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Taking the Conversation around Patient-Generated Health Data a Step Further

This piece is guest-authored by Sean W. Sigmon, Oracle, Health IT Now Steering Committee Member

As leaders in Washington continue to debate the repeal and replace of the Patient Protection and Affordable Care Act, the health IT industry continues to explore opportunities to lower costs and improve quality using new technologies and data. The Office of the National Coordinator recently released a draft white paper regarding patient-generated health data (PGHD). The paper provides an important launch point for a deeper conversation about:

  1. How can government incentivize the use of more real time data in health care?
  2. How will patients interact with their data and how can that interaction improve quality and lower costs?
  3. How can care providers manage expectations throughout the health system as patients transition to using a wider range of technologies to monitor our health?

Through Health IT Now, Oracle is proud to help drive and lead this conversation on how technology can improve patient care. 

How can government incentivize the use of more real time data in health care?

Look no further than your friend’s wrist or phone to see that PGHD is widely available. Fitness trackers and apps have become incredibly popular in recent years, giving people the ability to take control of some parts of their life. Unfortunately, the pace at which we are adopting these personal technologies has not kept up with the adoption of PGHD in patient care. To rephrase this, the healthiest individuals are embracing these gadgets, while chronically ill patients who could benefit the most (with fewer hospital visits, resulting in lower costs) are not. This group, likely, will require a push from providers to start using this new approach.

Now is the time for the government to determine what role it plays in bridging the gap between technology and the use of real time patient data in health care. This may mean taking a step back at times, getting out of the way, and avoiding a heavy regulatory hand. It may also mean providing the proverbial “carrot” and incentivizing faster adoption of these tools on the provider side. Additionally, it is incumbent upon the government to clarify providers’ obligations and responsibilities when it comes to using these data for proper patient care under a given provider’s watch.

For example, say a patient has consented to share her data from home weight scales, personal blood pressure monitors, or other “digital health tools” with her caregiver. Those “care coordination algorithms” capable of actively monitoring and interpreting the data generated by these devices then identify she is at great risk of heart attack or stroke. What is the traditional hospital system obligated to do today? Sadly, not too much. If that same patient got herself to the clinic or emergency room, she would probably be admitted to hospital at a high cost. Neither scenario is all that appealing.

At Mercy Virtual Care Center, however, digital health rises to a whole new level. Under Mercy’s innovative approach, care coordinators use data management tools to identify and engage chronically ill proactively. These patients are asked about medication compliance up front. Often, Mercy’s team makes arrangements to ensure a patient isn’t admitted unnecessarily and is treated in a cost effective way. Everyone benefits. Mercy is making it work despite the fact they get paid less when the patient isn’t admitted. Other providers should follow their lead. The federal government should incentivize this approach sooner rather than later.

This is the conversation our regulators and policymakers need to be having so we can fully embrace the opportunity that PGHD technology presents.

How will patients interact with their data and how can that improve quality and lower costs?

As Health IT Now’s Robert Horne pointed out recently, health IT is an important tool when talking about lowering health care costs. Empowering patients to have more control over their personal health care data and embracing technology will change how patients interact with the care system. If patients are part of the conversation about their data, it could lead to changes in how care is delivered, which ultimately should have positive impacts on the cost of health services. This is an important opportunity, but we must clarify the role patients will play in the system as we look at the increased use of PGHD in patient care.

It is possible to foresee a day in the not so distant future when technology is so advanced that a patient choosing not to submit their data to the health system will have higher cost sharing. Why? Because the provider will know exactly how much more expensive that patient is likely to be to the system when it cannot apply its advance monitoring tools.

How can we manage expectations throughout the health system as we transition to greater use of technology?

Of course, this transition will take time and it is essential that patients’ expectations are managed as technology becomes a more regular component of health care. Rightfully so, patients in the United States have certain standards when it comes to their health care. Therefore, we need to make very clear what care providers can and should do when it comes to using PGHD.

Given that this transition will take time, we need incorporate patients into the process so that they understand how their experiences at the doctor office may change, and how it should improve.

Oracle and Health IT Now are encouraged by the continued discussion around health IT and how it can be used to improve quality and lower costs. This recent draft white paper from ONC raises important questions, and we encourage the administration and policymakers to go even further. We appreciate being part of this essential discussion.

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