As reimbursement rules catch up, providers embrace technologies for remote care and patient monitoring. Centralized care, with a hospital as the “hub,” is the standard in the U.S. today. But this familiar model is changing rapidly, as providers embrace remote care at scale. After decades of experimentation, why now?

“Five to seven years from now, we’ll look back on this time period as when the inflection happened, when remote care flipped from eclectic proof of concepts and pilots to become the new standard of care,” said David P. Ryan, General Manager, Health & Life Sciences Sector, at Intel. Instead of the “first touch” being an urgent care clinic or, more likely, an emergency room, Ryan envisions a time when it’ll be an app, an email or a video call.

While evidence has been accumulating for 20-plus years that telehealth is cost-effective, Ryan said a giant obstacle in the U.S. had been reimbursement rules. These have only begun to change in the past two years. “[Telemedicine, telehealth and remote monitoring] is accelerating dramatically now because reimbursement has changed for everybody,” he said. Payers have seen the benefits—up to 75 percent fewer readmissions, up to $150,000 savings per patient/year—and are even moving forward on recommendations to reimburse providers when they teach homebound patients how to use remote-monitoring gear or conduct a “virtual check-in” with a patient.

Scaling up

The remote patient monitoring market saw a 44 percent jump in remotely monitored patients in 2016, according to Swedish market research firm Berg Insight. Berg estimated the number of remotely monitored patients will reach 50.2 million by 2021, with 25.2 million comprising those with connected home medical monitoring devices and the rest coming from personal devices.

Looking ahead, Ryan sees these monitoring systems becoming interlinked, providing telemetry for a wider range of disease states. “More sensors and more information will mean a data flow that is very valuable, provided analytics and autonomous algorithms are taken advantage of,” he said. This flood of data will also yield important insights for population health, he added.

But to make this work, the current fractured nature of medical- and consumer-grade solutions needs to end. “We think the future is a much more secure, enterprise platform, which providers and remote care companies can deploy,” Ryan said. “A single tech platform that will evolve over time.”

Healthcare decision-makers seem to agree. Nearly two-thirds (63 percent) of respondents to the Technology Innovation in Healthcare Survey by HIMSS Media cited interoperability, health information exchange, and data integration as the areas of healthcare most in need of technology innovation.

“You can look in the rearview mirror, and see hospitals increasing spending on remote care,” Ryan said, adding that the most-successful models don’t simply collect data but are interactive with the patient, helping behaviors, such as medication adherence and chronic condition management for diseases like diabetes and hypertension.

If the hospital is no longer the hub, what role will these systems at the network edge — in the home or on/in the patient’s body — play?

“The first generation of remote health was fueled by a cellphone app or a simple gateway that communicates a few data points,” Ryan said, adding that wide-scale deployment will require a much more software-defined, intelligent technology platform. He said such a secure, enterprise platform will support a range of applications, and be software defined. “Providers and their home-health partners won’t need to deploy multiple kits of technology or have to come out and replace things,” Ryan concluded.

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