ADVANCED TECHNOLOGIES IN HEALTHCARE
The reach of technological innovation continues to grow, changing all industries as it evolves. In healthcare, technology is increasingly playing a role in almost all processes, from patient registration to data monitoring, from lab tests to self-care tools.
Devices like smartphones and tablets are starting to replace conventional monitoring and recording systems, and people are now given the option of undergoing a full consultation in the privacy of their own homes. Technological advancements in healthcare have contributed to services being taken out of the confines of hospital walls and integrating them with user-friendly, accessible devices.
The following are ten technological advancements in healthcare that have emerged over the last ten years.
1. The electronic health record. In 2009, only 16 percent of U.S. hospitals were using an EHR. By 2013, about 80 percent of hospitals eligible for CMS' meaningful use incentives program had incorporated an EHR into their organizations. "For such a long time we had such disparate systems, meaning you had one system that did pharmacy, one did orders, one that did documentation," says Jeff Sturman, partner at Franklin, Tenn.-based Cumberland Consulting Group. "Integrating these systems into a single platform, or at least a more structured platform, has allowed more integrated and efficient care for patients," he says.
While the EHR has already created big strides in the centralization and efficiency of patient information, it can also be used as a data and population health tool for the future. "There's going to be a big cultural shift over the next several years of data-driven medicine," says Waco Hoover, CEO of the Institute for Health Technology Transformation in New York. "Historically, that hasn't been a big part of how medicine is practiced. Physicians go to medical school and residencies, but each organization has its own unique ways they do things. That's one of the reasons we see varied care all over the country. When data is what we're making decisions off of, that's going to change and improve outcomes of the consistency of medicine delivered."
2. mHealth. Mobile health is freeing healthcare devices of wires and cords and enabling physicians and patients alike to check on healthcare processes on-the-go. An R&R Market Research report estimates the global mHealth market will reach $20.7 billion by 2019, indicating it is only becoming bigger and more prevalent. Smartphones and tablets allow healthcare providers to more freely access and send information. Physicians and service providers can use mHealth tools for orders, documentation and simply to reach more information when with patients, Mr. Sturman says.
However, mHealth is not only about wireless connectivity. It has also become a tool that allows patients to become active players in their treatment by connecting communication with biometrics, says Gopal Chopra, MD, CEO of PINGMD, and associate professor at Duke University Fuqua School of Business in Durham, N.C. "Now I can make my bathroom scale wireless. I can make my blood pressure mount wireless. I can take an EKG and put it to my smartphone and transfer that wirelessly," he says. "mHealth has the opportunity to take healthcare monitoring out of the office, out of the lab and basically as a part of your life."
3. Telemedicine/telehealth. Studies consistently show the benefit of telehealth, especially in rural settings that do not have access to the same resources metropolitan areas may have. A large-scale study published in CHEST Journal shows patients in an intensive care unit equipped with telehealth services were discharged from the ICU 20 percent more quickly and saw a 26 percent lower mortality rate than patients in a regular ICU. Adam Higman, vice president of Soyring Consulting in St. Petersburg, Fla., says while telemedicine is not necessarily a new development, it is a growing field, and its scope of possibility is expanding.
The cost benefits of telehealth can't be ignored either, Mr. Hoover says. For example, Indianapolis-based health insurer WellPoint rolled out a video consultation program in February 2013 where patients can receive a full assessment through a video chat with a physician. Claims are automatically generated, but the fees are reduced to factor out traditional office costs. Setting the actual healthcare cost aside, Mr. Hoover says these telemedicine clinics will also reduce time out of office costs for employees and employers by eliminating the need to leave work to go to a primary care office.
4. Portal technology. Patients are increasingly becoming active players in their own healthcare, and portal technology is one tool helping them to do so. Portal technology allows physicians and patients to access medical records and interact online. Mr. Sturman says this type of technology allows patients to become more closely involved and better educated about their care. In addition to increasing access and availability of medical information, Mr. Hoover adds that portal technology can be a source of empowerment and responsibility for patients. "It's powerful because a patient can be an extraordinary ally in their care. They catch errors," he says. "It empowers the patient and adds a degree of power in care where they can become an active participant."
5. Self-service kiosks. Similar to portal technology, self-service kiosks can help expedite processes like hospital registration. "Patients can increasingly do everything related to registration without having to talk to anyone," Mr. Higman says. "This can help with staffing savings, and some patients are more comfortable with it." Automated kiosks can assist patients with paying co-pays, checking identification, signing paperwork and other registration requirements. Mr. Higman says there are also tablet variations that allow the same technology to be used in outpatient and bedside settings. However, hospitals need to be cautious when integrating it to ensure human to human communication is not entirely eliminated. "If a person wants to speak to a person, they should be able to speak with a person," he says.
6. Remote monitoring tools. At the end of 2012, 2.8 million patients worldwide were using a home monitoring system, according to a Research and Markets report. Monitoring patients' health at home can reduce costs and unnecessary visits to a physician's office. Mr. Higman offers the example of a cardiac cast with a pacemaker automatically transmitting data to a remote center. "If there's something wrong for a patient, they can be contacted," he says. "It's basically allowing other people to monitor your health for you. It may sound invasive but is great for patients with serious and chronic illnesses."
An article by Kaiser Health News, National Public Radio and Minnesota Public Radio discussed the effects a home monitoring system had on readmission rates for heart disease patients at Duluth, Minn.-based Essentia Health. The national average rate of read missions for patients with heart disease is 25 percent, but after Essentia Health implemented a home monitoring system, the rates of readmission for their heart disease patients fell to a mere two percent. And now that hospitals are being financially penalized for read missions, home monitoring systems may offer a solution to avoid those penalties.
7. Sensors and wearable technology. The wearable medical device market is growing at a compound annual growth rate of 16.4 percent a year, according to a Transparency Market Research report. Wearable medical devices and sensors are simply another way to collect data, which Dr. Chopra says is one of the aims and purposes of healthcare. He says sensors and wearable technology could be as simple as an alert sent to a care provider when a patient falls down or a bandage that can detect skin pH levels to tell if a cut is getting infected. "Anything we are currently using where a smart sensor could be is part of that solution," Dr. Chopra says. "We're able to take a lot of these data points to see if something abnormal is happening."
8. Wireless communication. While instant messaging and walkie-talkies aren't new technologies themselves, they have only recently been introduced into the hospital setting, replacing devices like beepers and overhead pagers. "Hospitals are catching up to the 21st century with staff communicating to one another," Mr. Higman says, adding that internal communication advancements in hospitals followed a slower development timeline since they had to account for security and HIPAA concerns.
Systems like Vocera Messaging offer platforms for users to send secure messages like lab tests and alerts to one another using smartphones, web-based consoles or third-party clinical systems. These messaging systems can expedite the communication process while still tracking and logging sent and received information in a secure manner.
9. Real-time locating services. Another growing data monitoring tool, real-time locating services, are helping hospitals focus on efficiency and instantly identify problem areas. Hospitals can implement tracking systems for instruments, devices and even clinical staff. Mr. Higman says these services gather data on areas and departments that previously were difficult to track. "Retrospective analysis can only go so far, particularly in places constantly changing like emergency departments," he says, but tracking movement with a real-time locating service can highlight potential issues in efficiency and utilization.
These tools also allow flexibility for last minute changes. "If [a physician has] an add-on case today, do they have instruments on hand, and where are [the instruments]?" he asks. At the most basic level, these services can ensure equipment and supplies aren't leaving the building, and for high-cost equipment and supplies of which hospitals may only have one or a few, being able to track their location can help verify its utilization, he says.
10. Pharmacogenomics/genome sequencing. Personalized medicine continues to edge closer to the forefront of the healthcare industry. Tailoring treatment plans to individuals and anticipating the onset of certain diseases offers promising benefits for healthcare efficiency and diagnostic accuracy. Pharmacogenomics in particular could help reduce the billions of dollars in excess healthcare spending due to adverse drug events, misdiagnoses, read missions and other unnecessary costs.
