Free EMR Newsletter Want to receive the latest news on EMR, Meaningful Use, ARRA and Healthcare IT sent straight to your email? Join thousands of healthcare pros who subscribe to EMR and EHR for FREE!

Big Gap Exists Between Wearables Hype And Physician Use

Posted on January 12, 2018 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

Not long ago, I wrote an article describing some major advances in wearables and health tracking technologies. Standout technologies included Grail, a cancer detection startup, Beddit, which makes sleep tracking technology, and Senosis Health, which developed apps using smartphone sensors to monitor health signals.

In the article, I argued that we’re past the question of whether wearables are valuable and that it’s time to focus on what we want to do with next-generation of superpowered health tracking devices instead. I was driven by stats like the ones produced by the Consumer Technology Association, which asserted last year that by 2020, physician use of patient-generated data will reach critical mass. It noted that wearables are being used more often in clinical trials and that some health insurers offering free wearables to patients, trends which it predicts will cause the market to explode.

But at least to some extent, I think the CTA (and I) were both wrong. As impressive as the new patient trackers are, they won’t be that valuable if nobody on the frontlines of medicine uses them. And even if trackers are being used in clinical trials or given away by health insurers, that doesn’t mean physicians are on board. The issue is not just whether devices work well, but whether doctors can actually use them in their daily care routine.

Recent stats suggest that few physicians actually use patient-generated data in their practice. In fact, the Physicians Practice Technology Survey found that just 5% of respondents reported that they use such such devices as part of their care routine.

I’m not surprised by this research. My own informal discussions with physicians suggest that the number of practices that actively use patient-generated data may be even lower than 5%.

Why are so few medical practices leveraging patient-generated data? The reasons are fairly straightforward:

  • Few of devices offer measurements that are consistent, predictable and valid
  • Vanishingly few are FDA-approved, which does little to inspire clinicians’ confidence
  • In most cases, the data produced by wearables and related devices isn’t compatible with practice EMRs

For what it’s worth, I do believe that many physicians — especially those with an interest in health IT– know that patient-generated health data will eventually play a valuable role in their practice. After all, in principle, there must be ways that such data could inform patient care.

But right now, the simple devices patients own aren’t sophisticated enough to serve practice needs, and most of the advanced patient tracking devices are at the idea or testing phase. Until patient tracking devices become more practical, and offer reliable, valid, usable data, they’re likely to remain a dark horse.

Challenging Physicians’ Digital Health Fears

Posted on September 12, 2017 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

Like you, I thought I’d read everything about the reasons some doctors struggle with adopting digital health. Then, the following article showed up on my radar. While it covers some familiar ground, it’s a fairly nuanced take on physician objections to integrating digital health into their practice.

The article, “Top 10 Reasons Doctors Fear Digital Health,” comes from Brennan Spiegel, MD, MSHS, a gastroenterologist and co-creator of the MyGiHealth app.  Given his digital health involvement, he obviously has a dog in the fight, but to my mind, that doesn’t detract from the value of what he had to say.

All ten of his observations make sense, but in the interests of brevity I’ll pick out a few that I found particularly interesting. Below, I’ve summarized some of the concerns expressed by his colleagues, then shared a condensed version of his responses:

“Use digital health devices in my practice? How the world will I have time to check all the data?”

His response:  We need to train a new type of specialist called a “digitalist” who will monitor, interpret and act upon remote patient data. They will reside in an e-coordination facility and remotely track data from biosensors, portals, apps and social media. (EDITOR’S NOTE: To see how an e-coordination center works today, check out this piece on the Mercy Virtual Hospital.) Their job will be to combine the data with clinical parameters and knowledge about the patient’s medical history then act on what they’ve learned.

* “What is my legal liability here? What if remote data show that somebody is doing poorly, but nobody checks it? What if the patient dies when there was clear evidence something bad was going to happen?”

His response: Until you have a digitalist watching your back, you cannot take responsibility – including legal responsibility – for monitoring, interpreting and acting upon the data. As I see it, that will be the digitalist’s responsibility.

* “Digital devices are cool, but most people quit using them before long. How could digital health make any difference if our patients refuse to use the stuff?

His response: To make inroads with chronic illnesses like diabetes, heart failure or obesity, we need to change behavior. One way to achieve this comes from Joseph Kvedar at Partners HealthCare. Dr. Kvedar’s team not only personalizes its apps but hyper-personalizes them. By integrating everything from the time of day, step counts, local weather and levels of depression or anxiety, these apps can send pinpoint messages to patients at the right time and place. This approach may work to foster behavioral change.

* “How will digital health improve the value of care? Can it both improve outcomes and lower costs? Until it can prove that it can, insurance won’t pay for it.”

Proving that digital health solutions provide economic value to health systems is the toughest and yet most important obstacle to taking digital health into the mainstream. As more and more digital health solutions roll off the assembly line, we need to see them subjected to formal health-economic analysis as with any other medical innovation.

I don’t know about you, but I found this to be an intriguing discussion, especially the notion of a “digitalist” responsible for remote data management and response. I look forward to talking to Dr. Spiegel someday (perhaps at the Connected Health show!) and getting more of his insights.