Last month I published a post entitled “What the market says you need in your patient portal” that garnered a lot of interest. In that post I addressed the balancing act that healthcare executives face when market based initiatives are sidelined in order to drive focus to regulatory requirements such as Meaningful Use. Sometimes the market and regulatory requirements are in sync. However, when those regulatory initiatives get delayed things get complicated. My advice is that, beyond Meaningful Use, ultimately the market will determine what true patient engagement means, and I highlighted seven features that a market driven portal should have. I will spend time during this series going into detail on those features. They include:
- Telehealth that moves beyond the virtual visit
- Dynamic scheduling
- Social collaboration
- Gamification and serious games
- Avatars for personalized health coaching
- Health information exchange across diverse care settings
- Integration of clinical and financial data
Today we will begin with telehealth. The topic has been in the news quite a bit recently – mostly in terms of telehealth reimbursement. The world of telehealth is not only in a state of transition currently, telehealth is also one of the major net deltas that we will see between healthcare of today and the healthcare of ten years from now. So, what does telehealth look like beyond the virtual visit? We are pushing towards a world where technological innovations will make the brick and mortar less and less relevant even in the world of healthcare. One of the more interesting developments in this area is a push by X Prize, by way of multiple multimillion-dollar prizes, to innovate technologies in such a way to diagnose common medical conditions with no intervention from a health care professional. With this drive in the marketplace in mind, telehealth in a market-driven patient portal you would find:
- Socially Enabled Patient Portals: In a socially enabled patient portal, physicians and patients can work together toward their combined goals of better health using tactics like dynamic messaging, activity feeds, blogging, and open question forums. These technologies are particularly effective in rural and low-income areas and are being used to enhance the quality of care for diabetic populations in low-income areas, for example. These technologies show great promise for providers and health plans interested in managing chronic disease in a cost-effective fashion, especially for the uninsured.
- Robotics: Children’s hospitals have been the early adopters of telehealth technologies. Some innovations of interest are in the realm of robotics. Boston Children’s Hospital has an impressive telehealth program with a video-monitoring robot. These 4-foot-6, 17-pound, two wheel robots help with post-operative consultations and care primarily as a means of videoconferencing, giving the families of hospital patients a way to keep in touch with doctors and nurses in between post-surgical appointments. Equipped with cameras, audio gear and a video screen for a “face,” the robots are operated remotely by Children’s Hospital staff. In addition to facilitating communication, they can take video and close-up photos of surgical scars or other key areas of interest to help medical staff monitor recovery.
- The Smart House: When it comes to uncovering issues early, the tracking of vitals, combined with analytics that readily alert clinicians when those vitals show potential for problem, have been crucial to telehealth outside the virtual visit. We are seeing innovations that embedded fiberoptics into carpeting that can track the activity of patients in and out of their bed while at at home. There is also an innovation called the Health-e-Chair that incorporates a vast array of biosensors to measure vital signs including weight, blood pressure, temperature, ECG, auscultation of heart and lung sounds, blood oxygen saturation, motion analysis and reflex response time. The chair incorporates a communication unit with a remotely controlled camera.
- Nanosensors: Taking the tracking of remote patient monitoring microscopic is no longer just something we will get to eventually. There are innovations on the market now that can make a big difference in population health. Diabetes is a serious issue in the world of healthcare (understatement of the year award nomination). One of the leading causes of blindness in the world, diabetes patients have a risk of developing retinopathy, which could ultimately lead to blindness. Nanotatoos have already proven out in diagnostic efforts to track blood glucose levels, for example. Google and friends are also innovating around embedded camera functionality into contact lenses to find early signs of diabetic retinopathy.
One in five Medicare patients are readmitted to a hospital within 30 days of discharge, and one in three are readmitted within 90 days. It’s estimated that 75% of all hospital readmissions are preventable. Telehealth provides many benefits as a virtual visit. However, it is taking telehealth beyond the virtual visit that the market will push towards as we work to bring down the cost of care and reduce readmissions. Stay tuned for a future post on how the integration of all of this data takes this effort a giant leap forward.
Anything you think I’m missing? I’d love to hear your thoughts in the comments below.
