What’s Next for the Digital Health Opportunity
By Anthony Lambrou, Pfizer
This blog series by members of the Global Coalition on Aging’s Digital Health Working Group explores the ideas, policies, and behaviors that enable digital health’s contribution to the goals of the Decade of Healthy Ageing.
Will 2022 be the year that the remote care revolution finally arrives? There are several reasons to think so. National home health spending has skyrocketed to $113B in 2019, up from $89B in just four years.
The COVID-19 pandemic has illustrated the immense demand and broad benefits of more accessible, tech-enabled care. Providers have seen what these tools can do. Also, CMS has announced plans to extend support for certain telehealth and remote care services into next year and beyond.
Yet to achieve the full potential of remote care, the field must still answer one deceptively simple question for all these groups. What’s in it for me?
Remote patient monitoring, or RPM, covers an extremely wide range of technologies, devices, and software. For example, wearables that track vitals like heart rate, oxygen levels and pulse to continuous glucose monitor and weight scales. At their core, these solutions aim to fill in the gap of vital information that gets lost between doctors’ visits. This may provide a more continuous, detailed and useful picture of health, ultimately supporting our journeys to healthier aging. Taken together, these advances could enable not just reactive care for an acute health emergency, but the “predict and prevent” model of care that can help avoid a crisis in the first place, especially as the number of older adults at-risk for chronic conditions continues to reach all-time highs.
Research has already proven the value of RPM. For example, studies find that these tools help to prevent falls for older adults, reduce hospital admissions for heart failure and help diabetes patients control their glucose levels. That means cost savings: one Veteran’s Association study finds RPM can cut hospital admissions by as much as 40% and lead to annual savings of $6,500 per patient. Clearly, spending on health innovation is not only good for personal health but great for our individual or national pocketbooks.
If the benefits are clear, why is RPM still not fully integrated into our health systems? In large part, it’s simple inertia. Many patients and physicians need clear, compelling reasons to change their routines, and RPM is no exception. In addition, health policy itself has long held back RPM with outdated codes that limit reimbursement to a narrow set of applications, locations and use cases.
To address these barriers, healthcare innovators must make the value of remote care clear for each of these groups as we make a broader push for reform of our health system to become more hospitable to health technology.
Patients: Predict & Prevent Before Health Crises Occur
For patients, the promise of RPM is simple. Live longer, with more healthy years, and less time battling chronic conditions. As RPM is not only applied to current conditions but could enable prevention through better monitoring, earlier detection and diagnosis, we will start to see greater adoption.
This opportunity therefore requires a profound change in mindset. Just like our health system, many people are accustomed to only thinking about health during times of illness. Instead, RPM offers tools to track and respond to many different aspects of health on an ongoing basis. Of course, acting on this data may require sometimes difficult lifestyle changes like modifying diet and/or activity levels, but could offer the promise of a longer, healthier life, with fewer hospital visits and lower healthcare costs.
Physicians: Richer Data, Earlier Diagnosis, Better Care
For the value to physicians, consider this anecdote from Dr. Mohamed Elshazly, a heart doctor with the Cleveland Clinic: “I’m looking at [the patient’s] hand, and he’s wearing an Apple Watch,” Elshazly says. When the Apple Watch detects an abnormal heart rhythm, it prompts the user to use their index finger to take an EKG reading on the watch. The patient had followed those directions during one of the palpitations. Elshazly asked to see the patient’s phone, pulled up the health app, and looked at the reading. “It was atrial fibrillation,” he says. “So I was able to tell the patient, we have a diagnosis.”
Of course, innovators will need to continue working to make sure RPM data is useful for doctors, not overwhelming, which will require better, more and more creative co-design (with the physicians and consumers qua patients of healthcare). With those filters in place, RPM becomes a powerful tool for doctors to make earlier, more accurate diagnoses, better manage the treatment of chronic illness and maximize their in-person time with patients for high-touch care.
Policymakers: Bring Healthcare into the 21st Century
For payers and regulators, it is my opinion that the impulse to restrict relatively new RPM solutions is shortsighted. Such an extremely conservative stance misses out on the much larger opportunity for RPM to streamline care, improve health outcomes and lower costs — put plainly, the idea of spending a bit more today to save a lot more tomorrow.
COVID-19 may represent a turning point. CMS has temporarily lifted many of its restrictions on RPM and telehealth, and there are now several proposals to extend this approach at CMS into 2022 and beyond. We also see this pattern across the globe from the UK NHS to Japan. However, to unlock the full value of RPM, we need permanent health policy changes to make these solutions central to health delivery going forward.
What we’ve seen so far is just the beginning of what’s possible. While COVID-19 validated the benefits of remote care, this was still primarily telehealth visits: a relatively simple tool within the reactive model of care. Just imagine what’s possible when we harness the full breadth of today’s technologies to strengthen detection and diagnosis, expedite interventions and move towards a more predictive, preventive healthcare system.
Anthony Lambrou is Corporate Strategy and Digital Innovation Lead at Pfizer and a member of GCOA’s Digital Health Working Group.
