The worlds of healthcare and audiovisual technologies are beginning to intersect around patient engagement, encouraging communications between patients and their providers and patient involvement with their health through easy-to-use tools.
Audiovisual products and services in healthcare settings include telemedicine and telehealth, surgical video, mobile and personal connected health tools, remote patient monitoring, medical instruction and network security.
While video conferencing between providers or between providers and patients are increasingly used where the cost of transport is high, such as to connect patients in rural areas or on an oil rig in the Gulf of Mexico, more tools are becoming available for improved access and follow-on care for better outcomes and to enhance the relationship and patient’s confidence in his or her provider.
One of the drivers is to reduce readmissions and their subsequent payment penalties, according to Joseph Kvedar, MD, director for the Center for Connected Health at Partners HealthCare.
“We have an aging population, lower budgets, pressures from taxpayers and other payers to contain costs, legal mandates for care, and enabling technologies that enable quality improvements. And we have everything from the speed of transmission, enterprise and home networks, and image quality that we’re able to deliver at bandwidths much lower than thought possible 10 years ago,” he said at the Nov. 27 Technology Crossroads conference sponsored by the National eHealth Collaborative.
Among the tools described at the gathering was the use of video to explain instructions for medication and care at home when a patient leaves the doctor’s office or hospital to share with family or other providers. Oftentimes, patients do not understand or remember what the doctor said, even with a written sheet of instructions. These videos can be short and used with smart phone apps. Some provider systems are developing the capability to embed a physician’s video in the member’s electronic health record (EHR).
To that end, “the audiovisual industry should consider getting involved in standards and interoperability work around standards for videos in EHRs,” said Leslie Kelly Hall, senior vice president for policy at Healthwise, referring to work spearheaded by the Office of the National Coordinator for Health IT to enable health information exchange.
Audiovisual technologies can demonstrate valuable uses for just-in-time care, being able to reach into a patient’s life when they need it and not just when they have an appointment and to foster patient self-care, with feedback loops and motivators, Kvedar said.
“We just achieved integrating into our electronic health record technologies, applications and sensors connected from the home, and a doctor or nurse looking at the electronic record that can include the patient’s access to see the home-monitoring data,” he said, adding that “we will get to the point where we can just call about abnormal readings.”
Kvedar described the example of connecting cardiac care at home. Patients upload their vital signs in the morning, and if they don’t, they get a reminder phone call. If the vitals are out of normal parameters, a nurse phones the patient to identify and discuss activities or diet at the point that they have an effect on the patient and not weeks later at an office appointment.
“All of a sudden, patients get it. This program has shown a 50 percent drop in readmissions. So, we’re trying it with other chronic conditions, like diabetes,” he said.A goal would be to be able to customize the motivational messages for the specific patient and layer that on the feedback loop. Also knowing that the physician or someone in the provider’s office is watching the patient’s data makes them behave differently. Next is trying to automate that. “I think we’re going to need that because there aren’t enough providers to go around,” Kvedar said.