Guest Blogger: Connected Health's Director Dr. Joseph Kvedar

(As the name suggests, HealthNex was always intended to be a nexus for ideas and exchange about ehealth and the evolution of healthcare into a true system. On that front, we're delighted to welcome Dr. Kvedar as a guest blogger, and encourage other experts who would like to join the conversation to contact us at healthnex@gmail.com with their interest in guest blogging here)

Joseph C. Kvedar, MD, Director, Center for Connected Health, Partners HealthCare System, Inc.

On May 8, the Center for Connected Health was privileged to co-sponsor a meeting in New York entitled: Personal Health Management: Adoption of New Benefits, Tools and Technologies.  The audience was made up of a healthy mix of corporate benefits managers, other executives, health care providers, technology companies, disease management firms and policy experts.  The dialogue was rich and enlightening.  We eagerly participated because we are interested in understanding the large employer mindset re: healthcare quality and cost. 

Connected health is about bringing care to where the patient is when the patient needs it, using communications and monitoring technologies. Value is created in several ways; by keeping patients out of the high cost part of the system; by improving self care; by allowing providers to engage at the time of need; and by allowing decision making to be as close to the point of care as possible.  Instead of visiting your provider, your provider can visit you --- and at the time when you most need it.

We listened carefully for themes from the presentations and comments from our benefits manager colleagues.  We listened for novel programs, using technology, to approach disease management.  We listened for the way entrepreneurs listen for new market opportunities. Here is what we heard.

Employers have given up on disease management
Though the ROI on wellness programs is recognized as ethereal, the one theme that emerged from the various employer presentations was wellness, wellness, wellness.  The rationale seems to be that by focusing employees on wellness, they will eventually take on ownership of their health care (when they are given a diagnosis) and not insist upon so much support from their health plans.

Employers are hungry for solutions to the problem of health care cost
While this will not be viewed as a news flash to anyone, the striking thing about the dialogue was the resignation that costs will continue to rise and that disease management has not met their needs.

An alternative view
There is evidence that a connected health approach can add significant value in the management of chronic disease, achieving the holy grail of extended access, improved quality and lower costs. Two examples are the treatment of congestive heart failure (CHF) and the monitoring/management of diabetes.  In our program, patients with CHF use monitoring technology to transmit daily vital signs and answers to activity of daily living questions.  The results are striking:  patients become more compliant and involved in their care. They stay healthier longer in their homes, and stay out of the emergency room and the inpatient service, the high cost parts of the health system.  The data are reproducible; in our case 22% readmission rate before admission to the program, 5% after. 

In terms of diabetes, a number of studies have demonstrated that patients who have their glucometer readings transmitted to their health care providers on a routine basis have a reproducible reduction in hemoglobin A1c, indicating better diabetic control.  It’s well accepted that patients with a lower A1c have lower costs and higher quality of life.

We see an enormous opportunity to improve care in this way.  We have just started recruiting for patients with hypertension to enroll in a self management program that involves regular blood pressure monitoring and feedback via the web.  Our partner is an innovative, Boston-based large employer – the data storage provider EMC.  We are optimistic about the possibility of connected health as a solution for large employers. We look forward to finding more innovative partners like EMC and to achieving that holy grail of improved access, high quality and lower costs in collaboration with corporate partners.

Comments

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