By and large, the barriers to integrating patient generated data into hospital systems are no longer technical, according to a panel of technology experts at the Partners Connected Health Symposium. Instead, the barriers are about physician workflow and organizational management.
"You need to have an organizational structure and a process that supports what you’re going to do here," Dr. Christopher Alban, a vice president and clinical informaticist at Epic, said. "The technology supports what you’re trying to do, but if you don’t have an organizational plan with the buy in on all those things from executive leadership, so what? You’ve got to have that structure. You can’t just throw technology at it and it’s going to be great."
Organizations don't just need general approval from the higher-ups, they need a clear plan of exactly why they're collecting the data and what they're using it for. For instance, Alban said, there's a big difference between collecting wearable health data on populations to identify at-risk patients and collecting data on existing chronic disease patients and monitoring it on an individual level.
"One of the key questions for any organization to recognize is ‘What is it you do?’," Alban said later in the panel. "If you take care of patients, ultimately you need to decide: Do you take care of patients in a population health mode or are you going to outsource it? Is that part of the core of what you do or not?"
Physician buy-in is also important, and can be hard to come by, especially if those goals aren't clear.
"The physician workflow, physician buy-in piece is under-recognized, but it’s huge," Dr. Stanley Shaw, the director of the Center for Assessment Technology and Continuous Health at Massachusetts General Hospital, said. "Because we see in our hospital, there are people implementing real-time risk calculators. It’ll blink red, you look at their screen and say 'What’s that?' and they say 'I’m not really using that now'. If the follow-through is not there, it’s really a shame."
Drew Schiller, the CTO and co-founder of Validic, said that the solution to that problem is to build systems that stem the flow of information to make it more manageable.
"Physicians don’t need all the data," he said. "They just need the right data at the right time in order to take the right action."
Schiller used the example of Sutter Health, a healthcare system that has implemented connected weight scales, activity trackers, and blood pressure monitors. When their system detects a sudden change in vitals or a patient stops using a device, it prompts a nurse to make a phone call.
"In most instances it’s benign and a phone call can take care of it, but in certain instances they feel the patient needs to be brought in for a full 360 review," he said. "In those cases, it’s actually avoiding a major health event. It’s a different model of care, but it’s an excellent way of managing a patient population. As we move to value-based care, that type of thinking is going to be really critical."
Another example several of the panelists raised was Ochsner Health System, which has a special area called the O Bar that helps on-board patients with connected devices. Ed Park, the president and COO at athenahealth, said that Ochsner's approach isn't about prescribing monitoring to a patient, but rather getting the patient to make the choice and commitment to monitor their own health.
"We're copying the idea of Weight Watchers, that technology is a tool for public commitment," he said. "It’s something you said you want to do and know is good for you and, because of the observation, you follow through on it. The economic, sociological, and social models around how you use these devices will become important to their success."