Someone to Watch Over Me

By Dr. Charlie Miraglia

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First of all, it’s probably best to point out that the topic on my mind today has absolutely nothing to do with the plot of the 1987 Ridley Scott film, or the lyrics of the 1926 Gershwin song of the same name. However, the title is appropriate in a more literal sense, given that the subject under consideration is telehealth and our ever-increasing ability to remotely monitor patients through innovative new technologies.

I don’t think anyone would argue with the statement that the current trajectory healthcare has been on is unsustainable, not just with respect to its delivery, but also with society’s ability to pay for it. Those providers who survive will not simply follow the changes that are coming, but will lead the charge and embrace the delivery of care models that will take full advantage of technological advancements – optimizing health, incentivizing wellness, and preventing disease.

The population is aging; by 2030 over 70 million people in the U.S. will be over the age of 65, more than double the number at the beginning of this millennium. With age comes the greater likelihood of chronic disease, or more significantly, multiple chronic conditions. What does that mean for the older individual suffering from more than one disorder? It means that they are more likely to have more hospitalizations, more readmissions to the hospital, and higher mortality rates. Combine these realities with a healthcare system that is inefficient, high cost and of highly variable quality, and the drivers for change become more apparent.

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Thanks to new and evolving technologies that facilitate and enhance remote patient monitoring, there is an unprecedented opportunity to improve management of chronic conditions. Consider also that telehealth will contribute to reducing costs and increasing quality by engaging and educating patients as well. In addition, monitoring patient adherence to treatment protocols, in conjunction with earlier intervention when issues arise, will undoubtedly reduce hospital readmissions and improve outcomes.

The key to adoption of telehealth programs and remote monitoring initiatives lies in the ability to connect and engage providers with their patients in a way that optimizes the exchange of data and information. Patients and their families and caregivers need to have timely access to information necessary to care for them at home. Providers need access to real time data specific to the patient’s condition that will allow appropriate adjustments to treatment plans, from medication changes to the addition of physical therapy or exercise programs. Engagement across the continuum of care will not only lead to greater compliance on the side of the patient, but a more comprehensive understanding of the patient’s condition at any given time by the provider.

Furthermore, delaying or even preventing hospital admissions or readmissions, or the need for more costly nursing home services by better monitoring and care of the patient at home, will drive down the overall cost of healthcare while leading to greater patient satisfaction. The large amounts of data collected from each patient throughout this monitoring process will also lead to a wealth of disease specific analytics that can be evaluated for the benefit of larger populations. This accumulated data, often referred to as “big data”, can be leveraged to deliver healthcare that is more preemptive, predictive, and personalized.

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