According to the CDC, 133 million Americans have at least one chronic disease, and that number was from 2005.
The cost of that disease burden, both in terms of direct medical costs and indirect costs to society, is immense. In a health system that is largely set up to deal with acute illness, we are not only unable to deliver what we know to be the best care, but we also face substantial costs due to system inefficiency.
As Don Casey, CEO of the West Wireless Health Institute, told us in an interview with iMedicalApps,
“…the way to manage chronic disease in our opinion is moving away from infrastructure, expert driven, location-centric care to infrastructure independent care”
Nicole Boramand, VP of Clinical Systems Innovation at West Wireless Health Institute, led a panel of innovators and leaders in remote monitoring who shared their insights into the practical challenges of implementing the remote monitoring systems to deliver this “infrastructure independent care.” Here are some highlights.
The panelists were quick to point out that remote monitoring can only be effective when implemented in the right environment. Dr. Randy Williams, CEO of Pharos Innovations (whose Tel-Assurance system for remote management of a range of chronic disease has been widely adopted), pointed out that remote monitoring is really a way to generate more data – the critical element for efficacy is having the right feedback loops in place to react to the data collected.
Dr. Brett Stauffer, Director of Clinical Decision Support (CDS) for Baylor Health System, additionally noted that implementation of appropriate incentives for everyone – the patients, physicians, nurses, etc – was critical to drive important behaviors, whether its the reducing the incentive to send someone to the hospital at every alarm or encouraging patients to simply participate in the system.
Both Dr. Williams and Dr. Stauffer highlighted the value of having high-volume centers, which allows the care team to build the necessary experience and insights to make the system work at its best. Dr. Williams noted his belief that the presence of a highly experience care coordinator at the successful VA remote monitoring programs was a critical feature.
The other necessity for success will be a culture change among physicians, according to all three panelists. In order to effectively scale these systems up, there will be some requirement for standardization and protocol-driven care, which is often anathema to physicians.
Mr. Claudio Saccavani noted his own experience in trying to determine alarm triggers for weights and blood pressure required him to simply make each physician individually determine alarms for each patient.
Perhaps taking a page out of the Apple and Google playbooks, all three panelists also commented on the need for simplicity and ease of use. For patients, Dr. Williams points out this requires giving patient’s choices that let them decide how to integrate the system into their day to day lives. For physicians, according to Dr. Stauffer, this means making information easy to act on.