What happened in health care technology this week, and why it’s important.
3 shifts in healthcare to expect from telehealth innovations in 2023
Eric Bacon’s article in MedCity News is first up this week. With Covid still at the forefront of healthcare leaders’ minds, some may not be prioritizing healthcare technology trends — let alone making predictions about what 2023 has in store for telehealth innovations. That’s why the secretary of the Department of Health and Human Services is also offering 1,135 waivers through October 2022. Another guideline adds 150 days beyond the PHE deadline, which could push things back to spring of next year. Bacon contends that the telehealth industry will continue to drive innovation that helps bring telehealth more permanently and creatively into the care continuum. You’ll see device integration and be able to perform even more complicated tests, like dialysis, at home. He identifies three major shifts we’ll soon see from telehealth innovations:
- Hospital in the home – The global Covid crisis made it clear that we need a better bridge between hospitals and our homes. It created a whole new setting that can be treated in a different way, which sparked the Acute Hospital Care at Home Program.
- Telehealth ICUs – While not a new concept, one study found almost half of acute care facilities had no intensivists on staff. This can, unfortunately, mean a patient cannot receive the quality of care they desperately need. Investing in telehealth ICUs allows better care for the sickest of the sick, regardless of their location, as intensivists can be brought to the patient through telemedicine technology. The United States is the global leader in telehealth ICUs, with a 20% market penetration. While impressive, that still leaves a significant 80% market that will be very competitive.
- Enterprise integration – Health system leaders can’t rely on piecemeal layers tied together with virtual duct tape. It ruins the care continuum and makes for an interrupted workflow. Whether you see a patient in the ICU or at home, it should be within the same workflow to simplify the process and make it scalable.
Why it’s important – The telehealth industry is quickly becoming a quarter-trillion-dollar sector. Some of the revenue that might have been coming from an acute facility is now moving toward healthcare in the home. This is especially true in specialized facilities, like skilled nursing facilities, that may have different rules for state licensure or reimbursement. The telehealth industry will continue to drive innovation that helps bring telehealth more permanently and creatively into the care continuum.
Infographic of the week – This one comes from Rock Health, which recommends a “back to basics” approach to tying innovation efforts to desired outcomes. This graphic demonstrates how based on your decisions around desired outputs (the what), you can begin evaluating the various pathways (the how) that lead to each. Several trails can take you to the metaphorical mountaintop of your choice, but understanding your options set is a good start. Excellent information, as always.
Featured Article: Incredible women in health tech | the 2022 longlist
Kirsty Rigg authored this article in Health Tech World online. When it comes to women in health tech, the imbalance is similar to what you would find in STEM overall (Science, Technology, Engineering, and Maths). Figures show that in health technology specifically, only one woman in five people is working in the industry. The lack of women in AI, health tech, and tech overall has been exacerbated by the COVID-19 pandemic, but the numbers generally never balanced out before that. She raises a glass to the powerful, inspirational, and outstanding women who have made their mark in health tech against the odds.
Why it’s important – Need I say anything? We need more visibility and recognition for these fantastic female tech entrepreneurs. Congratulations to all the women who made this impressive list and the many others who have not yet received the recognition they deserve.
Diagnosing Mental Health Disorders Through AI Facial Expression Evaluation
Researchers from Germany have developed a method for identifying mental disorders based on facial expressions interpreted by computer vision. Martin Anderson reports on the new research in his article on Unite.AI online. The new approach can not only distinguish between unaffected and affected subjects but can also correctly distinguish depression from schizophrenia, as well as the degree to which the patient is currently affected by the disease. Individuals with affective disorders tend to have raised eyebrows, leaden gazes, swollen faces, and hang-dog mouth expressions. To protect patient privacy, these composite images are the only ones made available to support the new work. The researchers have dubbed this technique Opto Electronic Encephalography (OEG), a completely passive method of inferring mental state by facial image analysis instead of topical sensors or ray-based medical imaging technologies.
‘Overall, the results predicted by the machine show better correlations compared to the pure clinical observer rating based questionnaires and are also objective. The relatively short measurement period of a few minutes for the computer vision approaches is also noteworthy, whereas hours are sometimes required for the clinical interviews.’
Research Paper, The Face of Affective Disorders
Why it’s important – Until now, facial affect recognition has been primarily used as a potential tool for basic diagnosis. The new approach, instead, offers a possible method to evaluate patient progress throughout treatment or else (potentially, though the paper does not suggest it) in their own domestic environment for outpatient monitoring. The authors conclude that OEG could possibly be not just a mere secondary aide to diagnosis and treatment but, in the long term, a potential replacement for certain evaluative parts of the treatment pipeline and one that could cut down on time necessary for patient monitoring and initial diagnosis.
MaineGeneral hits congestive heart failure readmission rate of 0% using RPM
MaineGeneral Health in Augusta had high, rising readmission rates for congestive heart failure. In January 2020, the organization launched a remote patient monitoring pilot, working with vendor Health Recovery Solutions to monitor CHF patients after discharge from the hospital. Bill Siwicki reported the story for Healthcare IT News. During the pilot, MaineGeneral Health learned it takes more clinical time to monitor and follow up with patients. Because of this, it hired a full-time employee to monitor the patient panel. As the program grew to more than 100 patients, the organization expanded to allowing referrals for patients with any chronic condition or COVID-19 and hired additional clinical staff. For remote patient monitoring, as patients record their data, it is transmitted in real-time to a central care team. If an issue is identified, the team can provide immediate support through video conferencing with the patient, education, or consulting the patient’s primary or specialty care provider to determine if the clinical intervention (medication change, for example) is necessary. MaineGeneral Health monitors patients for an average of 90 days before they graduate from the program. The vast majority of patients are 61 to 90 years old.
“Overall, MaineGeneral’s most recent RPM satisfaction rates show 90% of RPM patients are satisfied or very satisfied with the impact of the program and their ability to become an active participant in their health.”
Laura Mrazik, telehealth coordinator at MaineGeneral Health
Why it’s important – This case is an excellent example of the benefits of RPM in patient care. In May and June 2022, MaineGeneral achieved a CMS-CHF readmission rate of 0%, compared with 20% and 26.7% in the same months the prior year. Additionally, the overall CHF readmission rate has hit 0% in four of the last nine months. Also, MaineGeneral’s adherence rates to taking vitals – blood pressure, weight, O2 saturation – has consistently maintained an average higher than the vendor’s book of business.
The Bionic-Hand Arms Race
This is a fascinating article by Britt H. Young in IEEE Spectrum online that argues that the prosthetics industry is too focused on high-tech limbs that are complicated, costly, and often impractical. Today, the people who design prostheses tend to be well-intentioned engineers rather than amputees themselves. (One notable exception to this comment is Hugh Herr, associate professor of media arts and sciences and leader of the Biomechatronics Group in MIT’s Media Lab. Herr is building sophisticated devices that aid human movement by mimicking nature. I wrote an earlier post on a PBS documentary that featured Herr’s work.) The fleshy stumps of the world act as repositories for these designers’ dreams of a high-tech, superhuman future. The author knows this because, throughout her life, she has been fitted with some of the most cutting-edge prosthetic devices on the market.
“It’s time to ask who prostheses are really for, and what we hope they will actually accomplish.”
Britt H. Young, IEEE Spectrum
Why it’s important – In the United States alone, more than 2 million people live with limb loss, and 185,000 people receive amputations every year. Bionic hands seek to make disabled people “whole” to have them participate in a culturally two-handed world. But it’s more important that they get to live the lives they want, with access to the tools they need, than it is to make them look like everyone else. There are inexpensive, accessible, low-tech prosthetics that are available right now and need innovation investments to bring down costs further and improve functionality. And in the United States, at least, there is a broken insurance system that needs fixing. Releasing ourselves from the bionic-hand arms race can open up the possibilities of more functional designs that are more useful and affordable and might help us bring our prosthetic aspirations back down to earth. The author is working on a book about what the prosthetics industry tells us about the future of bodies and disability and the limits of tech’s ability to solve all our problems. I’ll be one of the first to purchase a copy when it’s available. I’m sure it will be a great read.
Sensor Detects Parkinsons’ During Sleep
A new sensor that passively monitors breathing during sleep can not only detect Parkinson’s but also track the progression of the disease over time, researchers report. Mark Michaud-Rochester’s article in Futurity reports that researchers used an artificial intelligence tool to sift through mountains of data from study participants to find patterns that identify the disease and determine severity. The study is one of several research projects exploring new ways to harness remote monitoring, smartphones, smartwatches, and other technologies to improve care and advance research in Parkinson’s and other diseases.
Why it’s important – Parkinson’s is the fastest-growing neurological disorder in the world, outpacing Alzheimer’s. More than one million Americans are currently living with the disease. While there are rare genetic forms of the disease, many cases of Parkinson’s are likely caused by exposure to certain industrial chemicals and pesticides. An early diagnosis could enable patients to start treatments earlier, potentially forestalling the progression of the disease. More precise measurement of the progression of the disease—which can vary significantly from patient to patient—will also enable scientists to better measure if experimental therapies are working. Proven remote monitoring technologies will also allow researchers to recruit study participants more widely, measure the impact new therapies more quickly, and, hopefully, find new effective treatments faster.
Smart Socks Help Prevent Falls Among At-Risk Patients
Researchers at the Ohio State University Wexner Medical Center have tested the PUP (Patient is Up) Smart Socks, developed by a MedTech company called Palarum, in their ability to reduce falls among at-risk patients. The socks contain pressure sensors that alert caregivers when a patient is attempting to stand up. This can include situations such as a patient getting out of bed to go to the toilet. The socks can wirelessly communicate with the system, which then alerts the caregivers closest to the patient so that they can arrive and provide assistance as soon as possible. A recent study showed that the system significantly reduced fall rates in patients at high risk of such incidents. Conn Hastings brings us this story in his article in Medgadget. This new system is present on the patients and staff themselves in the form of wireless smart socks containing pressure sensors and alert badges that staff wear. The socks alert the three nearest caregivers when a patient attempts to get out of bed, and then the next closest three if one of the first three is not present in the room within the first 60 seconds, and the system progresses to an all-staff call within 90 seconds.
Why it’s important – A fall can spell severe consequences for frail and vulnerable patients and can often be the start of a downward health spiral. It is not typically possible to monitor high-risk patients every minute of the day, but wireless technologies are well-suited to fulfill an assistive role in this context. Falls often happen when a high-risk patient attempts to get out of bed to use the restroom, and this is the time that having a caregiver present to assist can dramatically reduce the risk of such incidents. Current approaches sometimes involve pressure sensors in beds or seating, but these frequently give false alarms, leading to alarm fatigue and reduced effectiveness of such systems.