In this article we get a closer look at what the new-generation, digital continuous care means to patient, healthcare provider and payer, and how it affects the whole healthcare industry. We will show how continuous care changes the paradigm of the home monitoring of chronic disease patients, as well as the value that new care strategies and technologies bears to the stakeholders. So, enjoy the wild ride to new-generation digital care transformation!
Digital home care is nothing new in today’s medical world – everyone is familiar with medical devices for patient home monitoring such as glucometers, fingertip pulse oximeters, blood pressure monitors, thermometers and other connected to smartphone applications and clouds. The common denominator for all these devices is that they are designed for the sporadic measurements and usually are taken from the shelf when patient already feels bad. Transformation from episodic, manual and fragmented care towards continuous, automated and prolong one affects lifestyle and wellbeing of the chronic disease patient. It refers to three key healthcare trends:
- Improve patient life-style
- Improve quality of care
- Cost and risk reduction
A digital continuous care capitalizes on these three trends to plan and deliver personalized health monitoring products and services. Digital wearable medical technologies allowing comfortable and reliable patient continuous monitoring drive home healthcare from reactive post-event intervention, resulting in real-time and predictive systems and processes. When smart wearable technologies and patient homecare planning come together, they can dramatically change the way clinicians plan and react. Digital continuous care combines the convenience of a wearable, tracking device, with state of the art monitoring capabilities, previously only available in the hospital or care facility.
Real-times means the system can continuously process digital biomarkers and their derivatives, and stay synchronized with what’s happening with the patient. Intelligent software can continuously learn and adapt patient’s care plan and intervention protocols versus relaying on episodic data and prescribed actions. This intelligent software can also predict event, provide insights and communicate with caregiver and clinician. A digital continuous care increasingly leverages usability and intelligence embedded in wearable medical devices and software systems allowing providers to analyze data from continuous tracking, empower patients to participate in their own care plan and predict and alert against future potential complications.
The digital continuous care is the next step in the evolution of modern patient remote monitoring and management. For example, one of the reasons healthcare providers will inevitably employ digital continuous care is to reduce hospital stay and risk of readmission. The so called “prospective payment system,” shifted the financial risk of patients’ hospitalization from Medicare to the hospital, encouraging the hospitals to optimize patient stay. The prospective payment system pays a hospital the same amount whether a Medicare patient stays five days or four. With the digital continuous care mechanism the hospital stay could be ultimately optimized, so the hospital doesn’t have to keep patient for longer – patient will continue a hospital-grade care at home.
Likewise, digital continuous care can reduce post-emergency room hospitalization that, in many cases, hits the healthcare cost bottom line. Patient will be sent back home with the wearable medical device and being connected to a care team in real time. Furthermore, wearable medical devices integrated into machine learning and artificial intelligence eco-system will make emergency room visits almost obsolete. For example, the technology will indicate, monitor and alert disease deterioration even couple of days before it starts to dramatically affect the patient. Recent review on “Monitoring of Physiological Parameters to Predict Exacerbations of Chronic Obstructive Pulmonary Disease (COPD)” revealed that continuous and regular monitoring of patient’s biomarkers is a promising method to predict exacerbation. Specifically, nine studies proved a reduction in peripheral oxygen saturation (SpO2%) prior to exacerbation onset. Three studies for peak flow, and two studies for respiratory rate reported a significant variation prior to or at exacerbation onset.
Transforming from a conventional remote monitoring to accurately predicting patient health status is a slowly becoming reality. Clinicians and payers understand that the digital continuous monitoring with predictive analytics can enable mitigate patient risk much faster than they have been able to in the past. They are seeing the greatest value and momentum to start their journey, at least in small steps. However, it is challenging to try out some new technologies while to maintain current processes and workflow, that hampers a widely adoption and implementation of digital continuous care. So, to accelerate further penetration of digital continuous care into healthcare system, a new technology should be carefully tuned and embedded into the current clinical workflow without its dramatic disruption and added cost.
Leon Eisen, PhD
Founder and CEO of Oxitone Medical