First posted on Health Populi on 03/01/2013
Here’s Ann R., who is a patient in the not-too-distance-future, when passive sensors will be embedded in her everyday life.
The infographic illustrates a disruption in health care for people, where data are collected on us (with our permission) that can help us improve our own self-care, and help our clinicians know more about us outside of their offices, exam rooms and institutions.
In Making Sense of Sensors: How New Technologies Can Change Patient Care, my paper for the California HealthCare Foundation, I set out to organize the many types of sensors proliferating the health care landscape, and identify key drivers and barriers that are shaping this market that will drive major change into the health system and how health consumers, caregivers, and patient receive and manage care.
The word “passive” is used in the first sentence quite purposefully, because people don’t like to have to read, record, transmit, email, or remember much when it comes to their personal health data. Sensors for health are coming onto the market that can certainly “sense” — that is, detect, weigh, clinically analyze, or otherwise “read” — our most intimate personal details, from weight to sugar in our urine to moods and blood pressure. But more and more of these can go beyond data sensing and then communicate this information, automatically and seamlessly, from the device itself through the internet cloud, after which the data are routed to some database that can then be mined, judged, and followed up on by a smart engine (which might, say, text a patient to increase their level of diuretic by “x” tablets) or a phone call from a health call center that works with diabetics managing nutrition and adherence to treatment protocols.
The cost of the base sensor technology continues to fall, so that the range of available health sensors includes a long list of applications: sensing mood (say, depression), blood sugar, blood pressure and heart function, medication adherence, risk for an asthma attack, gait (say, for aging people at-risk for falls), and sleep, among other areas. The form factor of sensors, too, is morphing from funky cumbersome rubber wristbands to small, nimble, even artfully-designed jewelry in rings, t-shirts, and belts — or small objects the size of a watch battery that can sit in your pocket.
There are many positive market drivers that are often discussed in the media, particularly following the Consumer Electronics Show in January (here’s my own write-up on “Battle of the (wrist)Bands”). But the market issues and obstacles are worth your attention to ensure we don’t over-hype sensors and deploy them where they might not be necessary — or where the data generated by them can’t or won’t be used by clinicians to participate with patients keen to engage in co-creating health. The issue of doctors’ concerned about a “data tsunami” is particularly important as we approach the 2013 HIMSS conference where health providers will convene to discuss the challenges of interoperability, privacy and security, and implementation of EHRs this round of the meeting. Another layer of data management — coming from user-generated devices at home that weren’t prescribed by doctors — may not be very welcome for those physician practices still wrestling with getting up to speed on Meaningful Use Stage 2.
Still, the prospects for sensors are bright, especially buoyed by a first-generation of health consumers demanding and adopting sensor-based devices. They are paying for them with their after-tax, hard-earned dollars, and using them on a sustained basis. This bodes well for the wellness side of the sensor-health equation. The growing penetration of value-based health benefit plans among employers, coupled with wellness incentives, will further bolster adoption in a second wave of consumer use of devices, that are getting more clinically sophisticated and increasingly easy and nimble to use.
Health Populi’s Hot Points: It’s easy to hype the latest technology in health care. Issues of reimbursement, poor design, and lack of consumer and provider engagement so often prevent the adoption and sustained use of health tech. In the case of sensors, we’re approaching a convergence of factors where these small, increasingly passive devices (a key for consumer adoption and continued use) will be welcomed by people who, first, want to stay well. Over time, more “patients” beyond the well and fit, will welcome these tools into their daily lives to avoid re-entering the hospital or having to take time to visit the doctor for a blood pressure reading or coumadin check. I envision, under accountable and value-based care, the prescribing of these devices to enhance patient self-care and the medical team’s access to information 24×7 to help bolster patient care in the community. The use of passive sensors will become a new approach to patient health risk management.
For more on the concept of personal health IT adoption for consumers in the accountable and value-based payment era, you can take a look at the book Engage! Transforming Healthcare Through Digital Patient Engagement, now available through HIMSS, which includes my chapter written on this subject. The cover, painted for the book by patient advocate Regina Holliday, is worth the price alone.