Technology a Key Component in Shifting Healthcare Models, Attitudes

Just as the bulky, room-filling computers of the 1950s evolved into the devices we use today, healthcare will have to adapt from its office-building mentality to make way for care in a smaller, more personal space - a patient's home.

That was one of the messages from Eric Dishman, director of health innovation and policy for Intel's Digital Health Group, at this year's MGMA11 Conference in Las Vegas. Dishman's session, kicking off the second day of the event, explored home- and community-based care technologies that help patients to live more independently.

Dishman said he is not "anti-nursing home or anti-hospital," but, "the healthcare system has become too reliable on" these locations for care, especially for an expanding population of older Americans. "We need to change our practices - both the places we deliver care and our daily routines - as the only way to deliver meaningful reform."

The problem is not just one in America, Dishman added, as globally, the number of older individuals will grow exponentially. For example, he noted, in 1950, there were 3,000 people globally age 100 or older. The projection for 2050, however, is six to eight million centenarians.

So if the United States, as well as our global neighbors, is struggling with the cost of healthcare and the inadequate number of professionals to deliver that care, "practice as usual is not sustainable," Dishman said. "We are not going to have enough doctors and trained medical professionals … we can't create enough [medical] students to keep up with this age curve."

So while technology is the answer, Dishman was quick to note that inserting technology into healthcare is not a magic pill or a panacea to make everything better in an instant. Solutions such as in-home monitoring or telehealth are just one piece of the puzzle.

Technology can help when it comes to changing the dynamics for both patients and healthcare providers. Dishman cited several case studies done during his tenure at Intel; including an 86-year-old man with Parkinson's disease. The man was a devoted woodworker who wanted to continue his passion, but also required medication on a frequent basis.

Emerging technology can help this man, and other patients like him, in a nonintrusive way which perhaps is the biggest deterrent to older patients using technology, Dishman said. No one likes an alarm or computer voice giving them prompts to do something they don't enjoy in the first place.

Technology like prompts via television or phone can unobtrusively help with medication reminders. Devices can be placed in the home that monitor patient movement and will query if medication has been taken when the sensor "detects" that the homeowner is preparing to leave the house, or upon his return. It can also note how long the homeowner has been away from the home and again provide a reminder.

This kind of technology, used at home, can provide monitoring and take preventative steps to avoid a return to the hospital or doctor's office, when a condition worsens. It also assists home-care professionals by providing patient data on habits, movements, etc., to give a clearer picture of what's going on in the home.

And of course, let's not forget the emerging healthcare trend of community, be it an accountable care organization or medical home, where various physicians and specialists from multiple practices are partnering to care for patients. Technology can link them together to share patient data and plan next steps in patient treatment plans.

Dishman noted both patient and provider hesitation in using new technology, but also said that e-mail doesn't replace the telephone, it just makes for a different communication relationship.

"Given our global aging statistics, given the challenges we are facing now …if we don't use the technology lever to amplify things … we'll be in trouble," Dishman said.