How IoT paves the way to value-based care

By David Paré

Pulse Series: This is the second of my monthly blogs on news, start-ups and developments in the healthcare industry, part of the 21st Century Series on Australian Healthcare.

Two significant trends are merging to create innovative approaches to care coordination. The internet of things (IoT) has expanded into a new and exciting field, the internet of health things (IoHT), while at the same time the drive towards value-based care is pushing clinicians to find ways to improve outcomes and, wherever possible, keep patients out of hospital.

In the value-based era, clinicians are paid based on actual patient outcomes. Insurers are putting pressure on hospitals to demonstrate patient outcomes and paying them accordingly, as opposed to paying by the number of activities performed by the clinician (e.g., surgery, consultation, etc.).

But care and medicine are imprecise. Doctors don’t always know what’s wrong with patients until they’ve carried out multiple tests; hospitals are performing patient treatments with partial data about the patients’ health and wellness, usually after an acute event (i.e., “I’m sick, so I see a doctor.”). It is, and always has been, about the information — or data — available to you.

The world of IoHT and the vast stores of big data it brings with it allow carer and clinician to make decisions based on actual and real-time data about the patient. Globally, vast numbers of initiatives are in play — from wearables and implanted medical devices to monitors, and from community networks to ease of network access aimed at enabling innovation.

In this blog, I’d like to highlight a few Australia-based and global innovations that are advancing IoHT and the opportunity to achieve value-based care through population health management.

From sensors to networks

Curo is a Melbourne-based start-up that has developed a home monitoring solution, with aging family members in mind. A set of non-intrusive sensors is set up in the home of the elderly individual to measure last activity, home temperature, whether the individual is home or out, and completion of expected daily or weekly tasks, such as taking medication. The sensors gather data to establish a baseline of patterns over a set period, alerting carers and family members when there are deviations from those patterns.

The kit is also meant to bring peace of mind to carers. Research shows that carers often struggle with stress when trying to manage the care of many individuals, and this can have an impact on the care they give to each person. Using a wellness index together with the Curo sensors, the carer can determine from the data whether one of the individuals he or she cares for requires an urgent visit.

Another example of innovative IoHT is ConnectedLife, a Singaporean company that claims to be the biggest user of Microsoft’s IoT platform. ConnectedLife has developed several IoHT devices and wearables to monitor and prevent acute events from chronic diseases. For example, the company developed devices to monitor dyspnea, fluid retention, activity decrease and coughing, which together provide sufficient data to anticipate and prevent acute events before they happen. As 30 per cent of patients are re-admitted to the hospital after 30 days and 50 per cent after 6 months of a heart intervention, this provides a great alternative and a cheap approach to improve outcomes and quality of life for the patient.

Although IoHT and IoT in general have become more mainstream, it is still complicated and difficult for the common innovator to take advantage of the technology without substantial funding and deep technical skills. To address this issue, community groups as well as medical and technical networks have sprung up with a goal of further advancing IoT. As an example, two years ago I co-founded the  IoE community, which brings together IoT enthusiasts in a number of fields, including health. The community now has 1,400 members in Perth, a similar number in Sydney, and a network of communities in Brisbane, Melbourne, Singapore, South Africa, Brazil, South Korea and Germany. This is a community of more than 10,000 IoT enthusiasts from whom you can get advice, thought leadership and skilled resources.

In addition to networking the IoT community, the group also collaborates with The Things Network, a European organization with a global community of nearly 21,500 people in 89 countries building a global IoT data network. The objective is to create an open and free IoT network using a technology called LoRaWANTM, a low-power WAN specification that is designed to make it easy for users and developers to develop IoT devices. In Western Australia, the Perth IoT Communications Network (PIoTCN) was created to drive the creation and operation of an open, decentralised and free IoT communications network. The idea is to lower the barrier for adoption of IoT technologies and allow innovators in health and other industries to future-proof their ideas.

Accelerating innovation

More specifically, to accelerate innovation and commercialisation of clinical apps and medical devices, Perth-based SPARK Co-Lab — a design course at Stanford University that has been successfully aiding the translation of new medical discoveries over the last decade, focusing on medical device technology and pharma — is partnering with the IoE community to connect MedTech innovators with skilled IoT, cloud and analytics professionals.

One other platform I’d like to draw attention to is Validic, which is developing solutions to simplify data access, integration, standardization and storage. One of the challenges with the many apps and devices is that each uses a different technology, and using or gaining insights from these can be complicated and expensive. IoHT integration platforms such as Validic have made it possible to connect all the devices — from Fitbits to Garmins to Apple apps and more — making it easier to access data across all the devices from a single point.

IoHT is growing rapidly. Estimates have placed its value at more than US$163 billion (AU$206 billion) by 2020. While the technology and apps being developed are exciting, what’s most important are the analytics and insights that can be derived from the data captured. That’s the real value of IoHT, and just like artificial intelligence and machine learning, it will help to advance the goals of value-based care, improving care coordination, and delivering better outcomes to patients and their carers.


David Paré is the chief technology officer for DXC Healthcare and Life Sciences in Australia and New Zealand. He is an innovative thinker with 20 years of experience in business and technology management consulting, helping organisations through their digital transformation.

 

 

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