Monitoring patients remotely is one way to reduce healthcare costs, but it may also facilitate outcome-based reimbursement programs.
According to a report from the Population Reference Bureau, 71.4 million people in the U.S. will be age 65 or older by 2029 - representing about 20 percent of the total population. At the same time, HHS projects a shortage of 20,400 primary care physicians by 2020. As any economics professor will confirm, a rise in demand with a simultaneous drop in supply results in higher prices. Reducing the need for office visits and/or hospitalizations is paramount to cost-effective care for these aging baby boomers, and will necessitate innovation in care delivery and patient engagement.
Not only are baby boomers living longer, but according to a study published in the Journal of the American Medical Association, "U.S. baby boomers have higher rates of chronic disease, more disability, and lower self-rated health than members of the previous generation at the same age." Moving to an outcome-based reimbursement model is one way to control costs and incentivize improved patient outcomes.
The key to making sure outcome-based reimbursements are fair to physicians will be accurate analytics. How does one decide what constitutes an improved outcome? By using nationwide patient data to establish a baseline. Mortality rates, comorbidities, average life expectancies, medication efficacies, and thousands - if not millions - of other variables and metrics will need to be tracked over time, and in large patient populations.
One of the biggest issues with getting the data necessary to establish outcome baselines and other healthcare analytics has been getting EHR software vendors to come together and solve issues with interoperability. But even if interoperability is improved there will still be issues with the fragmented, episodic nature of care delivery and documentation. How can a "healthy" baseline be determined for an individual - or group - if all captured data comes from instances when the patient is ill?
A reduction in hospitalizations for chronic conditions, better data for outcome-based reimbursements, and population health modeling - what if I told you that a solution already exists that will help do all of this and more? Implantable or wearable devices for remotely monitoring patients have the potential to save millions of dollars through reduced hospitalizations and also provide comprehensive, real-time monitoring of physical activity, vital signs, and other metrics. This data can be used to better manage chronic illnesses and predict if and when an intervention will be necessary. While tracking devices are an easier sell to patients managing a chronic condition, TechnologyAdvice's health wearables study revealed that 57.1 percent of healthy U.S. adults would consider using a wearable tracker if it would reduce their health insurance premiums.
Remote monitoring devices could reduce costs and improve health for other at-risk patient populations by monitoring respiratory patients with mobile spirometers, tracking patient adherence to medication regimens, helping long-term care residents to prevent falls, or to monitor pregnancies. According to a report from ABI Research, up to 100 million remote monitoring devices are expected to ship during the period 2014-2019, and while many of them will be used to manage chronic conditions, growing consumer interest in health and fitness tracking could help provide physicians with both a higher quality and quantity of data. Companies like Apple, Google, and many others are already moving into the remote monitoring marketplace. Apple's HealthKit and similar platforms promise to aggregate data from a myriad of apps and devices in order to make it easier to derive actionable insights.
In short, remote patient monitoring will allow continuous tracking of both healthy and at-risk patient vital signs in order to prevent emergent conditions, predict if and when an intervention will be necessary, and develop baseline outcomes for various conditions, so that outcome-determined reimbursements can be fairly implemented. All of this, presumably, should reduce healthcare costs and improve health outcomes, particularly for those patients managing chronic illnesses, but it remains to be seen how and when remote patient monitoring will go mainstream.