Samuel Alfano , Do, Medical Director, Clinical Informatics, Crozer-Keystone Health System
A connected Health often refers to Technology-enabled care where the use of new technologies aims to enable patients to access Healthcare remotely, outside of traditional models of care delivery. In reality, it includes any system that allows Healthcare to be more patient-centric and patient participative. The rise in alternative payment methods for care delivery, coupled with the increasing difficulty of accessing Primary Care, has fueled the surge in Connected Care across the Health Care System. This type of care includes programs in Telehealth, remote care such as home visits, disease and lifestyle management, and new software to support patient connectivity. When I think of connected care, I recognize three different areas that can be impacted. These are remote care, self-care, and monitoring of determinants of health.
Remote care is the most common, with programs focused on Telehealth and enhanced communication between providers and patients. This includes electronic visits; email and texting between patients, providers, and other members of the healthcare team; and traditional Telehealth programs that provide access in areas where care is lacking.
Connecting patients and their data to global positioning systems, twitter accounts, and local and governmental databases will allow us to include social determinants of health into our care plan for patients
These programs will continue to grow as we try to provide care outside of traditional brick and mortar facilities and increase access. Changes in reimbursement from fee for service to quality based and captivated care is driving this growth. Care of patients with chronic diseases has become increasingly complicated and involves multiple visits and multiple providers and caregivers. These patients can be positively impacted by frequent contact with their health care team, especially if it can be facilitated by technology and communication tools.
Self-care is growing in popularity, especially among our younger patients. They are often looking for guidance and goals to improve their health. Provider-defined goals can be combined with digital technology to give immediate feedback and advice. Apps that can be linked with a patient’s portal and help guide exercise programs, diet choices and medication adherence already exist and will increase in popularity as the current generation ages. New technology is emerging to link these apps with biosensors to measure blood pressure, heart rhythm, blood sugar, and other biomarkers are available or in development at this time.
Connecting patients and their data to global positioning systems, twitter accounts, and local and governmental databases will allow us to include social determinants of health into our care plan for patients. Examples include identifying the availability of fresh food and vegetables for our diabetic patients or monitoring weather and alerting patients with pulmonary disease. Case managers access to crime statistics, bus routes, pharmacies, and social services can help make sure patients are safe, compliant and can participate in their care plan. We are just starting to understand how this “outside” data can be used to improve the lives of the patients we serve.
The traditional practice of medical care is changing rapidly. Providing care in unique and novel ways will allow patients enhanced access to care while making the use of providers and facilities more efficient. Providers and patients will always need to interact face to face. Touch is a very powerful part of the practice of medicine. Connected care should not be aimed to limit these interactions but should enhance our ability to provide this care.