Connected health offers plenty of potential to fill existing care gaps

The average patient with five chronic conditions typically will sit in front of a doctor for only 15 out of the 8,760 hours in a year.
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Rasu Shrestha, MD, chief innovation officer at UPMC, speaks at Think Tank

The average patient with five chronic conditions typically will sit in front of a doctor for only 15 out of the 8,760 hours in a year.

“As we move to value-based care, we have to look at how a connected health eco-system can help to fill the care gap by addressing care issues during those 8,745 hours when patients are not face-to-face with their doctors,” said Tom Foley, director, global health solution strategy at Lenovo Health.

This connected-health challenge was addressed by the 50 thought leaders gathered at The Health Innovation Think Tank:  A Collaboration of Global Health Industry Thought Leaders, a one-day event co-sponsored by Lenovo Health, Justin Barnes Advisors, University of Pittsburgh Medical Center/Critical Care Medicine (UPMC), Inventiv Health and HIMSS Media.

“We are shifting away from bricks-and-mortar hospitals. We are moving to cities and homes and even the patient’s smartphone,” said Rasu Shrestha, MD, chief innovation officer at UPMC and one of the “catalysts” who spearheaded discussions during the one-day educational event. As such, healthcare organizations need to zero-in on “meeting the demands of the new norm where care venues are changing” and where 24/7 availability and ubiquitous digital data-based interactions is commonplace.

To address this challenge, UPMC has established UPMC Enterprises, an innovation and commercialization arm that develops new digital healthcare companies, technologies and solutions. Through this initiative, UPMC has implemented telemedicine in 36 different service lines. In addition, UPMC now discharges patients “not only with a patient summary and discharge notes but with apps and connected devices.” For example, congestive heart failure patients are discharged with access to specialized portals and connected technologies that measure the vitals and feed the data into a centralized hub, where “algorithms tell us the patient is about to fall off the guard rails and we can intervene” with the proper care management, Dr. Shrestha said.

What UPMC and other trailblazing organizations are finding, however, is that with this increased emphasis on connectivity, the need to address challenges such as usability and integration become ever more pressing. As such, a best practice is for healthcare innovators and independent software vendors to “inject strategies from the gaming industry to help with user interfaces and consumer engagement,” said Justin Barnes, director of Justin Barnes Advisors and host of This Just In Radio Show.

Marty Fattig, CEO of Nemaha County Hospital, pointed out that it’s important to concentrate on interoperability as patients – especially those in rural areas such as the one where his critical-access hospital is located – could generate data via their interactions with a variety of providers. Nemaha County has worked through the University of Nebraska and the Office of the National Coordinator for Health IT to enable hospitals, primary care providers and pharmacists to share data.

In addition, with connected care becoming more prevalent under value-based models, care is apt to move from being very “linear” to becoming more “circular.” Patients might start a care episode in an emergency department but the condition will continue to be treated and monitored through interactions with providers as well as connected technologies, according to Hank Fanberg, Office of the CIO, Technology Advocacy, CHRISTUS Health, Irving, Texas.

 As such, providers need to adopt a more holistic approach to care delivery and payment. More specifically, it requires an increase in payment alignment – as acute- and ambulatory-care providers need to work together to achieve outcomes under value-based care.

What’s more, to succeed under these models, providers need to stay abreast of legislative and regulatory changes, according to Jeff Coughlin, senior director of federal and state affairs, HIMSS. Providers specifically should be cognizant of the in-and-outs of the Chronic Care Act and understand documentation requirements associated with the Medicare Chronic Care Management Codes, which are designed to reimburse an average of $42 per month for each patient.