Tag: Patient

Health Informatics insights: remote health monitoring


I just got better from a month long ordeal with an infection, which required daily visits to a care provider to assess the state and provide care. Though, the care was exemplary by Ontario CCAC, there are areas of improvement needed in care coordination among providers and remote health monitoring to increase efficiencies.

Remote health monitoring, means different things to different people.  The following report from California Health Foundation offers the current state of the market with a clear definition on the terms and the state of the market.

The Connected Patient: Charting the signs of remote health monitoring


Image Source: California Health Foundation – The connected patient: charting the vital signs of remote health monitoring.

Key insights: little has changed in the last four years with mixed results from pilot projects

Why little has changed when the economic benefits offer several millions and billions of dollars in savings and efficiencies ?   The author of the report points to the structural issues of the US health care system, which tends to be fragmented and focused on episodic care.  I believe that this is not just a US problem and is a common issue between the publicly funded Canadian healthcare& and friends south of the 49th parallel.  By far the biggest barrier to more pervasive adoption of DM has been the continued fragmentation of operations and information technology across health systems.

That is a well known problem with the providers paid on a fee for service basis.   In the US there are recent developments with the introduction of HITECT act and Accountable Care Organizations towards an outcomes based system.  In Canada, from my view the change appears even slower and the outcomes based model is being discussed at the provincial level, who are essentially payors of the service.

Though there are several drivers for remote health monitoring including communication technology advancements, mobile data standards, the chronic care tsunami we are facing as a society,  there are some significant challenges in adoption at the physician office,  consumer engagement and payment models for this service.

In spite of the challenges there are significant economic benefits and prospects to remote health monitoring both in US and Canada.

& Rethinking Our Approach to Disease Management: Technology and Information Flow Considerations

State of Health Information Exchanges: New Report


eHealth Initiative released a new report on the state of Health Information Exchange in the US and here are my findings and view of the survey.

Key Findings:

  • 234 active health information exchange initiatives (HIEs) in America
  • More than half the HIEs are not dependent on federal funding
  • Revenue source from transactions and subscriptions fees to data users and providers, which points towards sustainability of HIEs in  the long run rather than depending federal funding.  The model is similar to Canadian Diagnostic Imaging Repositories in some provinces, where the central organization (non-profit entity) has a sustainable revenue model continuing operations.
  • Data exchange between the various providers is on the rise from medications to lab results, inpatient discharge summaries, radiology results, inpatient diagnoses and procedures looks promising for the EHR.
  • Benefits and ROI of a HIE: Various measures of benefits and ROI are presented from reduced time spent to locate clinical results and records, decreased dollars on duplicate diagnostic procedures and decreased cost of care for chronic disease patients to name a few.
  • More Patient Engagement: There is no questions that patients want to get engaged and the survey underscores that point once again. HIEs are the avenue to break patient health information islands.

Thanks to the folks at eHealth Initiative for the survey,  I understand that this is a high level survey, a more detailed one will be very useful to shed light on the %of data exchanged between stakeholders for each type of data and the governance and architecture model followed for ensuring sustainability and scalability of the service.

Please click on this link to access the full survey and the associated webinar.

Saravana Rajan