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 readmissions 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 readmissions, 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, readmissions and other unnecessary
costs.
Before a full-fledged system of pharmacogenomics comes to fruition,
the healthcare industry needs a tool that can aggregate and analyze all
the big data and digital health information, Mr. Hoover says. "When we
really start to have the ability to study a lot of that data, it's going
to transfer how we match up that information at the population,
individual and macro levels," he says. "The ability to actually compare
that information is going to be valuable as we move forward, making sure
medications we are taking are going to work for us."
Tools for big data analysis for pharmacogenomics are still being
developed, but data analytics and data aggregation for the purpose of
population health may be the next big advancement on the horizon.
"Understanding and connecting all these variables is going to be
profound as it relates to moving forward in healthcare and designing
interventions and analyzing patient populations and ultimately improving
the lives and health of the American population," Mr. Hoover says.
