Just-in-Time Care a Key Value of Mobile Health Devices, Says Kvedar

12-15-2012 7-00-13 PM

The two core value propositions for mobile health devices are improving self-care and providing just-in-time care, according to Joseph Kvedar, MD, director of the Center for Connected Health at Partners HealthCare in Boston.

Dr. Kvedar addressed the topic of “Enhancing Care Delivery with Connected Mobile Devices” in the third Webinar in the HIMSS 20/20 series.

According to Dr. Kvedar, just-in-time care can be particularly valuable since it can trigger interventions with patients who have chronic diseases such as COPD and diabetes. In this care model, wireless medical devices in the patient’s home or attached to the patient’s body are connected to a healthcare organization’s clinical information system. A caregiver monitoring a diabetes patient, for example, can quickly detect an abnormal glucose reading and contact the patient.

“This technology is valuable medical tool that can be used on a daily basis,” said Dr. Kvedar. In addition, the data can be tracked over time to provide a profile of the patient.

Another advantage of these devices is that they provide an objective, reliable source of patient data.

“Self entry of data is not effective,” Dr. Kvedar warned, since people will tend to give information on weight and exercise that reflect aspirations, not actual readings.

One caveat on wearable devices is that the readings can be inconsistent. Dr. Kvedar said he often wears three or four devices during the day to test them, finding that they don’t necessarily agree on certain metrics such as activity level.

High cost is another concern about portable devices. “Many of them are expensive, and you need to get them back from the patient,” he said. He said a number of companies are working on low-cost devices that won’t have to be returned.

The other core value proposition, improving self-care, is exemplified by consumer applications such as devices like FitBit. Dr. Kvedar said these consumer devices are clearly popular and can be valuable, although their overall effectiveness may be limited. “Any stimulus, such as device reading or social post, tends to diminish over time.”

According to Dr. Kvedar, text messaging is an effective an underrated form of communication, particularly in underserved populations. He said that many Medicaid patients, for example, do not have smart phones, but have phones with text messaging. Text messages can be sent in multiple languages, and most recipients respond well to the communication.

The real value of mobile devices for healthcare organizations is in reducing workflow and keeping patients out of the hospital. There is still some resistance by physicians to these devices, he warned.

“Physicians want to know ‘how will I get paid?’ for using the device and ‘how does it fit into my workflow?’” Dr. Kvedar said.

In addition, many current devices don’t integrate easily into EHRs. However, as hospital infrastructure is improved and new payment models emerge, the stage will be set for increased use of mobile devices.

This article was contributed by James Harris, president of WestsidePR.com, a healthcare technology marketing agency.

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