Connected Health Requires a Robust Communications Infrastructure
Joseph C. Kvedar, MDCenter for Connected Health
Health care is changing rapidly
We are at the tipping point for adoption of an exciting, refreshing new way of providing health care — Connected Health. Since we all have such a personal stake in health care (we are all patients at some point in our lives), this is directly relevant to all of us. Connected health is about bringing care to you the patient, wherever you are and just in time — when you need it. Think of the power and convenience that offers! Current successful examples of Connected Health include:
- The management of patients with chronic illnesses, such as congestive heart failure, using monitoring technology in the home
- Employee self management of hypertension using a monitor that wirelessly transmits blood pressure to the health care provider; data can then be aggregated and presented to the patient in trended form and in the context of what his/her blood pressure readings mean to his/her overall health, and
- A glowing decorative piece of furniture that changes color according to whether the patient has taken his/her medication that day.
Connected health unlocks value by taking patient care out of the bottleneck that we know as the doctor’s office. Most people find that their health care experience is unpleasant and they cite inefficient systems, long office waits and inconvenient appointment scheduling among the reasons. Connected health dispenses with all of that.
So, what are the remaining stumbling blocks?
Most of the time when people ask me about this, I tell them about the need for a new economic model that rewards quality as opposed to quantity. Progress is being made on this front and I am going to forgo that discussion here. Instead, I’m going to focus on another stumbling block. This one is more about relationships and caring. Heath care, when it is at its best, is about caring. And, the communication of caring is most effective when people are together, when they can see each other’s eyes, read facial expressions, body language and the like. If we are going to truly move health care out of the office to where the patient is, we need to find a way to transport all of the aspects of caring to the patient, along with monitoring their vital signs and sending them text message reminders. The other part of this challenge is that we need a way to do it that extends the provider work force, i.e. makes providers more efficient. This is because we are in provider shortage mode now and will be for the foreseeable future.
There may be novel ways to communicate emotion and caring that will be discovered, but in the meantime if we are going to enhance text communications with more real visual cues, we will need reliable high bandwidth communication to do so. The penetration of broad band is growing in the US, but we are woefully behind our European neighbors and improved health care is one reason we need to catch up.
Just to recap the logic here, we have unprecedented growth in chronic illness in the face of worsening provider shortages. The bottleneck is right in the doctor’s office. If you continue to have to travel to the office for a face-to-face visit in order for health care to €˜happen’, the current primary care crisis is only going to worsen and the system will grind to a halt. So we have no choice but to move care to where the patient is. In order to really achieve that goal, we need not just to monitor our patients but to CARE for them. That requires image/video rich communication and that in turn requires ubiquitous, reliable high bandwidth.
At the Center for Connected Health, we are engaged in a number of initiatives designed to bring care to the patient where the patient is and when the patient needs it. The substrate for all of these is the growing challenge of chronic illness. As providers, we are highly motivated to improve care for chronic illness and those who pay for health care are motivated as well.
Our experience caring for patients with congestive heart failure is most promising. Using a toolset that includes daily weight, blood pressure, heart rate and pulse oximetry, as well as some information about daily activity level, we’re able to improve the quality of patient care, decrease the need for skilled nursing visits and decrease costly re-admissions to the hospital. All of that equates to improved quality at lower cost.
Similar results have been noted with monitoring of glucometer readings in diabetics. We are also seeing promising results in a program where employees with hypertension can monitor and self manage their condition.
All of these examples are low hanging fruit. As we increase both the complexity of illness we deal with online, as well as the richness of the emotional interactions, we will need more and more bandwidth. That is why it is so important that broadband internet access spreads in this country.
Joseph C. Kvedar, MD
Director, Center for Connected Health
Partners HealthCare System, Inc.
www.connected-health.org
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2 Responses to “Connected Health Requires a Robust Communications Infrastructure”
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November 7th, 2007 at 2:32 pm
Having affordable high speed internet access is critical to “connected health”. The Communications Workers Of America are working on this issue with their project, Speed Matters”. Check out the website for more information at http://www.speedmatters.org
December 13th, 2007 at 4:35 pm
[...] convergence of robust broadband technology and a growing awareness of the benefits of e-health is producing new and innovative approaches to handling chronic diseases, such as diabetes. The [...]