Connected Health: Telehealth success requires business of change

BOSTON—Connected health will become the standard of care in the future, said the panelists of a session of connected health at scale on Oct. 26 at the ninth annual Connected Health Symposium.

American Well Systems delivers telehealth using technology to “extend the skillsets of healthcare professionals directly into the hands of patients,” said Roy Schoenberg, MD, MPH, CEO. The company’s goal is to extend the traditional healthcare system into the homes of its end consumers. This requires aligning the sometimes competing interests of patients plus making it meaningful for providers by giving them some added benefit beyond the regular way of practicing.

Telehealth has experienced tremendous market growth over the last several years, Schoenberg said. His company started off by making its telehealth systems avail to payers because that is the one entity that already brings together patients and providers. The company has since grown significantly, such as seeing pharmacy retail chains putting telehealth stations into their stores.

Most recently, Allscripts, a developer of EHR and practice management systems, announced that it is going to incorporate telehealth into their offerings, making telehealth available as part of their underlying architecture.

BeClose, an in-home safety and wellness provider that is in the “happiness and safety business,” said Liddy Manson, CEO. Of the 40 million people over 65 in the U.S., about 10 million live alone in a freestanding house. Eventually, most of those 10 million people will probably need more care but there are only 1 million nursing home beds. The vast majority (96 percent) of older adults say they want to live in their own home for as long as possible so BeClose’s goal is to help them do that and be safe, she said.

“We are not in the business of changing behavior.” Rather, BeClose is designed to meet residents on their own terms and allow caregivers to get an accurate picture of what’s really going on. The so-called “panic buttons” offered by several vendors don’t get pushed in 80 percent of accidents, Manson said. Most elderly people only wear them when their adult children visit. BeClose employs passive sensors around the home to track activity, such as medications, eating, sleeping and entry and exit. If a patient is in the “red zone” for three days, for example, the data suggests a new plan. Those trends, such as leaving the home in the middle of the night or not eating for a few days, can help pinpoint problems.

Connected health at scale is in the future, said Jasper zu Putlitz, MD, MPH, CEO of Bosch Healthcare Systems. “It will become the standard of care.” Bosch provides telehealth systems and is the Department of Veterans Affairs’ largest home health provider. The technology needs to be easy to use, said zu Putlitz, because “we’re not going to reach scale without impact.”

Patients aren’t necessarily engaged by technology but around content, he said. His company’s systems provide patients with a daily dialogue that’s valuable and flexible. “Content matters,” he said, because patients improve their knowledge and then change their behavior.

Users can’t simply prop the system on existing processes, however, he said, because it won’t have any impact.  Rather, they should “embed telehealth interventions into care redesign and change management on the professional side. I cannot emphasize that enough. This is an exciting thing here but we have to build it in.”

These kinds of systems won’t reach scale without integration, zu Putlitz said. “Integration with EHRs is an absolute must.”

Controlling the data is important as well, said Manson. “We’re finding that providers are so infatuated with the notion of data that people ask for much more than they can handle.” Making data useful is a harder problem to solve at scale, she said.

Overintegration sometime introduces delays, countered Schoenberg. That forces patients to be treated only where their data is. “We’re becoming prisoners of our data integration schemes rather than the other way around.”

Had Steve Jobs chosen to work on issues like these, he would have solved all the problems by now, said Manson. But he didn’t because “it’s not fun. Google shuttered their health effort and Microsoft has pulled back. People want to do games and other things that are entertaining. It takes people like us to push forward.”