Dr. Campbell: Managing data from home monitoring a challenge for - WNCN: News, Weather

WNCN News

Dr. Campbell: Managing data from home monitoring a challenge for doctors

Posted: Updated:
RALEIGH, N.C. -

Technology in medicine advances at a rapid pace.  In the U.S. today, most patients have access to mobile phones, smartphones and tablets.  Medical device makers continue to innovate and create ways in which these technologies can be used by patients and physicians to monitor complex biologic machinery such as implantable cardiac defibrillators and Pacemakers at home – without the need for routine office visits.

These technologies create large masses of DATA.  These home-generated data can be instrumental in managing chronic disease  but can also create logistical as well as legal issues for physicians and their staff.

For the longest time, physicians have relied on patients to bring in a log of their blood pressures or blood sugars from home (often scribbled on a notepad, and often not accurately recorded) in order to determine when medication adjustments are needed.  In patients with congestive heart failure, physicians rely on a log of daily weights in order to make changes in the patients daily diuretic regimen in an effort to prevent hospital admissions for decompensation.  

Now, device makers have created insulin pumps and glucometers that can be downloaded to a laptop and the information emailed to the physician for analysis.  ICD makers such as Biotronik actually have created cell phones that interact with the implanted device and transmit regular data to the physician 24 hours a day.

The big question is:  Does home monitoring really make a difference in outcomes and does it impact cost of care?

This week in the Annals of Internal Medicine, an important meta analysis was published evaluating the effectiveness of home monitoring technology on outcomes in patients with high blood pressure.  In the study, 52 different comparative trials were analyzed.  Each of these trials evaluated the effectiveness of home monitoring of blood pressure and compared outcomes to patients who received home monitoring plus additional online or in-person support.  

The study showed that all patients who had remote home monitoring of blood pressure had lower readings at 6 months but only those with home monitoring plus additional infrastructure and support from their physician's office had more long-term benefits.  Moreover, those patients with the added support experienced a more substantial reduction in blood pressure when compared to standard care or to remote monitoring without additional support.

As reported in the Wall Street Journal this week, the economic impact of home monitoring and data management on physicians and physician practices may be significantly negative.  Currently, physicians are not reimbursed for much of the home monitoring data management (with the exception of ICDs and Pacemakers which are reimbursed by Medicare). Many practices are hiring complete departments of highly skilled nurses and staff to deal with the enormous amount of incoming patient data from remote sources.  

The additional staffing required to process and react to home monitoring data creates additional overhead – all in a practice setting where reimbursement continues to decline.  At some point, something has to give.

Don't get me wrong, I am a huge proponent of the ePatient and of mHealth.  Using technology to help patients manage chronic illnesses at home is the way medicine will be practiced in the future – and this practice will ultimately improve outcomes.  However, as technology advances, we must also find a way to advance the way in which physicians and their staff are able to process and utilize data in a cost effective and meaningful way for the patient.  If the government intends to successfully overhaul healthcare and institute a fully electronic universal electronic medical record, then some consideration must be given to practice workflow, data management and the costs associated with the challenges that these new frontiers will present.

The Annals of Internal Medicine study is clear – home monitoring and data collection helps patients manage their chronic disease – but the largest benefit is seen when home monitoring is combined with additional support from the patient's healthcare team.

 

  • NewsMore>>

  • New taxi options in Raleigh offer more than standard fare

    New taxi options in Raleigh offer more than standard fare

    Friday, April 25 2014 12:11 AM EDT2014-04-25 04:11:57 GMT
    A pair of new ride sharing smartphone apps launched in Raleigh on Thursday, to the dismay of some traditional taxi services.Uber and Lyft are both well-established in some larger cities. The services connect independent drivers in their personal vehicles with people who need a ride. The car is ordered and paid for using the app. Once inside the vehicle, no money exchanges hands.WNCN decided to try out the service for ourselves. We downloaded both apps. Uber did not have any cars available nea...
    A pair of new ride sharing smartphone apps launched in Raleigh on Thursday, to the dismay of some traditional taxi services.Uber and Lyft are both well-established in some larger cities. The services connect independent drivers in their personal vehicles with people who need a ride. The car is ordered and paid for using the app. Once inside the vehicle, no money exchanges hands.WNCN decided to try out the service for ourselves. We downloaded both apps. Uber did not have any cars available nea...
  • Sexercise provides more than physical fitness

    Sexercise provides more than physical fitness

    Friday, April 25 2014 12:01 AM EDT2014-04-25 04:01:21 GMT
    Physical and mental health are both benefits of traditional exercise, but there can be hidden benefits as well in other non-traditional ways to get fit.
    Physical and mental health are both benefits of traditional exercise, but there can be hidden benefits as well in other non-traditional ways to get fit.
  • Man found shot in Raleigh apartment

    Man found shot in Raleigh apartment

    Thursday, April 24 2014 11:33 PM EDT2014-04-25 03:33:21 GMT
    Raleigh police said a 35-year-old man died Thursday afternoon after being found in an apartment with gunshot wounds.
    Raleigh police said a 35-year-old man died Thursday afternoon after being found in an apartment with gunshot wounds.
  • Health with Dr. CampbellMore>>

  • Dr. Campbell: New treatments for migraine headaches

    Dr. Campbell: New treatments for migraine headaches

    Wednesday, April 23 2014 7:51 AM EDT2014-04-23 11:51:27 GMT

    The FDA has just approved a new device to prevent migraine headaches. This is the first device of its kind and may revolutionize the way we treat headaches.

    The FDA has just approved a new device to prevent migraine headaches. This is the first device of its kind and may revolutionize the way we treat headaches.

  • Dr. Campbell: Can too much running be bad for your health?

    Dr. Campbell: Can too much running be bad for your health?

    Wednesday, April 16 2014 5:00 AM EDT2014-04-16 09:00:21 GMT
    Running regularly has long been linked to a host of health benefits including weight control, stress reduction and better blood pressure and cholesterol. However, recent research suggests there may a point of diminishing returns with running.A number of studies have suggested that a "moderate" running regimen -- a total of two to three hours per week, according to one expert -- appears best for longevity, refuting the typical "more is better" mantra for physical activity.The study, conducted ...
    Running regularly has long been linked to a host of health benefits including weight control, stress reduction and better blood pressure and cholesterol. However, recent research suggests there may a point of diminishing returns with running.A number of studies have suggested that a "moderate" running regimen -- a total of two to three hours per week, according to one expert -- appears best for longevity, refuting the typical "more is better" mantra for physical activity.The study, conducted ...
  • Dr. Campbell: The coast of childhood obesity

    Dr. Campbell: The coast of childhood obesity

    Wednesday, April 9 2014 9:50 AM EDT2014-04-09 13:50:32 GMT
    Obesity and obesity-related illness accounts for an enormous healthcare expenditure in the United States today–approaching $150 billion annually.
    Obesity and obesity-related illness accounts for an enormous healthcare expenditure in the United States today–approaching $150 billion annually.
Powered by WorldNow

1205 Front St., Raleigh
N.C., 27609

Telephone: 919.836.1717
Fax: 919.836.1687
Email: newstips@wncn.com

Can't find something?
Powered by WorldNow
All content © Copyright 2000 - 2014 Media General Communications Holdings, LLC. A Media General Company.