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CEO David Ormesher on the role of wearable technology in an outcomes-based payment world

HBA 2015 Annual Conference - November 5, 2015

Between the iWatch, the Fitbit, Misfit Wearables, and countless wearable healthcare products in some stage of development or adoption—it’s clear a technology-driven change is coming to the provider-patient relationship. But what change? In what areas? And how can healthcare leaders get ahead of the curve?

The Healthcare Businesswomen’s Association (HBA) made these questions the heart of their panel discussion, “Digital Technology: Innovations in Personal Health Monitoring.” The panel discussion met at the HBA 2015 Annual Conference in Atlanta. The talk, moderated by Tracy L. Yedlin, Digital Lead, Cross-Brand Marketing Team, Takeda Pharmaceuticals, featured:

  • David Ormesher, CEO, closerlook, inc.
  • Simon Smith, Vice President, Strategy, Klick Health
  • Ben Greenberg, Vice President, Product Management and User Experience, WebMD

Combining both healthcare business and marketing points of view, Ormesher spoke to the challenges and opportunities wearable technology poses in an outcomes-based payment world. Here is a quick summary of his comments.

With a shift in risk, hospitals are on the hook

Outcomes or performance-based payments represents the most significant risk-shift in the history of healthcare in America. For the fourth year in a row, hospitals are being penalized for patient readmissions, to the tune of millions of dollars. With reimbursement margins squeezed already, these deepening cuts in Medicare payments impact operating budgets, healthcare provider paychecks, and will place the ultimate viability of some providers in question.

Providers are now referred to as "at-risk providers.” And most are ill-equipped to take on this risk. It’s hard for any doctor to take responsibility for the actions of her patients once they leave the office, but now they are expected to do just that.

This reality is putting incredible pressure on the CEOs of large hospitals and physician practices. They are now bearing the financial responsibility for health outcomes like never before.
 

How do providers handle this challenge?

How do providers—pharma's customers—manage this risk? Nurse call centers are part of the answer, but they rarely catch a deteriorating situation early enough. And when you look at the sheer numbers involved, there is not enough human capital or financial capital to track and monitor every HF or COPD or transplant or cancer discharge.

We need fresh thinking that meets two criteria: it must provide early notification and must do it at scale.

The promise of wearable technology solutions

Only technology can meet this risk management challenge at scale. Inexpensive wearable sensors, linked to an analytics platform that communicates meaningful physiological exceptions to clinical staff, can give adequate early warning notifications that allow for intervention before readmission is necessary.

The key is notification of meaningful physiological exceptions.

There are solutions coming out that promise tracking data on a doctor’s patients. Sorry, doctors don’t have time to review remote patient data, and they don’t get reimbursed for it. So unless they are promised only reliable notification on pre-acute patients, they will be very reluctant partners.

The pharma opportunity ahead

There is a well-defined path for evaluating whether remote patient monitoring is a good strategy for pharma to embrace, and it delivers value in a couple of different ways.

1. Technical feasibility

Narrow your scope to one or more clinically-measureable symptoms that indicate the status of a disease that your product treats. Determine if there is a remote wearable sensor that captures that data and an analytics algorithm that can measure and parse meaningful change. 

2. Clinical relevance

Identify a health system or hospital where you could jointly test the platform together. You will likely have to fund the studies. Begin with an observational study. Then based on results, develop protocol for an interventional study.

As an added benefit, this process will be a valuable opportunity to build deeper strategic relationships with your large providers.

3. Cost effectiveness

Based on the results from the Interventional study, you’re now ready to build the business model. This is where you determine whether this solution is cost-effective, and this is where the provider begins to plug in their own numbers on the savings from early intervention and the benefits to their quality scoring for Medicare reimbursement.
 

Interesting technologies and services

The goal for any effective remote patient monitoring is to be able to predict and notify with a high degree of confidence those patients who need intervention and to do it with enough notice to matter. And to minimize false positives, which very quickly undermine confidence.

Interesting offerings in this space include:

  • VitalConnect - the only FDA approved bandaid sensor
  • Airstrip - a mobile data monitoring platform for hospital and home settings
  • physIQ - an FDA-approved personalized physiology data analytics company

Exception-based monitoring, like these services provide, will be used to detect adverse events, transplant rejections, and chemotherapy responses. It can be used in long-term care settings and ICUs. It can be used for monitoring clinical trial patients.

And digital monitoring provides objective data, collected passively—a major improvement over traditional patient journals, which were subject to the whims and subjective emotions of the patients. 
 

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The drugs, Optistavin, Easovartis and Librylin, and names, results, case studies and specific information, referenced in this advertisement are fictional and were created solely for illustrating the digital marketing capabilities of closerlook, inc. Any resemblance to actual drugs, medications, treatments, persons, living or dead, or to actual events, is purely coincidental. closerlook, inc. does not assume and hereby disclaims any liability to any party for any loss, damage or disruption caused by such party’s reliance on the fictitious information contained in this illustration.

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