Kvedar: Mobile health offers value propositions

Mobile health brings a revolution to healthcare, said Joseph C. Kvedar, MD, director of the Center for Connected Health in Boston, speaking during a Dec. 14 webinar presented by the Health Information Management and Systems Society.

“One of the topics fueling the fire is the change in the way we’re paying for healthcare. We have a scenario where, at least in healthcare delivery, our world is being turned upside down.” What were once considered expenses have become opportunities for efficiency.

The Center is committed to a care delivery strategy that moves care out of the physician office or hospital and makes it a direct function in the lives of our patients. “We’re equally committed to using technology to give more and more power and decision making ability to patients. That enables us to take the burden off a staff that’s already overburdened and stretched too thin.”

Two value propositions are emerging, Kvedar said, and are going to be cornerstones of mobile health. One is improved self care and the other is equipping providers with a rich data stream to enable just-in-time decisions to keep people healthy. “We did not perceive how much, when you give people these tools, they start to take care of themselves. That is really the biggest value going forward.”

Much of mobile health offers feedback loops which come from measuring something objective about patient and sharing that information either with the patient or a provider in the moment, Kvedar explained.  This has been a revolution in the last few years with more and more tools to help sense information such as blood pressure, activity level and weight, and use sensors to wirelessly transmit data to either a home hub or directly to the cloud.

Mobile health is a “huge enabler” for the concept of the feedback loop which helps people better understand their health, gain insight, set goals and keep health at the top of their minds. “Left to our own devices, over time any stimulus will start to decay. We become used to something and it blends into the background. That’s not okay if you’re chronically ill.”

The other value proposition mobile health offers, just-in-time care, involves evaluation and measurement built into the intervention. For example, the use a tool to see whether patients took their medication at the right time. This has been applied to blood pressure control, heart failure and diabetes, among other conditions.

“We have seen terrific outcomes in all cases and decided to integrate those device data into our core clinical systems.” The Center uses a remote monitoring data repository. Data are sent remotely into the cloud and, through a series of service calls, data are displayed either in a patient’s chart for the provider or in the patient portal for patient access. “We’re happy to be among the first delivery systems to illustrate this end-to-end clinical integration.”

Mobile health is gaining traction with the idea that mobile devices can enhance physician efficiency. “There’s no need to wait for a revolution in payment reform.” The tools available in this sector help physicians make better decisions about care in the moment. “This area is really going to move forward, in my opinion, the fastest,” Kvedar said.

On the opposite pole of innovation is consumer health and wellness. This growing space doesn’t deal with FDA approval and heavy regulation.

The newest market entrants are all driven by the supply and demand curve of physicians. “We don’t have enough clinicians to meet demand, particularly if we continue to insist that patients must be seen physically.” The supply-demand curve will “drive a lot of innovation in two sectors: pushing care directly into the hands of patients and task automation. Sixty percent of our costs are labor. We have to get better at this,” Kvedar said.