Dr. Steven R. Gerst: The Future in Healthcare is Here. Remote Patient Monitoring Achieves Great Success With Continually Advancing Technology
Steven R. Gerst, a respected authority in Health Informatics, shares the latest breakthroughs in medical technology and the healthcare industry. Here, Dr. Gerst analyzes how the American healthcare industry is integrating wireless advancements in technology enabling Digital Medicine/Remote Patient Monitoring throughout the system. Telemedicine is transforming the delivery of healthcare.
Fort Lauderdale, FL, December 20, 2016 (Newswire.com) - Working with patients remotely can be a very viable alternative for medical professionals. The revolutionary debut of Digital Healthcare/Remote Patient Monitoring (RPM) will provide a more efficient and effective method for patient treatment.
With a direct, real time connection into the hospital and physician’s electronic medical record system, RPM allows the immediate capture and notification of any medical issues experienced by a patient with a chronic condition. This encompasses 71% of the general population and 86% of the Medicare population (1).
The Internet of Healthcare Things (IOHT) uses mobile cellular and web-enabled medical devices allow patients to virtually and immediately connect to their healthcare providers. Home monitoring systems, implantable devices, ingestible sensors, smart phone apps and items that patients can wear (digital wearables) are now available and will use 5G narrow band connectivity for long battery life and patient mobility.
The patient generated health data (PGHD) produced by these devices can evaluated by healthcare providers in real time, rather than through patient portal cashed databases currently in use. These patient portals are currently uploaded into the provider’s EMR once every 24 hours. This is may be sufficient for low acuity chronic conditions (e.g., obesity), but it is not sufficient for acute conditions such as Congestive Heart Failure (CHF), Chronic Obstructive Pulmonary Disease (COPD), fragile diabetics or unstable asthmatic patients.
The cost savings from implementing real-time RPM systems can be considerable. Over $1 trillion is spent per year on managing patients with the 19 chronic illnesses defined by the centers for Medicare & Medicaid for which providers may be reimbursed under CMS’ Chronic Care Management Code 99490 (2) and post hospital discharge under Transitional Care Management Codes 99495 and 99496 (3) for these virtual, “non-face-to-face” remote monitoring.
This provider reimbursement authority has also been granted by Congress through the Secretary of Health and Human Services to approve experimental projects promoting the objectives of the Medicaid and CHIP programs. Section 1115 of the Social Security Act allows hospitals to apply for waivers to implement these programs in some states. (4)
According to the Center for Disease Control, chronic disease accounts for 1/3rd of total U.S. healthcare expenditures – over $1 Trillion of the $3 Trillion spent annually. Managing heart conditions, COPD, asthma and diabetes constitute the largest expenditures and offer the greatest potential using Digital Medicine/RPM to improve patient outcomes, lower adverse events, and reduce costs when shifting to a Value Based- Outcomes driven approach to treatment and reimbursement.
In a report by Goldman Sachs, an estimated $305 billion will be saved by 3 new innovations:
- $200 Billion from Remote Patient Monitoring
- $100 Billion from Telehealth, and
- “An infinitely large savings” from Behavior Modification regarding obesity management, smoking cessation and overall lifestyle improvements.
The report estimates commercially available opportunities to provide these services and technologies at approximately $36 billion per year.
The Goldman Sachs’ report charts the hurdles that must be overcome and how far we have progressed in the adoption of digital health including:
- FDA Regulation: With over 100 digital health applications approved to date, the FDA has laid out guidelines for regulation and approval for digital health.
- Patient Adoption: Developers are creating seamless interfaces for users of all levels of tech competency.
- Physician Acceptance: While most healthcare organizations have attempted to integrate mobile into their healthcare offerings in some way, there are many who are still not recognizing its viability, and are waiting for better technologies.
- Reimbursement: Securing reimbursement is essential to the viability of digital health business models; while some argue that it is counter to the objective of connected health.
- Privacy: Making mobile therapies HIPAA compliant represents a tremendous challenge in wireless healthcare.
RPM allows medical data to be more widely and instantly accessible, greatly improving preventative medicine and public health informatics to stem the spread of controllable conditions as well as contagious disease.
This capability is critical to nearly half of all adults in the U.S. (117 million people) suffering from Chronic Conditions. Nearly half (58 million Americans) suffer from 2 or more. (5) Digital Medicine and Remote Patient Monitoring allows medical providers to quickly and efficiently monitor these patients directly in comfort of their homes, analyzing and evaluating the patient’s condition to prevent the exacerbation of their chronic conditions and reduce medically unnecessary and costly 30–day readmissions.
Within the last decade or so, cellular and internet connectivity, has grown to over 7 billion cell phones worldwide. 92% of adult U.S. residents own a mobile device. This permits patients to receive remote monitoring reports for healthcare. In fact, RPM will likely become a standard in rural healthcare.
As the cost of medical devices, sensors, processing power and bandwidth all become more competitive, RPM and IOHT will allow the Triple Aim of the Affordable Care Act to be achieved- “Improved access, better quality healthcare at a more affordable cost.” This will improve the wellbeing of the population and can reduce the 17.5% burden of disease management on the U.S. economy allowing the U.S. a greater competitive advantage in world trade markets.
Dr. Steven R. Gerst is a Managing Partner of Telemetrix Systems, LLC (steve@telemetrixsystems.com) which offers real-time, remote patient monitoring systems directly into the provider’s Electronic Medical Record System. He is an Entrepreneur-in-Residence at the University of Miami, Miller School of Medicine, U Innovation, Office of the Vice Provost and is on the faculty of the School of Nursing and Health Sciences where he lectures on Management Information Systems in Healthcare.
Dr. Gerst is a graduate of the Columbia University College of Physicians and Surgeons (M.D.), Columbia College (B.A.), Columbia School of Public Health – Health Administration (M.P.H.) and the Goizuetta School of Business at Emory University (M.B.A.). He is a Diplomat in the American College of Healthcare Executives. He is also Dean Emeritus of the Masters of Science Program in Applied Health Informatics at Bryan University (Los Angeles, Sacramento, Toronto and Phoenix) where he serves on the Board of Advisors and has taught on the faculty.
Dr. Gerst also is a Principal in the Asclepius Life Sciences Fund, LP, a Cayman Islands activist Hedge Fund which invests private equity and venture capital in biotech and biopharmaceutical ventures (http://asclepiuslifesciences.com/).
- Gerteis J, Izrael D, Deitz D, LeRoy L, Ricciardi R, Miller T, Basu J. Multiple Chronic Conditions Chartbook. [PDF - 10.62 MB] AHRQ Publications No, Q14-0038. Rockville, MD: Agency for Healthcare Research and Quality; 2014
- Department of Health and Human Services, Centers for Medicare and Medicaid, Medicare Learning Network, “Chronic Care Management Services,” ICN 909188 May 2015. As found at https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/Downloads/ChronicCareManagement.pdf
- Department of Health and Human Servces, Centers for Medicare and Medicaid, Medicare Leaning Network, "Transitional Care Management Services, "ICN 908628 March 2016. As found at: https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/Downloads/Transitional-Care-Management-Services-Fact-Sheet-ICN908628.pdf
- Medicaid.gov. Section 1115 Demonstrations. As found at: https://www.medicaid.gov/medicaid/section-1115-demo/about-1115/index.html
- Ward BW, Schiller JS, Goodman RA. Multiple chronic conditions among US adults: a 2012 update. Preventable Chronic Disease. 2014;11:130389. DOI: http://dx.doi.org/10.5888/pcd11.130389.
Source: Steven R. Gerst