2018: The Year It All Came Together For Connected Healthcare

October 3, 2018Blog, Solutions

"The Turning Point"

451 Research predicts that 2018 will be remembered as the year when everything came together for connected healthcare.

Although remote monitoring and telemedicine have been used to augment healthcare for years, a coalescence of technological improvements, increased patient awareness, clinical provider and payer business model changes, and regulator support have set the stage for rapidly increased usage of the two to forge a connected healthcare, across a range of applications, to begin in 2019.

The application of connected healthcare promises to help clinicians treat more patients more easily, and on a more cost-effective basis by remotely monitoring, diagnosing and treating patients outside of the hospital. However, connected healthcare requires increased investment, as well as vigilance by IT and security departments as more devices are used to both care for patients and develop new treatments.

Familiarity with Fitbit and Facetime drive acceptance of remote medicine and remote monitoring

Clinical providers that are seeking to do more with less and payers who aim to reduce costs will lead the charge to adopt connected healthcare. This care delivery model – and the patient experience it brings about – is made possible by new devices, enhanced bandwidth and support by regulators.

Improvements in technology have delivered a range of ‘smart’ medical devices and sensors. Increased network bandwidth, access to cloud storage and the advent of healthcare-specific artificial intelligence applications have made it easier to collect and analyze this increasingly broad range of patient data, and then test it against increasingly large baseline populations.

Patients, too, are more accepting of connected healthcare thanks in part to Apple and Fitbit, which have raised awareness about the benefits of wearing monitoring devices, and consumption of remote health services such as American Well for telemedicine diagnosis and treatment, and Microsoft’s HealthVault for health information storage and insights. Patients who wear Fitbit health and fitness trackers or Apple Watches and who Facetime with their friends, grandkids or spouses are likely to feel comfortable with remote monitoring and interacting with their doctors remotely. Insurers, such as John Hancock and Optum, further the idea by incentivizing subscribers to utilize health trackers and report results. They’re making the actuarial bet that providing programs to encourage healthier habits in individuals today will improve the health of their entire subscribership bases over time and bring down costs.

Finally, regulators have begun to embrace remote, device-augmented medicine. The US FDA has begun fast-tracking the approval of new medical wearables. The Center for Medicine and Medicaid Services (CMS) has begun changing how it manages billing such that it effectively creates a better business model for telemedicine. The CMS’s planned expansion of the ‘unbundling’ of billing code 99091 in 2019 means that clinicians can bill for remote monitoring and more easily deliver telemedicine, allowing them to intertwine the two.

Obstacles remain: Human nature, not technology or even logistics, as the biggest challenge

The devices to track vitals such as heart rate and respiration rate or constantly measure critical metrics like blood pressure and blood glucose levels are beneficial, but their near ubiquity also creates challenges. Delivering, setting up and recovering these devices, as well as collecting, verifying, normalizing and analyzing all data, then communicating key findings to clinicians all represent significant logistical and technical challenges. This is due to the numerous devices and networks, data formats, values collected and electronic health record (EHR) systems in play. Simplifying the process will take a large ecosystem of vendors, new practices and standards, and a good deal of cooperation with clinicians and patients to optimize the practices of monitoring large patient populations.

Efforts will start small, with core groups of vendors that can supply the applications, devices, networking, security and support needed to build out specific use cases and applications for connected health. Managed services providers such as Integron and healthcare-oriented VARs and ISVs will play an especially important role in orchestrating the setup, trialing and launch of initial efforts and, later, larger, farther-reaching programs.

Numerous business challenges, including proving overall return on investment and maintaining security and privacy of patient data, will remain. Early trials have borne out positive results from reduced readmissions of acutely ill or post-operative patients by keeping patients with chronic diseases at home for longer and reducing emergency room visits by remotely monitoring how regularly patients take medications. Additional trials will be necessary across more use cases and applications to help prove ROI.

Clinicians, too, may need some convincing. Doctors often embrace new technologies for diagnosis and treatment and, as they become proven, push their IT departments to support them. Yet clinicians are generally wary of the false positive. For numerous ethical and legal reasons, they are unlikely to rely solely on smart device data, whether enhanced by AI or not, for diagnoses. Instead, they’re most likely to embrace smart medical devices as another tool for decision support and workflow optimization, two things that improve their effectiveness and efficiency in managing day-to-day patient needs.

The Outlook

Overall, 451 Research believes that there is enough weighty evidence for further adoption of connected healthcare and that the segment will continue to achieve positive momentum, resulting in greater uptake over the next five years. 451 Research predicts that the number of connected medical devices in use in inpatient facilities, as well as patient remote monitoring devices, will grow by over 150% from 1.5 million in 2018 to 13.3 million in 2023. By 2023, we predict that remote patient monitoring devices will represent nearly 40% of the market.