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Integrating patient-generated health data into care delivery can lead to better remote patient management without adding additional workload to the frontline clinicians. PGHD usually includes health history, treatment history, biometric data, symptoms and lifestyle choices, which patients, family members and other caregivers create or gather to help address a health concern.
In hopes of helping health IT professionals simplify data access, integration, standardization and storage, Validic, a PGHD platform vendor, collaborated with Partners Connected Health, one of the programs at Partners HealthCare. They worked together to provide care teams with access to PGHD collected from digital health apps, wearables and in-home medical devices.
The data can be further incorporated into care plans and EHR systems to provide insights into clinical workflow. After implementing the PGHD program at Partners-operated Revere HealthCare Center in Revere, Mass., for years, Partners and Validic have seen success, as well as challenges from the end-user experience, as noted in a panel at the recent 2018 Connected Health Conference.
Process actionable data with 'invisible healthcare' technology
To provide effective remote patient management while supporting more active clinical intervention, Drew Schiller, CEO at Validic, brought up the concept of "invisible healthcare" during the panel, which is blending and integrating technologies into care delivery without making extra efforts or ideally even noticing the technology when using it.
"[We] think about how we can help the clinical staff members make the data easily acceptable in their workflow," Schiller said.
As an early adopter of this program, Revere HealthCare Center expected to keep patients out of the doctor's office and instead give patients more touch points through the use of PGHD, according to Christine Goscila, a nurse practitioner at the health center, who has used a blood pressure monitor integrated with PGHD for about two years.
Drew SchillerCEO, Validic
Through automation of PGHD collecting processes, clinicians can free themselves from making phone calls to follow up with patients. In doing so, patients can switch their points of contact from physicians to nurses, who have more availability to care for patients day to day. In addition, the patient-generated data collected by electronic devices are free from manual errors in most cases, which can make relatively accurate outcome predictions and therefore assist with clinical decisions.
"Our mission is to use technology to make personal data actionable," Schiller said. "[A PGHD program] allows the care team to spend less time doing the basic tracking work, but spend more time doing work with highly risky patients. Let the doctors be doctors."
Integrating PGHD into the clinician workflow: Advantages and challenges
To integrate PGHD into healthcare systems and help with remote patient management, many EHRs today can input such data into a flow sheet, which can be accessed by both patients and clinicians. Streamlining the raw PGHD can make the clinical analysis easier and allow it to be a direct part of care delivery.
During the treatment process, only certain data is needed from patients as outlined by their specific treatment plans. It enables providers to control the data coming into their workflow, especially if they handle a large patient population.
Basically, "in our particular PGHD-connected platform, the providers have to invite the patient to share," while patients cannot decide the input of their health data, according to Kelly Santomas, senior director at Partners HealthCare.
In the meantime, the data interpreted with clinical insights goes out to the apps patients use to collect their health data. From that perspective, the data educates patients about their treatment plans and health conditions. The bilateral access to patient data through this program helps clinicians and patients to collaborate and find out personalized solutions to improve the patient outcomes.
"To patients that have been engaged [in the PGHD program], it's been really incredible," Goscila said. "It's really a learning curve benefiting from patient-generated data and a way to increase the work satisfaction of providers, as well as patients' satisfaction since they have more touches and personalized treatment than they had before."
However, one of the biggest challenges in incorporating PGHD remains the integration of patient-end platforms, which is as important as the interoperability on the provider's side.
"Sometimes the connectivity can become an issue. It's not on the connected health side; it's on their apps' side. And so you are constantly trying to figure out where the connection infrastructure is," Goscila said.
Two improvements clinicians would like to see in the PGHD program are educating patients about the clinical purpose of collecting their personal health data and developing a better way to distribute the workload within care teams to allow more availability. Both are critical steps to push the move to population management by using PGHD.