CARE MANAGEMENT

Better Healthcare Through Patient Data

AUG 28
As the healthcare industry continues to struggle with a combination of forces – ranging from rising costs, to an aging population, to an increased prevalence of chronic conditions requiring around-the-clock care, to a shortage of healthcare workers – there is unique opportunity to leverage more patient data to improve healthcare.  The industry’s growing needs combined with the growth in value-based care initiatives has led to a transition to non-episodic, remote patient monitoring (RPM) through patient generated health data (PGHD).

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The following are some of the most prevalent macro trends that plague our healthcare system and how the insights gained from PGHD and RPM can help solve those issues:
 
  1. Significant increase in the number of people with chronic conditions: An estimated six in 10 American adults live with at least one chronic condition and 42% have more than one. Chronic conditions account for the most deaths in the U.S. and are responsible for more than 85% of the nation’s annual healthcare expenditures, creating an urgent need for health systems to better manage these populations. 1 Patients with chronic conditions face worse health outcomes, have higher hospital readmission rates, and generally incur higher healthcare expenses. 2  In lieu of waiting until conditions worsen to a level requiring acute care, PGHD and RPM can lead to more prompt action from providers. Rather than working with patients on a needs-basis, providers can more consistently monitor a person’s health remotely and intervene as negative trends are identified from a patient’s data. For people with chronic conditions like diabetes or hypertension, the ability to share health data with doctors in real-time and on a regular basis can be highly valuable for identifying trends and behaviors occurring outside the doctor’s office, such as nutrition, sleep patterns, and levels of stress, which, if not visible to providers, could hinder the improvement of outcomes and lead to increased utilization of higher cost healthcare events.
  2. Shortage of Resources: Based on the current deployment methodology of healthcare resources, the growing total population, and the aging population of current physicians, recent estimates suggest a shortage of 260,000 nurses by 2025 and 120,000 physicians by 2030. 3 Given these labor trends, the healthcare industry is faced with the challenge to reduce preventable episodes and rethink and reshape how healthcare is deployed. PGHD and RPM enable the reduction of events by preventing hospital readmissions and create a more efficient mode of healthcare delivery. Historically, PGHD had to be manually elicited from and collected by healthcare professional during face-to-face interactions. PGHD and RPM technology has enabled the collection and use of a broader set of PGHD while limiting valuable office time. RPM also promotes efficiency through group monitoring, which limits the total resources needed to be deployed per patient – with regular access to health data, caregivers can stratify the population based on level of attention needed, and remotely monitor a wider group while simultaneously reducing the burden on limited resources.
  3. Limited Patient Engagement: The way the current episodic system is set-up, many patients find it challenging to take ownership of their own health decisions as healthcare is largely viewed as a reactive solution to acute symptoms. When patients are enabled to collect, access and share their own health data, it creates a level of accountability where individuals realize and understand that their actions have a direct effect on health outcomes and are empowered to make meaningful changes. 4

These issues are pressing and need a solution that changes the way the system and all its participants define and perceive healthcare. The implementation of remote monitoring programs helps improve the full continuum of care through proactive interventions and patient knowledge and empowerment that can lead to lower costs of care, fewer acute episodes, and decreased stress on the healthcare labor market.
 
Addressing the Opportunity from a National Perspective
 
MyHealthEData-compressor-(2).pngThe potential benefit of PGHD and RPM has gone beyond clinical circles and has grabbed the attention of policy makers. The Office of the National Coordinator for Health IT (ONC) updated its Patient Engagement Playbook, an evolving set of healthcare best practices for providers, to include information about integrating PGHD into patient care. ONC recognizes the benefits to PGHD use and acknowledges its ability to promote efficient and accurate diagnoses, patient-centered care, meaningful chronic care management, and reductions in repetitious lab testing.   In March of 2018, the Trump administration announced the MyHealthEdata initiative which aims at increasing patient engagement through providing patients access to their own health records and allowing them to share this data with providers they feel best meets their needs. 6 The Centers for Medicare & Medicaid Services instituted changes to the reimbursement policies regarding time spent on remote care such as the unbundling of certain Current Procedural Terminology (CPT) codes under the 2018 Physician Act to no longer require an in-person visit to reimburse physicians and increase the amount of billable Medicare hours available for doctors who utilize remote care services. 7
 
Innovative Companies are Leading Positive Change
 
There is reason to believe that providers are already riding this wave being propelled by regulators and researchers. According to a 2015 market research, nearly two thirds of hospitals and healthcare systems had adopted some form of remote monitoring and analytics into their care processes. 8 In 2016, seven million people were using remote monitoring and connected medical devices as a key part of their care routines. By 2021, this number is expected to grow to 50.2 million. Berg Insight’s most recent report on mHealth and home monitoring estimates that RPM revenues will grow from $7.5 billion in 2016 to more than $32.4 billion by 2021. 9

As the industry continues to acknowledge the potential for improved outcomes and cost savings generated by RPM, innovative companies are providing solutions to meet this growing addressable market.
 
  • AlayaCare is a provider of cloud-based home care software with a platform centered around improving in-home post-acute health. Their RPM and telehealth solution offers an end-to-end system enabling both traditional and virtual care delivery through real-time data and remote monitoring. Their RPM initiative has seen results for their clients through reduced hospital readmissions and ER visits.
 
  • Conversa’s innovative ‘Conversational AI’ technology allows healthcare organizations to deliver automated, personalized doctor-patient conversation experiences that lead to more informed and meaningful patient relationships, effective population management, and better clinical and financial outcomes.
 
  • Critical Signal Technologies (CST) leverages its proprietary social work monitoring model and HIPAA compliance care center to empower older adults, people with disabilities, and those battling chronic illness to live independently. CST’s suite of services includes emergency responses systems, outcome-based transitional care programs, senior living safety solutions and vital signs monitoring to improve outcomes elevate patient engagement and reduce spend.
 
  • Sentrian’s Remote Patient Intelligence (RPI) solution identifies patients through impact analysis, detects deterioration, and informs the patient’s care manager so they can intervene before hospitalization is required. One recent study suggests the solution is three times more accurate in identifying the deterioration patterns vs. first generation systems, without increasing false alarms. 10
 
  • Valued Relationships, Inc. (VRI) is a tech-enabled RPM and surveillance platform that utilizes medical alert and telemonitoring technologies to improve patient care, prevent hospitalizations, and reduce medical costs, while empowering the elderly, the disabled, and individuals with chronic conditions to live safely and independently at home. In a recent study, patient data was collected and regularly monitored. Over the 12-months of the study, VRI’s solution reduced hospital readmissions by 58% and ER visits by 55%. 11
 
  • Vivify Health is a digital health platform that leverages PGHD from consumer mobile devices to manage population health. The firm prides itself on the 65% readmission reduction it has achieved through its RPM program and it recently surpassed 5 million monitored days across its customer base, which now includes over 700 hospitals and 200 non-hospital sites of care, such as home health agencies and accountable care organizations (ACOs).The firm prides itself on the 65% readmission reduction it has achieved through its RPM program and it recently surpassed 5 million monitored days across its customer base, which now includes over 700 hospitals and 200 non-hospital sites of care, such as home health agencies and accountable care organizations (ACOs).  12

The strategic moves made by the companies in this space show that there is an immense need, exceptional benefit and growing opportunity for using PGHD in care management. The explosive availability and popularity of consumer health devices, increased willingness and ability of consumers to capture and share personal information, and technological advancements in this field will all contribute to a change towards more continuous care for patients with chronic conditions being the norm.

At TripleTree and TT Capital Partners we believe a more comprehensive and cohesive end-to-end approach to patient engagement will enable a more successful healthcare system.  We are encouraged by recent progress and will continue to engage the industry as new strategies and capabilities are implemented.  In the meantime, let us know your thoughts on this important business driver.
 
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Tejas Singh
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Mike Acosta