The Internet of Medical Things (IoMT) - Part 2
Part 2 of 2
How IoMT is Reducing Readmissions
The Centers for Medicare and Medicaid Services (CMS) began to financially penalize hospitals for excessive readmissions related to heart failure. The Hospital Readmissions Reduction Program (HRRP) was added to the Social Security Act by the Affordable Care Act in 2012, and reduces payments made to hospitals. Up to 3% of regular reimbursements can be held back, which has become a significant expense. According to the CMS, approximately $564 million in payments will be withheld from 2,573 U.S. hospitals in 2018.
According to 2018 abstract from the Journal of the American Heart Association (AHA), heart failure is the primary reason for hospitalization in the United States, and more than 25% of patients hospitalized for heart failure will be readmitted within 30 days.
The AHA cites a three-month study from 2013 that compared telemonitoring care (TMC) and usual care (UC) for heart failure patients who were at high risk for readmission. A nurse-based telemonitoring program was used with 40 patients (who also received two home visits by a nurse) and 80 patients received usual care. The experiment found that the all-cause, 30-day readmission rate for the TMC group was 12.5% compared with 27.5% for the UC group. The heart failure, 30-day readmission rate for the TMC group was 2.5% versus 10% for the UC group. The decrease in heart failure readmissions also reduced the CMS penalty by roughly $118,400.
Even studies using mobile apps have reported similar results. In 2014, a Mayo Clinic study found that patients who participated in cardiac rehab, along with using smartphone apps to keep a record of their weight and blood pressure, lowered both cardiovascular risk factors and 90-day readmissions. Patients who used the apps and rehab treatment combination had a readmission rate of 20%, compared to 60% of patients who only completed rehab.
Improving Patient Care and Clinical Communications with Apps
Medical staff are using apps to access medical information quickly, enhance patient care, and communicate with each other. Mobile apps such as Nursing Central and Symptomia provide easily accessible, comprehensive resources about symptoms, diseases, health tests, and medications. MediBabble Translator is available in five languages and has thousands of translated questions and instructions so providers can conduct a patient’s step-by-step medical history.
Patients often have a whole team of medical professionals treating them. The Institute of Medicine found that each year the average elderly patient sees seven physicians (five specialists and two primary care physicians) across four different practices. Healthcare providers need to be able to communicate with each other about their patients’ needs. miSecureMessages is a HIPAA and HITECH-compliant secure messaging app that enables care teams to securely text with each other and share photo, video, and audio attachments.
The privacy and security of electronic protected health information (ePHI) is one of the primary concerns when it comes to IoMT. Cyber criminals are targeting ePHI because they can get a premium price for it on the dark web.
Our global healthcare industry will be worth an estimated $8.7 trillion by 2020. Hackers are profiting and selling stolen patient data to be used for insurance fraud, medication fraud, and other financial fraud schemes.
The effort to combat cybercrime and protect ePHI is ongoing and improving. According to Protenus, a healthcare IT company specializing in protecting patient health data, there were 477 reported healthcare breaches affecting approximately 5.6 million patient records in 2017. When comparing these numbers to their 2016 findings, there was a slight increase in the number of breaches (450 in 2016 vs. 477), however, the number of affected patient records experienced a remarkable decrease (27.3 million patient records in 2016 vs. 5.6 million).
Integrating new technology and ensuring its interoperability with existing systems and software can be an obstacle. Hospitals and healthcare organizations rely on a mix of different and disconnected systems to provide functionality for multiple areas in various departments. While sharing information between disparate systems has traditionally been a challenge, using an Integration Engine can bridge the communications gap.
Integration engines, such as MergeComm, use an information architecture concept known as a Single Source of Truth (SSOT). When separate departments use different data and systems, data silos are created. Retrieving information from, and updating these data silos, is time-consuming and leaves room for human error. Using a SSOT enables several databases to function as one. Information is communicated between databases and updated data is spread to the entire system – reducing the likelihood of duplicate information.
Future of IoMT
Studies prove that IoMT is already improving care plans, outcomes, and readmission rates. The products currently on the market provide helpful information and measurements, but in the future, they could become sophisticated enough to detect diseases, bacteria, or even provide a credible warning that a person may have a disorder, such as sleep apnea, or provide information about how a disease is progressing.
Researchers at Rutgers University-New Brunswick have created a smart wristband that uses biosensor technology to count blood cells. Microscopic blood samples are collected through pinpricks and sent through a channel narrower than the diameter of a human hair. The sample is analyzed, then the results are digitized and sent wirelessly using a smartphone with an app.
Innovations such as insulin-delivery devices are already being used to improve medication adherence, and as smart device technology for real-time biometric tracking improves, so does the possibility for the delivery of precision medicine. The precise application of medicine has advantages over pills taken orally, metabolized, and distributed throughout a person’s body with possible side-effects.
The ultimate goal of IoMT is to make quality care accessible to everyone – no matter where they are located, improve people’s health, lower healthcare costs, and provide automation tools to minimize human error.