We sit poised for an amazing confluence of technology and health care. Technology, in particular, information technology, has helped us make significant advances in care coordination, virtual care and remote patient monitoring. It has also enhanced technical support for care delivery, provided a platform for analytics and provided a conduit for direct patient communication.
Each of these areas have examples that reflect the benefits of information technology in health care. For instance, software tools that allow data sharing are foundational for care coordination and collaboration. These solutions improve the ability to personalize patient care, address care gaps and needed services, e.g. healthcare appointments, and communicate events such as hospitalizations to a care team. In some instances, they also include the patient’s caregiver and/or significant other. Examples of such tools include imprivata and Eccovia. To be successful, these tools must demonstrate ease of information transfer and be Healthcare Insurance Portability and Accountability Act (HIPAA)-compliant.
The pandemic has catalyzed a shift in direct-to-patient services through telehealth and remote patient monitoring. The rapid transition to care delivery via video or telephony propelled virtual care forward. This was manifest in the rapid rise in telehealth appointments at the start of the pandemic and the persistence of telehealth as a care delivery modality today. There also has been an acceleration in remote patient monitoring (RPM). The classical template for this has focused on glucose monitoring for diabetes or ambulatory blood pressure or heart rate monitoring for cardiovascular conditions. With the expansion of tools and access to more biometric data, there is growth in supporting more care at home outside of the traditional healthcare environment, a necessity for making hospital-at-home real. This has been fueled, too, by a recent change in available reimbursement codes for these services.
Information technology expansion has been a crucial underpinning of patient safety efforts as well. One normally thinks of biomedical devices, alarms and alerts to prevent safety events. Maybe more impactful is the information from these devices. These data have been collected and moved into proprietary analytic programs to determine patient features in the inpatient environment that predict high-risk events, e.g. Quant HC and the original eCart tool. Such information can be used to enhance appropriate care and mitigate risk through specific interventions.
There are similar approaches addressing populations as well. Population health platforms, such as Arcadia or Lumeris, ingest multiple data flows including claims data and clinical data and plumb that data in outputs that define medical spend per patient and population, clinical quality and more.
Almost all of these approaches have been healthcare entity to patient. With the continued evolution of technology from communication platforms to wearables, there are different ways that information technology can integrate with health and healthcare. Direct to consumer approaches have advanced individual health monitoring and consumer preference such as self-initiated telehealth appointments or patient appointment scheduling, i.e. ZocDoc. This opens up significant opportunities for interacting with people outside of direct healthcare settings, understanding their health needs and identifying or aligning resources that can support those. This, in turn, has generated new roles such as health coaches and new uses of technology such as the use of bots, direct messaging and additional data collection to help inform individuals about their own health.
While all of these changes are impactful for health care today, they unmask challenges for their efficient use within the healthcare ecosystem. The pace and progress of information technology within health care still feels paradoxical compared to other industries. It is accelerating and, at the same time, glacial in its adoption, diffuse and unchanneled for best insights and use, and still adapting to regulatory requirements. Interoperability of data systems and technology across a common platform—think of the immediate challenge of every new tool interfacing with the electronic record which has been difficult on older platforms. With greater comfort and use of the cloud, there is opportunity to better align tools from a care standpoint.
There are also inherent difficulties with how to plumb, scrub and use the rapidly expanding pool of data most effectively. People and systems must eliminate the “white noise” in the data. There also must be consideration for additional talent and skills to mine and present data in useful formats. This has been a gap in many healthcare entities. Furthermore, there are the ever-present concerns related to privacy and security. Finally, in many organizations, there is a lack of a functional digital health structures that integrates technology into strategy and execution.
The technical knowhow to overcome these challenges is unfortunately accompanied at times by financial constraints and planning. So, from the healthcare organization perspective, looking out it is both exciting and difficult. What will be as if not more intriguing over the next several years will be finding the right intersection between consumer-driven demands shaping healthcare technology use and the adaptability of delivery systems. This includes new and traditional healthcare entities and services to incorporate this information into their platforms while they sustain the other necessary pieces of integrating information technology into their work.