Source: pixbay.com user: mcmurryjulie

June 15, 2017

Next step in Telehealth: eReporting and eCare

In the midst of rapidly advancing technologies in healthcare, patients and clinicians are often overwhelmed with technologies that are incessantly marketed to them to improve care quality and patient satisfaction. The most notable technology currently being telemedicine for remote visits. Beyond telemedicine, a different set of telehealth technologies are gaining momentum focused on things such as ‘patient engagement’, ‘remote-patient monitoring’, and ‘care management’. What do these technologies really mean, especially considering many technologies utilize smart phones and web portals.

These telehealth technologies are designed to:

  1. Improve communication between the provider and the patient
  2. Improve reporting by patients for better situational awareness, decision-making and intervention
  3. Improve care quality using patient-centric and data-driven approach

Note, the three above mentioned points are not necessarily distinctly separate but often interconnected.

What are the benefits and outcomes of the design goals?

Communication

Messaging, reminders, emails offer convenience to easily communicate with your patients, understand their concerns and problems. Gain quick feedback as well as improve patient adherence to their care plan with reminder messages and personal follow-ups. If messaging capabilities are combined with patient-generated clinical data, then communication can be initiated by providers based on the data available (e.g. vitals, PROs, medication adherence, etc) for quick turnaround for follow-up. Patients feel more satisfied knowing that they are better connected to their providers. Even simple text messaging can increase medication adherence by 10% and save approximately $800 per year for diabetes patients due to reduced outpatient visits and improved communication based on the results from a study done in Chicago (Source)

Reporting, Decision-Making, and Care Quality

Studies of integrating electronic patient-reported outcomes as a regular oncology practice was studied by researchers at Memorial Sloan Kettering Cancer Center (Source). Patients who reported outcomes electronically were able to live longer (31.2 months versus 26.0 months) and withstand longer periods of chemotherapy (8.2 months versus 6.3 months) than those that only received regular care. Due to consistent electronic reporting & feedback from the patients, nurses responded 77% of the time to symptom alerts to intervene and modify patient care plan.

Blog 13 E Reporting graph
Impact of electronic reporting vs usual care on cancer patients.

 

Obtaining patient reported outcomes (PROs) in context of pre and post-op care enables clinicians to track progress, check for relapse, and intervene in timely manner. It also enables clinicians to address patient concerns proactively.

Blog 13 Cancer Survival
Overall Survival Among Patients With Metastatic Cancer Assigned to Electronic Patient-Reported Symptom Monitoring During Routine Chemotherapy vs Usual Care. Source

 

A team at University of Massachusetts Memorial Health Care (Source) undertook a study to determine the effectiveness of PRO collection (Electronic and Paper) for orthopedic surgery patients. By administering PRO surveys as part of clinical workflows, it can improve surgeon efficiency, measure shifts in symptoms over time, develop data-driven trends, bolster patient medical records, and improve shared decision-making, and lastly data aggregation over entire population for population health-based decision making. If reporting measures are digitized and infused with advance feedback mechanisms such as chatting and video then we can create serious positive impact on patient outcomes.

Typically, most patients spend no more than few hours per year in an healthcare setting; while that number is higher for patients undergoing surgery they spend majority of their time not inside the hospital. Taking this into consideration, one of the simplest and most effective way to involve patient in their health is via mobile phones. Improved patient care, adherence, and reporting can be achieved by treating patients in a setting convenient and comfortable to them. If we are touting video visits as an effective way of treating patients that is comfortable and convenient for them, then we must take steps beyond that video consultations. A new paradigm in healthcare will be when we become serious about treating patients with a variety of means highlighted above outside the clinic and via accessible technology providing consistent feedback. Thankfully, we don’t have to wait for new means to arrive some day, they are already here.

About DocToDoor

DocToDoor is a custom branded Telehealth solution designed to empower physicians to manage care through the entire care continuum for post-visit, chronic care, and post-op recovery. We are empowering physicians with user-centric remote patient monitoring & engagement and telemedicine platform to manage and care for patients through the entire breadth of patient-provider relationship.


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