I just came from the quadrennial meeting of the 21st IAGG World Congress of Gerontology and Geriatrics, where I noticed some things worth sharing. There’s been a tectonic shift in industry framing of aging — from costs of infirmity to value of capability and contribution of elders. Not too long ago there was resistance to these notions. Today, the World Health Organization Strategy on Ageing has codified and recast these and other concepts in a new action plan focused on functional ability that’s being received with universal acclaim (HuffPost).
What strikes me most is that to achieve this collective vision of healthy & active living at all ages we must also see a tipping point in deployed infrastructure for care beyond the hospital setting. Providers and policymakers must accelerate and expand support for caring for people remotely and in their home. Unless remote care becomes ‘standard of care*’ with medical care, we will never get costs under control and society will forever lack a sufficient remote care digital infrastructure to support independent living into old age.
*Standard of Care: The quality of care that a health care provider should have provided, measured by the level of care that a reasonably skilled health care professional would have provided in similar circumstances. (According to MedicalMalpractice.com)
Don’t get me wrong. Remote and in-home care, especially remote patient monitoring (RPM) is happening, and faster than before. In recent years, there has been an abundance of evidence demonstrating that RPM, integrated into a care plan, leads to benefits for patients, their families, communities and national health care systems overall. Through RPM, physicians, nurses, elder caregivers and other healthcare providers can gain deeper and more objective insights into patient health, and in many cases, help lead to earlier detection and diagnosis, and therefore earlier and more effective treatment and management of multiple conditions. As one ages, there are also benefits for RPM’s role in helping to maintain “functional ability,” itself essential for a healthier, more active and lower-cost aging process.
In an example of RPM delivering tremendous results, research from the University of Mississippi, Ascension Health and Care Innovations shows that RPM technologies can greatly reduce emergency room visits and hospital readmissions. Such tested RPM applications include videoconferencing with healthcare providers, tablet-based patient education and devices that can prompt and track diet, exercise and medication adherence.
RPM in particular is saving medical costs for systems that use it and improving outcomes for their patients. According to the Veterans Health Administration, RPM can reduce hospitalizations by as much as 40 percent for some diseases, leading to annual savings of $6,500 per patient. The estimated annual cost-savings potential of RPM, if adopted widely, could be as high as $6 billion.
Access to that level of care is elusive for most unless you happen to be within one of the few systems that have deployed it. Furthermore, most deployed systems are addressing just one or a few specific conditions. There are of course exceptions in some countries outside the United States (e.g. Singapore ), but largely, comprehensive RPM care is limited and inconsistently available. Well-defined standards of care could help RPM reach its full potential.
I believe achieving RPM as standard of care is achievable and not in some distant idealized future. The rate of deployments is increasing, the evidence on efficacy and cost savings is overwhelming and irrefutable, patient and clinician satisfaction when they have deployed is high, and payment systems are changing to recognize and reward remote care use.
Consider that the average Medicare spending per person doubles between the ages of 70 and 96. Chronic conditions like COPD, heart disease, diabetes, and dementia, which often develop with age, account for nearly 90 percent of U.S. healthcare costs. By connecting patients with physicians and other care providers virtually and enabling quicker ability to address emerging health concerns, RPM can save enormous health costs with respect to reduction of physician and ER visits, early diagnosis of diseases, and mitigation of hospital admissions and readmissions. Over time, investments in the widespread adoption of RPM could help control costs and improve overall care – for governments, healthcare providers and families.
We believe that, to fairly and cost-effectively treat an ever-growing number of people needing care, RPM can and must become a “standard of care” targeting not only post-acute care management for heart attack, stroke and orthopedic and neurological surgeries, but also treatment for chronic conditions like diabetes, COPD, heart disease, and dementia. Our hope is that by 2020, RPM is a medical standard of care and by 2025 at least 50 million people are benefiting annually in the United States from its deployment in medical and independent living use cases. The technology industry is addressing the technical challenges and the remote care services vendor ecosystem has perfected the care workflows solutions. Now, all key industry stakeholders must work together to proliferate and democratize access to remote care. Platforms for RPM, initially deployed for medical uses, can be the digital bedrock of all distributed systems for medical and functional ability support on a national scale.