Health IT’s Sharpening Focus: Calibrating Health Care

Sometimes the state of healthcare seems more like the movie “Snakes on a Plane” rather than the symbol of the serpent entwined on the Rod of Asclepius (the Greek god associated with healing and medicine). The movie title alone conjures pretty frightening images. The good news is that the rising numbers for healthcare investment, information technology spending, and consumer behavior related to their healthcare choices reveal a course change that’s not reptilian at all:

Sometimes the state of healthcare seems more like the movie “Snakes on a Plane” rather than the symbol of the serpent entwined on the Rod of Asclepius (the Greek god associated with healing and medicine). The movie title alone conjures pretty frightening images. The good news is that the rising numbers for healthcare investment, information technology spending, and consumer behavior related to their healthcare choices reveal a course change that’s not reptilian at all:

• According to a recent report in MedCity News, healthcare spending on telecommunications will outpace overall healthcare industry growth rates—climbing to $14.4 billion by 2017, at an annual growth rate of 10 percent.
• Venture capitalists and incubators are researching both life sciences companies and IT companies—they could create matches between life science innovators and IT to spur more digital health innovations.
• Improved networks and information technology are allowing providers to leverage their traditional medical care resources (e.g., hospitals, clinics, equipment) across a larger base of remote patients. These networks and electronic health records (EHR) will allow collaboration among clinicians, care teams, patients and provider organizations.

At the same time, however, healthcare costs are rising, in part, due to the nature of how many Americans seek treatment and manage their own health conditions:

• Two-thirds of emergency room (ER) trips aren’t emergencies (according to the U.S. Centers for Disease Control & Prevention),
• Half of Americans suffer from at least one chronic condition (pulmonary disorders, hypertension, and mental disorders top a Milken Institute list), and
• Few seniors covered by Medicare see the same physician consistently.

This all makes for very expensive healthcare delivery.

Something has to give; but what?

• Chronic management is starting to move from the ER and doctor’s offices, while home monitoring and mobile monitoring is growing. The current market for home blood pressure monitors is $1 billion, glucose monitors is $7 billion and markets are growing for blood coagulation monitors and home-based cholesterol testing kits.
• Online physician-patient visits are growing and 39% of doctors now communicate with their patients through email. The U.S. Veterans Administration showed that telehealth resulted in 25% fewer hospital bed days, and 19% fewer admissions.
• Several companies in the U.S. and elsewhere, small and large, health and non-health–related, are coming up with solutions to care for patients at home utilizing various platforms and devices.
• Kiosks and mobile units are springing up across the country to bring healthcare to the consumer.

How can we continue on this journey toward even more healthcare efficiencies?

Calibrated care refers to ranking patient-provider interactions in order of severity, much like an automated telephone system works in customer service for other products. It determines the lowest interaction mode necessary (via the web, a smart phone or tablet), and can use software programs to measure need (e.g., Is this a prescription refill? A need to change dosage? A complaint of chest pains?), and determine the right interaction level. Moreover, software is under development (with more on the way) that saves data from every interaction to aid in follow-ups.

While some nurses report feeling their jobs are threatened by telehealth, nursing has historically embraced innovation and new ways to improve patient care.  A recent report on nurse-led telehealth intervention for diabetics resulted in a significant reduction in HbA1c levels.

While doctors may be slow to adapt to changes and insurers are not fully confident, the bottom line is: consumers are demanding these changes. More than 80% of consumers want more internet-based information on their health, and Kaiser Permanente reported that 87% percent of seniors using its online health record system were happy enough to pay for it.

Ultimately, these innovations will allow a fully remote, digital version of Patient-Centered Medical Homes (which will, of course, depend on having the right technology to make them work). This new focus could create a real movement toward digital health and make it a significant part of our healthcare system.

Do you think a software-based calibrated care system could work? What possible obstacles could there be? Could these systems reduce healthcare costs? In what specific ways? Share your thoughts with us.