Whether they have chronic ailments like diabetes or just want to watch their weight, Americans are increasingly tracking their health using smartphone applications and other devices that collect personal data automatically, according to health industry researchers.
“The explosion of mobile devices means that more Americans have an opportunity to start tracking health data in an organized way,” said Susannah Fox, an associate director of the Pew Research Center’s Internet and American Life Project, which was to release the national study on Monday. Many of the people surveyed said the experience had changed their overall approach to health.
More than 500 companies were making or developing self-management tools by last fall, up 35 percent from January 2012, said Matthew Holt, co-chairman of Health 2.0, a market intelligence project that keeps a database of health technology companies. Nearly 13,000 health and fitness apps are now available, he said.
The Pew study said 21 percent of people who track their health use some form of technology.
They are people like Steven Jonas of Portland, Ore., who uses an electronic monitor to check his heart rate when he feels stressed. Then he breathes deeply for a few minutes and watches the monitor on his laptop as his heart slows down.
“It’s incredibly effective in a weird way,” he said.
Mr. Jonas said he also used electronic means to track his mood, weight, mental sharpness, sleep and memory.
Dr. Peter A. Margolis is a principal investigator at the Collaborative Chronic Care Network Project, which tests new ways to diagnose and treat diseases. He has connected 20 young patients who have Crohn’s disease with tracking software developed by a team led by Ian Eslick, a doctoral candidate at the Media Lab at the Massachusetts Institute of Technology.
Data from their phones is reported to a Web site that charts the patients’ behavior patterns, said Dr. Margolis, a professor of pediatrics at Cincinnati Children’s Hospital. Some phones have software that automatically reports the data.
Patients and their parents and doctors watch the charts for early warning signs of flare-up symptoms, like abdominal pain, nausea and vomiting, before the flare-ups occur. The physicians then adjust the children’s treatment to minimize the symptoms.
“One of the main findings was that many patients were unaware of the amount of variation in their symptoms that they were having every day,” Dr. Margolis said.
The Pew survey found most people with several chronic conditions said that tracking had led them to ask a doctor new questions, led them to seek a second opinion or influenced their treatment decisions.
Mr. Holt said self-tracking products and services companies formed the fastest growing category among the 2,100 health technology companies in his database. He said venture capital financing in the sector rose 20 percent from January through September 2012, with $539 million allotted to new products and services for consumers by Sept. 30.
He attributed the rise to a “perceived increase in consumer interest in wellness and tracking in general, and the expectation that at-home monitoring of all types of patients will be a bigger deal under the new accountable care organizations,” as President Obama’s health care law takes effect.
But even an enthusiast like Mr. Jonas said he saw “a dark side to tracking.”
“People who are feeling down may not want a tracking device to keep reminding them of their mood,” he said.
There is widespread agreement that the growth in healthcare spending is unsustainable and that continuing down the same path of limited, incremental fixes won't provide the lifeline the healthcare system needs. Albert Einstein famously defined insanity as "doing the same thing over and over again and expecting a different result." Using this definition, until recently most "same-old, same-old" cost-containment efforts could be described as insane.
However, we can "stop the insanity" as the healthcare system evolves from a fee-for-service model that bases reimbursement on the volume of visits as well as tests and procedures — even when there is a lack of evidence about their clinical effectiveness or overall value when compared to other testing and treatment options. The transition to value-based purchasing that ties reimbursement to the quality and cost-effectiveness of patient care is fueling outcomes-based quality initiatives such as eliminating payment for preventable adverse outcomes including 30-day readmissions, reducing avoidable emergency department visits and preventing complications such as surgical-site infections.
Under this new model, hospitals and health systems will be forced to assume greater financial risk through their participation in new payment arrangements such as accountable care organizations, patient-centered medical homes, bundled payments and shared savings programs. This means that their survival will depend on their ability to deliver evidence-based, cost-effective, safe, high-quality care.
The unprecedented availability (some would say the deluge) of data now coming online provides the healthcare industry with an opportunity to embrace rigorous clinical analytics to drive systemic change. This will generate substantial, immediate and ongoing savings while providing smarter, better and more efficient patient care. For example, clinical analytics tools typically enable hospitals to reduce surgical complications by 5 to 10 percent, returning $1.5 to $3 million in annual savings.
To thrive in a business environment that rewards value rather than volume, hospitals must identify and eliminate variations in cost and quality for surgical and other acute specialty care, because surgery-related expenses outpace all other healthcare expenditures.
Eliminating surgical complications and wasteful care will significantly reduce the costs associated with unnecessary care that The Dartmouth Atlas, the New England Healthcare Institute, McKinsey and Thomson Reuters all estimate account for about 30 percent of the nation's healthcare spending.
Clinical analytics tools are now available to identify, quantify and correct variations in surgical and other specialty care, but there is also significant variation in their capabilities, affordability, ease of use and benefits. There are eight "must-have" key features for a clinical analytics solution that can fuel a hospital's success now and into the foreseeable future:
1. An affordable, cloud-based, hosted solution that won't require scarce internal information technology resources or support.
2. Continuously updated, risk-adjusted clinical data configured for each surgical specialty and sub-specialty. A one-size-fits-all solution won't provide the necessary intelligence. For instance, by applying bariatric-specific clinical measures, a clinical analytics programs established by the Michigan Bariatric Surgery Collaborative helped 38 Michigan hospitals reduce overall bariatric surgery complication rates by 24 percent and decreased post-surgery ED visits by 35 percent.
3. Granular, dynamic benchmarking for procedures, physicians, outcomes and hospitals at the national, regional and enterprise levels, down to determining which treatment is best for a specific patient. For example, a patient with prostate cancer may want to factor in not only which treatment option offers the best prognosis based his specific circumstances, but which one will also preserve his ability to enjoy sexual intimacy.
4. Real-time, easy-to-understand dashboards that provide actionable intelligence based on current data. It really doesn't matter what a retrospective report indicates was occurring six months or a year ago. Capturing what took place within the past 10 minutes provides the relevant information needed to support point-of-care decision-making.
5. The ability to identify best practices, standardize care processes and provide decision-support as a baseline for eliminating unwarranted variation.
6. Accelerated performance feedback and improvements in efficiency, quality and financial outcomes by capturing and analyzing clinical outcomes and other vital data from multiple disparate sources.
7. Quick speed-to-value — deployment and training should be completed in two to three months, not years, and should be so easy to use and intuitive that physicians, nurses and administrative personnel can begin utilizing the data-driven intelligence being generated within days of the deployment.
8. Helps meet meaningful use and other regulatory and accreditation requirements.
The use of clinical analytics can help health systems offset revenue declines, survive and thrive in the evolving marketplace and achieve the triple aim of providing higher quality care, achieving better outcomes and delivering both at lower cost. Using the software to aggregate and analyze clinical, financial and administrative information, healthcare providers will be able to identify actionable opportunities for patient care interventions and quality improvement while gaining the ability to track and benchmark the performance of every physician, hospital, patient, procedure, department and service across their enterprise.
Moving forward, providers will have to change how they do business to survive current and future market forces and healthcare reform. They must be vigilant and proactive about delivering high quality, efficient care, minimizing avoidable complications and bending the cost curve. A robust clinical analytics solution enabling data aggregation that leads to real-time actionable information will play an essential role in hospitals' ability to achieve sustainable, meaningful quality and cost improvements across their enterprise.
Treato, an Israeli company that scours thousands of social media sites to glean patient insights about pharmaceuticals and treatments, has landed $14.5 million in new capital.
Launched about a year and a half ago, Treato has developed an algorithm to search across social media sites large and small, from Facebook on down to local online communities for patients with specific medical conditions, to ascertain what people are saying about medications. Treato looks for patterns that could signify adverse reactions to drugs, off-label uses, reasons why people switch from one medication to another and other bits of intelligence.
... 50 years (1.1%). The announcement of slowing health care costs comes at a time when the White House is actively promoting key provisions of the Affordable Care Act (ACA) such as the opening of the health insurance marketplaces in October 2013.
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