HIMSS 2017: Connected healthcare brings new challenges
Estimated reading time: 8-10 minutes
Ahead of HIMSS 2017, we spoke to six key opinion leaders about what they thought the biggest issues were facing the industry and why from customer-centric health technology solutions to interoperability and data security
Patient centric care means mobile first
Health technology solutions are only as good as their design and functionality; they need to focus on the problems they are meant to solve as opposed to creating tech for tech’s sake. The end users remain providers and patients so that view will always be important in making the UX/UI functional of any product.
As a physician and health tech executive both remain critical to me. It is very important in today's consumer centric model that any patient engagement strategy meet patient needs where they are: on their mobile devices, anytime and anywhere. Not in a patient portal. Not in a wearable device.
When it comes to continuity of care telemedicine is an enabler of this when the physician you can connect with IS actually your physician.
Doc in the boxes don’t work in real life nor in virtual life. Best practices in this space will depend on creating a stickiness with consumers with their true primary care doctor that knows them, their history and their bodies. Value based care will be impossible to execute without interoperability. The clinical benefits will be multiple. Patients will be triaged and actioned appropriately and proactively in a clinical environment better suited to preventive care then what I would call reactionary/emergency room care which consumer experience in today’s fee for service model.
It has been well reported that many medical devices work off of legacy systems and/or have not been updated due to lack of oversight or inability to do so. If those devices are connected to a network or otherwise accessible, then there is a security weak point.
Any weak point like this could be exploited by someone attacking a healthcare entity’s system to gain access to data and use it for unintended or unauthorized purposes. Healthcare organizations should be aware of the risks to medical devices and incorporate assessment of these issues into their risk analysis. The risk analysis required by HIPAA (Health Insurance Portability and Accountability Act) needs to be all encompassing and take all issues into account.
With this knowledge, an organization can then implement appropriate measures to cover the risks. With regard to data, the proliferation of data both from the creation and input standpoints create security risk and the growing number of sources that provide data input mean that there is a corresponding increase in the number of entry points for the data. Each new entry point is a means of access that needs to be secured and monitored. While the data itself may not be an issue, the opening provided for it could create an unintended security risk.
People make health where we live, work, play, pray and learn: that is, mostly outside of the healthcare system -- far from the doctor's office, hospital, or diagnostic center, for example. Digital technology can provide a bridge to the healthcare system via sensors, tools, and trackers for people who are living their lives each day.
When these "things" (in the growing Internet of Things healthcare ecosystem) are beautifully designed to mesh into peoples' life-flows, they can make real differences to people's individual health, and in aggregate, drive public health. The key best practice is radical user-centered design: being passionate about the ethnographic research that informs how people actually "live, work, play, pray and learn," in the context of their personal values.
That's the promise of the best user-centered design for health and wellbeing, for all people. One area where digital health can scale scarce resources is in mental health. A fine example of digital technology bridging the gap between patient/consumer and health care providers is The Big White Wall in the UK. This platform enables people to record their mood, network and interact with peers dealing with behavioral health challenges, and touch base with health care providers. The model has proven to be cost-effective, saving the National Health Service at least 340 pounds a year for each patient using the service.
Cost efficiency is a large factor in connected health. One of the best returns we have seen on efficiency is through e-Prescribing. e-Prescribing improves organizational efficiency, reduces error and improves care coordination. Prior to e-Prescribing an average 20% of provider and pharmacy time was spent on clarifying communication.
This delayed medication therapy, increased cost and resulted in ADE’s, ADR’s and hospital re-admissions.
e-Prescribing provides a connected health model that delivers value and improves connectivity between provider, patient, pharmacist and care setting. Wearables are another model of connected health success. The ability to deliver personalized, relevant information in bite-sized nuggets, has inspired consumers to make changes in diet, exercise and, in some cases, long term behavior.
We are still in the infancy stage of wearable advancement as it relates to chronic diseasemanagement and care coordination. Yet wearables provide us with a communication tool that crosses provider, patient and language barriers.
The integration of virtual reality and augmented reality into connected care is on a fast -track globally. The first step is to understand what VR, AR, and MR actually mean and their applications in healthcare. Virtual reality actually stimulates patients’ senses together in order to create the illusion of reality.
Augmented reality (AR) is a blend of virtual reality (VR) and real life. AR users are able to interact with virtual contents in the real world and to distinguish between the two.
A new term Mixed Reality (MR) is a hybrid reality that merges real and virtual worlds to produce new environments / visualizations where physical / digital objects co-exist then interact in real time. The patients can connect with their physicians through these new emerging tools to receive a different type of connected interaction. I have seen the applications of VR and AR in a rehabilitation hospital. The applications of VR are being used in the treatment for diversion for painful vaccines in pediatrics, chronic pain relief, physical therapy, exercise, combat loneliness in long hospital stays, and physiological therapy. The next phase with AR is predicted to take over VR as a preferred tool. MR is still pretty new for further applications for connected health is ongoing currently it is being applied in surgical procedure in VR and AR. There has been a recent surgical procedure with Snapchat's Spectacles to record surgery as an educational tool. There has been recent discussion about integrating VR and connected health with the NHS system.
I believe that interoperability between personal health devices and services have been the greatest accomplishments, because it enables meaningful use of data when collected holistically. In the past, our health systems were siloed and we focused on disease as opposed to the person.
My patient experience involved the orchestration of a multidisciplinary team to complete a facial reconstruction and not having access to a central medical record meant each specialist had to work in isolation, as a result of those communication gaps I became antibiotic resistant because at one stage I was overprescribed the same antibiotic twice which aggravated my condition. In the real world, using a scenario like infection control, interoperability is critical on a global level. It empowers both the patient and provider with the complete information they need to make informed decisions. Siloed, complex data won’t empower any of us in the system.
As patients, we have become too accustomed to believing antibiotics will fix us every time we get sick, unaware that our bodies can become immune if we use them regularly.
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