HIMSS 2013 - Remote Monitoring Rising...Slowly by Jim Bloedau

Where on the remote monitoring adoption curve the vendors exhibiting at HIMSS 2013 were was the focus of my attention at this year’s conference. Keeping in mind that a large part of HIMSS’ audience are large IDNs and “chiefs” of the care continuum who are leading the automation and innovation efforts, history has shown that what vendors were showing is a reflection of what the market is asking for.  Here’s what I saw.

Remote Monitoring Devices: Remote monitoring was limited to the garden variety of BP, O2Sat, peak flow, weight and communication hubs.  Although some vendors have not migrated their monitoring devices to wireless (Cardiocom) the newer wireless devices stood out.  Among these, Numera appears to have the longest list of device partners and most modern wireless lineup of vendors of the group.  They have also positioned themselves with an ultra modern update of the ancient “help I can’t get up” personal emergency response (PERS) device that can delineate between real falls and just someone dropping it, geo-locate and make the call for help – a very nice product.  It will be interesting to track how the market matures around this and other remote monitorin technology that includes long term players Honeywell “Hommed”, Bosch “Health Buddy” and the market leader Philips “Healthcare at Home”.

Population Health Management:  Population health management was one of the top three buzz words on the exhibit floor.  This was limited more to the professional side and was mostly a renaming of disease management.

What fits into this category is the advent of intelligent home health hubs that can individualize suggested wellness steps based upon the answers of a couple of simple questions. These questions may lead to what to do suggestions and feedback loops showing progress trending, mood trending, calendaring or medication adherence. These hubs are rudimentary  and intended for the aging at home patient who is not technologically savey.  The daily questions they offer have branching logic that is used to determine what content to serve up based on a profile of you - similar to adds that Google search individualizes for you.  It is an exploratory way to keep the content fresh and engaging to prevent user fatigue and patient's slipping back into unhealthy habits. 

Another vein of population management is “patient engagement”- another prevalent buzz word - which uses behavioral design thinking to get us to be better at healthy habits. When speaking with Philips, the term “behavioral science” came up several times when talking about their DirectLife product.  One of the leaders in behaviorial design for healthcare application is the Persuasive Technology Lab at Stanford and being led by BJ Fogg and his "Behavior Design" model - interesting and attacks the biggest problem in healthcare - compliance.

Amoung the leading EHR vendors, there was a paucity of remote care technology.  The exception was Epic who demoed MyChart Bedside, a tablet concept for the home, where the patient can be monitored and manage activities of daily living (ADL) like “meals on wheels.”   

Implications: Clearly both of these examples indicate the beginnings of a trend from a one to many delivery of healthcare to a one to one "engagement."  We already see this 1-2-1 in our daily online lives as ads are served up to us based on some mysterious database somewhere being common.   This is also the beginning of a platform model for healthcare where the consumer/patient also creates value by becoming a source of data that allows individualization of message for better wellness and if physiologic monitoring is included, preemptive interventions that avoid acute care episodes.  What I saw at the conference is that everyone is very focused on ICD 10, Meaningful Us, ACO/PCMH and EHR implementations.  What I heard was that all see the possibility and value of BYOD, mHealth and remote care technology, but lacked of bandwidth to do much with it now.