Joseph C. Kvedar, MD
Director, Center for Connected Health
Partners HealthCare System, Inc.

The Center for Connected Health in Boston has become a national leader in identifying ways broadband technologies can be used to deliver higher-quality, more cost efficient care. Last year they launched the Center’s Diabetes Remote Monitoring program and Dr. Joseph Kvedar, MD, the Center’s Director was gracious enough to blog on NextGenWeb with an update on how the program is doing.

Consider that the prevalence of diabetes has increased 200% in the last 20 years. In the year 2002, 11% of total US health care expenditures were on diabetes. The total cost of the disease that year was $132 billion. And probably worse yet, one in three people born in 2000 will develop diabetes at some point in their lifetime. By anyone’s yardstick, this is a big and growing problem.

Can patient-focused technologies play a role in solving the problem? At the Center for Connected Health at Partners Healthcare in Boston, we are convinced of the powerful role these technologies can play.

We see striking evidence, over and over, of the power of patient-provider connectivity to improve the quality of care and to do so at lower cost. At its core, this concept is a simple one…if your doctor is always available to you as a ‘private health coach,’ you can imagine how much better you’d be at following her advice. It turns out that capturing information about you that is relevant to your condition and presenting it to both you, as a tool for biofeedback, and to your health care provider, is a feasible way to approximate the vision of your doctor being with you all of the time. It’s very powerful.

Our vision for the optimal tool set for connected diabetes care involves monitoring of the patient’s glucose readings, activity, blood pressure and adherence to the medication regimen. In order to get started, we’ve chosen to get the most fundamental data moving first, the glucose readings.

Right now a dozen or so patients in a practice at the Massachusetts General Hospital are participating in a pilot program of this type. Whenever they take a glucose reading, the information is automatically routed over their phone line to our system where it is catalogued. The data is analyzed and presented in near-real time to the patients. We surround the trends with educational information and encourage the patients to fill in relevant information about medication, diet and exercise in a journal. All of that information is made available to a nurse practitioner whose job it is to manage this population of patients.

The feedback to date from both the patients and the NP has been quite positive. In the near future we’ll be enrolling many more patients and documenting their clinical progress to see if we can achieve an improved quality of care as evidenced by lower hemoglobin A1c.

And there’s an economic driver, too! The physician side of our organization is held accountable through our contracts with the local health plans, to keep hemoglobin A1c below a certain level for our diabetic patients. We have millions of dollars at risk for this outcome. Using tight connectivity between patients and providers as a strategy, we are optimistic we’ll be able to achieve these goals.

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