIMSS Media is the fastest growing B2B media group focused exclusively on healthcare and technology markets. Through its suite of market-leading brands, such as Healthcare IT News, Healthcare Finance and MobiHealthNews, HIMSS Media delivers news, analysis and must-have information to an audience of senior healthcare and technology influencers. HIMSS Media is also the leading producer of important live events, such as the Privacy & Security Forum, Pop Health Forum, Revenue Cycle Solutions Summit and Big Data and Healthcare Analytics Forum.
Associate Vice Chancellor of Health Transformation, and Chief Innovation Officer for Health Affairs, University of Texas System
On staying focused...
Pam DeSalvo Landis
Director, Innovation, Intermountain Health Care
Vice President, Information and Analytics Service, Carolinas HealthCare System
On interface design...
MD, Chief Experience Officer, Cleveland Clinic
On understanding the issues...
“We’ve under-imagined how to get people to share their data and how to get people to give their data back, because what we give them back is admonishment that they’re going to have a heart attack if they don’t shape up. Who wants to give up their data in exchange for getting scolded?”
“What we really need is a much more agnostic, neutral system. The current system would be equivalent to asking automakers to not just build cars but build their own roads so when the customer buys their car they can drive somewhere. Instead, car manufacturers should focus on building a better car, and know there’s a highway there that the customer will be able to use.”
On getting patients to buy in...
“Proctor and Gamble has a program called ‘Living it’ where they have lived in people’s homes to do a better job of designing laundry detergent. If it was important enough to do it for laundry detergent or for tax software, it’s just as important – if not more important – to do it for patients and clinicians in healthcare.”
“You ask patients to do something like search for a doctor through the portal and they can’t. At first, you think, ‘Well, if they would just do this and this, they could figure it out.’ ... Well, if I was 10 inches taller and 30 pounds lighter and 20 years younger I could be a supermodel, but that’s not going to happen. So that’s the wrong approach to take. It really forced us to think about what is important to us and what is important to the consumer.”
“I just showed you 85 things that are really neat that you can do on the TV. But according to market research, what are the two things patients want to see? Who is on my care team, and what is happening to me today. If you are solving the pickle problem – if they are able to order pickles and mustards but not figure out what’s happening to them – that’s not designing for patients.”
Connected health at HIMSS17 kicked off with a two-day forum on Digital and Personal Connected Health, co-sponsored by the Personal Connected Health Alliance, a HIMSS organization, and mobihealthnews. Attendees heard an all-star line-up of connected-health innovators from leading health systems, payers and vendors.
Dining room table for 6 people
In "The patient room of the future: designing for millennials," healthcare architecture firm NBBJ used peer-reviewed research, design strategy, virtual reality, feedback from top hospitals and even ideas from the micro-apartments of Japan to develop a space-efficient design that includes….
When millennials start spending time in the hospital, what features are they going to look for?
Double bed for family members
A home office
It was also easier to personalize care plans using mobile apps, and a majority of patients adhered to their medications, reviewed educational content or completed surveys daily.
Manager, Case Management and Care Coordination, Blue Cross Blue Shield of Nebraska
Exploiting their capabilities is the key to big improvements in patient engagement, said Norine Domenge in her session "Driving patient engagement through mobile-enabled care management."
Mobile phones are so much more than phones
Patients might talk to a care manager twice a month over a landline following a hospital discharge, but 63 percent of mobile users had some type of contact with their care manager at least weekly, and overall had four times the amount of contact as landline users.
“...Don’t conflate a positive outcome from a clinical perspective with a market success from a patient perspective. And that’s where I think we need to do more. Build more engaging tools into your software, and the mobile industry has taught us what those things are: They’re things like games, they’re things like contests, things like that. We’ve got to build those in and then you have a better chance of success, even if it works in a clinical trial environment.”
MD, CIO, Beth Israel Deaconess Medical Center
“...Don’t conflate a positive outcome from a clinical perspective with a market success from a patient perspective…” - Joseph C. Kvedar
“Wearables, while still relevant, have gone from the peak of the hype curve to the trough of disillusionment. Google Glass, smartwatches, and innovative fitness trackers have not quite achieved their promised potential in healthcare, and no one is quite sure how to integrate their data into the workflow. That being said, Internet of Things is bigger than in previous years, with home scales, glucometers, and blood pressure cuffs becoming more connected than ever before. Middleware like Apple HealthKit has significantly reduced the interfacing burden.”
“Wearables, while still relevant, have gone from the peak of the hype curve to the trough of disillusionment…” - John Halamka
Adrienne Boissy, Cleveland Clinic @boissyad
Michael Zaroukian, MD, Vice President, CMIO, Sparrow Health System, and Chair, HIMSS North America Board of Directors
Telemedicine for Underserved Groups with Diabetes, Matthew Rumbaugh, Marketing and Sales, University of Mississippi Medical Center
Can You Heal Me Now? Voice Agents For Home Health, Nathan Treloar, Co-founder/President, Orbita
Building a Scalable Remote Patient Monitoring Program, Todd Leto, General Manager, SVP, Trapollo
Engaging Consumers to Drive Telemedicine Outcomes, Henry DePhillips, MD, Chief Medical Officer, Teladoc
The adjoining theater offered a full slate of half-hour education sessions to help attendees explore the details of successful connected health. They included:
Rebooting Gamification and Virtual Reality, Denise Silber, CEO, Basil Strategies
This annual exhibit area is a popular stop for attendees who want to see how interoperability standards actually work with real products. This year’s redesigned showcase had a new focus: the importance of individuals being responsible for and connected directly to their health information.
Vendors qualify for inclusion in the exhibit through their participation in the IHE Connectathon, held a few weeks before HIMSS Annual Conference, where they establish working connections among their products using standard protocols.
HIMSS17 attendees could take tours of the 34,000-square-foot area, where guides walked them through use cases such as Surgery and Recovery, Healthy Heart and Diabetes Management.
View Exhibit Area
The adjoining theater hosted educational sessions, and the showcase also hosted special networking events for specific interest groups, including physicians, payers and nursing informaticists.
Mobile health, connected health, telehealth, telemedicine – call it what you will – will continue to boom in the next few years as clever new gadgetry meets human ingenuity to address the healthcare system’s increasingly urgent need to deliver better care with fewer resources at less cost.
HIMSS Interoperability Showcase
Connected health experience: More than 50 companies participated in this special exhibit area, showing all manner of products and services to promote connected health and the many ways it can take advantage of the Internet of Things. Attendees could see myriad patient monitoring devices, wearable sensors, mobile apps, telemedicine devices and services, and even games and virtual reality experiences.
#Connect2Health was a major focus of the HIMSS17 exhibit area, including two dedicated areas:
People with Parkinson’s don’t want to be reminded they have Parkinson’s, so the term “Parkinson’s” does not appear in the interface.
Parkinson’s tremor makes some devices difficult to manipulate, so an iPad mini was chosen for maximum ease of use.
Designing empathetic care through telehealth for seniors described a one-year randomized clinical study for a remote physical therapy mobile application for people who have Parkinson’s disease. App users saw a 9 percent increase in mobility, compared with a 12 percent decline among patients receiving standard physical therapy.
CEO, Co-Founder, Wellpepper, Inc.
Parkinson’s causes cognitive impairment, so designers focused on what information to leave out.
Clinical Informaticist, RN, The University of Washington School or Nursing
Understanding your audience is critical for designing effective telehealth applications.
Chronic disease management
Director, Mixed Emerging Technology Integration Lab, Institute for Simulation and Training, University of Central Florida
Virtual reality is a “green field” for innovation in healthcare, according to Rick Krohn and David Metcalf in "Virtual reality gets personal in healthcare." They covered a host of possible applications, including: