IoT Helps You Proactively Manage Chronic Health Conditions

health

In our series on the potential of the IoT for the healthcare industry, so far we’ve looked at healthcare mobile apps and remote patient monitoring (RPM). Both of these topics play into our focus for this week: how health care professionals can harness the power of the IoT to manage their patients’ chronic conditions and to improve outcomes.

Focusing on the “big three” chronic conditions

For the purposes of discussion, we will focus mainly on the “big three” chronic conditions that affect thousands of Americans, cost millions for insurance providers and individuals alike each year and are proven to have better outcomes with close monitoring. These chronic conditions are:

  • Heart conditions – predominantly congestive heart failure (CHF)
  • Asthma (COPD)
  • Diabetes

Tapping into the IoT to affect meaningful change

If health care providers, insurance companies and major health networks focus their initial IoT integration efforts on devices and treatments for chronic conditions that affect so many people, real change may be evident in a short amount of time. Goldman-Sachs researchers David H. Roman and Kyle D. Conlee write:

“From a clinical standpoint, chronic disease management sits at the bulls-eye of the healthcare cost challenge given that these conditions account for a large and growing proportion of overall spend ($1.1 trillion annually, or one-third of total U.S. healthcare expenditure.” (4)

Roman and Conlee go on to explain that these three chronic conditions that cost the most each year – heart conditions (mainly congestive heart failure), asthma (COPD) and diabetes – are the “most fertile ground” for healthcare IoT. That’s because research has shown that remote monitoring of these conditions leads to:

  • Improved patient outcomes – better quality of life
  • Lower adverse events, including trips to the emergency room and doctor’s office
  • Reduced healthcare costs

Therefore, not only does using IoT-connected devices to monitor and manage patients’ chronic conditions have a potential to drastically improve the life of a heart patient or a diabetic, for example, IoT applications in healthcare has the ability to help reduce health care costs for everyone.

Using the IoT to improve outcomes for chronic conditions

In patients with known chronic conditions, the main way that providers can use the IoT and IoT-connected devices is with regular, proactive monitoring. Remote patient monitoring (RPM) connects a medical device – such as a blood pressure cuff or glucose monitor – to a computer at a healthcare facility at which a provider can access and analyze the data. This cumulative data can help providers forecast future events, thus warning the patient ahead of time and also leading to improved future practices that can positively impact all patients with the condition.

Taken a step further, smart IoT-connected devices can be pre-programmed by a health care professional to send a warning or trigger in the event of an adverse effect. For example, a glucose monitor receives a reading in a dangerous range for an elderly diabetic patient and the local life squad is immediately summoned. As Maria Regan of Forbes has written, “By lessening the time it takes to diagnose and treat a patient, smart, internet-connected devices will lead to fundamental improvements in medical care.” Or, in less urgent situations, the IoT-connected blood pressure reader could send an alert to a patient’s cardiologist that readings have been irregular recently and the patient’s medication levels may need assessed.

Time will only tell what emerging technologists in the healthcare field will develop to continue to help manage chronic conditions. Patients who have increased access to technology like iPhones and iPads – and are also taking an increased interest in keeping their health care costs down – will surely help to drive the adoption of these new technologies.

References

Cousins, Mathias, Tadashi Castillo-Hi and Glenn H. Snyder. “Devices and diseases: How the IoT is transforming medtech.” Deloitte University Press. Accessed online.

Regan, Maria. “How the Internet of Things may help save heart attack and stroke victims.” Forbes.com. Accessed online.

Roman, David H. and Kyle D. Conlee. The Digital Revolution Comes to US Healthcare. Internet of Things, Vol. 5. Equity Research, Goldman-Sachs. Published 29 June 2015.

 

Originally appeared on The IoT Collective.

mHealth: Proactively Managing Your Health

mobile-health

Mobile apps that collect, store and transmit health-related data have been around for several years now. They’re a critical element of remote patient monitoring (RPM) and diagnostics, since your smartphone or tablet can serve as the storage repository for health data collected by other sources and IoT-connected devices. Doctors and others in the healthcare field certainly believe that mobile apps have the potential to improve patient care and health. For example, a 2016 study of health professionals found that remote monitoring has the greatest market potential for mobile health apps (Source: research2guidance; eMarketer).

Early concerns with mobile health apps

The FDA writes that mobile health apps “can help people manage their own health and wellness, promote healthy living, and gain access to useful information when and where they need it” (“Medical Mobile Applications”). Early on, providers and consumers alike shared many about surrounding the security and efficacy of these apps:

  • Is my health data secure? 
  • Will using this app really help me to better manage my diabetes?
  • As a provider, will I be held legally responsible if this app is ineffective or causes a patient harm?

…among a myriad of other concerns. In the past few years, however, the FDA has begun more tightly regulating mobile health apps. In so doing, health care providers can more confidently “prescribe” use of these apps to their patients, and patients themselves can feel more comfortable using them.

Capabilities of mobile health apps

The FDA classifies a mobile healthcare app as any of the following:

  • Medical devices that are mobile apps, or meet the definition of a medical device
  • An accessory to a regulated medical device
  • Transform a mobile platform into a regulated medical device

(Source: “Medical Mobile Applications”)

A mobile health app may be as simple as a patient key entering health data such as what they’ve eaten or blood pressure readings they’ve taken at home. Or, the app may be fully integrated to automatically receive readings from a blood pressure machine or glucose monitor, for example, and then securely send that data to the provider’s office. In the event of readings or data that cause alarm and need quick intervention, the app can even be set to trigger an alert to the patient, a caretaker (in the event of an elderly or disabled person) or even the rescue squad.

Technology access and mobile healthcare apps

5 years ago, a lot fewer people had smartphones or tablets. So, access to these technologies to run mobile health apps was certainly a legitimate concern. However, these days, patients of all ages and demographics are increasingly likely to own a smartphone. Of the leading global markets, the United States has the highest smartphone penetration, with 63.5% of Americans expected to use a smartphone in 2017. This shows a substantial increase from the 40% of Americans who had a smartphone in 2012 (Smartphones in the U.S.). So, this access barrier is becoming less and less of an issue as the years go by and even the older populations are familiar with smartphones and tablets.

Additional oversight coming to mobile health apps

In late 2015, an additional governing body for mobile health apps came into fruition, born out of leadership from some prestigious American health organizations. A joint effort between the American Medical Association (AMA), the American Heart Association (AHA)Healthcare Information and Management Systems Society (HIMSS) and the digital health non-profit DHX Group, Xcertia will provide guidelines for creating and using mobile health (mHealth) apps. The new organization won’t actually certify mobile health apps – that’s for the FDA to do – but “Xcertia’s guidance is intended for others to use when developing, evaluating or recommending mHealth apps” (O’Reilly).

Leaders of this effort say that the guidelines they provide will help providers realize the full capabilities of mobile health apps – to more proactively manage their patients’ health and enable their patients to live fuller, healthier lives. Eric Peterson, MD, chair of the AMA’s Center for Health Technology and Innovation, said of the power of Xcertia: “The AHA is an evidence-based organization, so we can add an emphasis on evaluation that is critical for the mHealth space to realize its full potential and, truly, deliver better outcomes for patients” (O’Reilly). Time will tell the impact that Xcertia will have on the utilization and quality of mobile health apps, but its founding undoubtedly signals an important step in this technology: the American medical elite taking a true leadership and ownership position in the advancement of mobile apps.

References

“Medical Mobile Applications.” U.S. Food & Drug Administration. Last updated 22 Sept 2015. Accessed online.

O’Reilly, Kevin B. “Safety, efficacy guidelines in store for mobile health apps.” AMA Wire. American Medical Association. Published 13 Dec 2016. Accessed online.

Research2guidance; eMarketer. Greatest market potential of mobile health app categories according to mHealth professionals as of 2016. Accessed from Statista.

Smartphones in the U.S. – Statista Dossier. Accessed from Statista.

 

Originally appeared on The IoT Collective.

IoT Improves Health Through Remote Monitoring

kitty-apple-watch

As I discussed in the first blog post in this series, potential applications for the Internet of Things (IoT) in the healthcare sector run deep and wide. Integrating with the IoT will enable health care providers of the future to see more patients, from a wider geographic area and at lower costs. Data collection and transmission en masse thanks to Electronic Medical Records (EMR) will allow quicker, more accurate diagnosis and treatment of a wide variety of conditions. And – as is the focus for this post – IoT-connected devices can perform remote patient monitoring (RPM) and diagnostics to improve patient quality of life.

Defining remote patient monitoring (RPM)

Goldman-Sachs researchers David H. Roman and Kyle D. Conlee define remote patients diagnostics and monitoring as “devices and applications that allow care providers to keep tabs on chronically ill, recently released, and overall ‘high-risk’ patients” (9). Simply put, remote monitoring devices allow care professionals to gather and analyze their patients’ health data without having to physically see the patient. This allows providers to have round-the-clock visibility into how their patients are doing, and enables them to be more proactive in terms of flagging and responding to potentially adverse health data.

Oftentimes, RPM takes advantage of technology that a patient already has in place in his or her home, such as wireless Internet and a smartphone or tablet. Sometimes, additional equipment such as an electronic blood pressure cuff or blood sugar testing device may need to be connected to the existing home network for health monitoring.

Using IoT-integrated devices to improve patient outcomes 

Research has shown that patients who perform regular monitoring of chronic conditions using IoT-enabled devices have better outcomes than those who don’t take advantage of these technologies. For example, a 2015 study of 269,471 patients with pacemakers, implantable cardioverter-defibrillators or cardiac resynchronization therapy found that those patients who spent more time each week using remote monitoring had higher survival rates than those who didn’t use the remote monitoring that was available to them (Niraj, et al.).

Environmental monitoring via the IoT

Another type of health monitoring that IoT-enabled devices can facilitate is environmental monitoring, meaning devices installed in living spaces that enable certain high-risk individuals to live more independently. With remote environmental monitoring in place in homes and assisted living apartments, for example, older or disabled people are able to live more independently for longer. Knowing that a doctor or the life squad will be immediately notified in the event of an adverse health event – such as a spike in blood pressure or drop in blood sugar – can help set families’ minds at ease.

Using RPM to improve patient quality of life

In a 2014 report titled “Connecting Patients with Providers: A Pan-Canadian Study on Remote Patient Monitoring,” Canada Health Infoway writes:

“The role of information technology is a critical enabler to improving health services delivery. As decision-makers consider options for delivering high quality care at the right cost, there is a need for innovative solutions that potentially reconfigure traditional service delivery models. RPM is a critical enabler for this transformation with the potential to incentivize self-management, support the delivery of care in home settings and significantly improve the patient experience.” (Emphasis added)

Indeed, for all patient groups, RPM has the potential to reduce the number of hospitalizations, frequency of readmissions and lengths of hospital stays. Remote monitoring allows for more proactive healthcare that can anticipate patient needs before a situation becomes dire. All of these factors contribute to improving patient quality of life and help to drive down healthcare costs for everyone.

References

“Connecting Patients with Providers: A Pan-Canadian Study on Remote Patient Monitoring: Executive Summary.” Canada Health Infoway. Published June 2014. Accessed online.

Roman, David H. and Kyle D. Conlee. The Digital Revolution Comes to US Healthcare. Internet of Things, Vol. 5. Equity Research, Goldman-Sachs. Published 29 June 2015.

Varma, Niraj, et al. “The Relationship Between Level of Adherence to Automatic Wireless Remote Monitoring and Survival in Pacemaker and Defibrillator Patients.” Journal of the American College of Cardiology 65 (24): 2015. Accessed online.

Originally appeared on The IoT Collective.