Digital Disease Management to optimize care and improve patient outcomes

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Understanding Medication Adverse Effects and How Healthcare Data Management Can Provide Proactive Prevention

Understanding Medication Adverse Effects and How Healthcare Data Management Can Provide Proactive Prevention

March 10, 2020

Adverse Drug Reactions vs. Adverse Drug Events – Detect and Avoid for Patient Safety

We are experiencing a health craze. Everybody is becoming health conscious and there is an abundance of herbs, supplements, lotions, etc. that people are using in their quest to rid themselves of, and prevent, ailments.

In addition, there are numerous prescription medications (almost 6,800) and countless over-the-counter drugs available in the US market. The use of so many substances in health care opens the door to possible interactions between substances, resulting in medication adverse effects. In the clinical space, terms such as adverse drug events (ADEs) and adverse drug reactions (ADRs) are used to describe some of the possible medication adverse effects that can result from drug use. But does the average person understand the meaning of these terms?

An adverse drug event (ADE) is defined as “an injury resulting from medical intervention related to a drug.” An ADE results from harms caused directly by the drug itself and include medication errors, ADRs, overdoses, and allergic reactions. An ADR, on the other hand, is a harmful and unintended response to a drug at normal doses and during normal use.

The Office of Disease Prevention and Health Promotion, part of the US Department of Health and Human Services, has named ADE prevention as an important patient safety priority in its National Action Plan for Adverse Drug Event Reporting. It noted that ADEs accounted for an estimated one-third of hospital adverse events and approximately 280,000 hospital admissions annually. The ADE Action Plan was established to coordinate multiple stakeholders and align Federal efforts in identifying common, preventable, and measurable ADEs that may result in significant patient harm. The goal is to jointly work towards reducing patient harm from these specific identified ADEs nationally.

Three types of ADEs were selected as the high-priority targets of the ADE Action Plan as they were identified as being common, clinically significant, preventable, and measurable. These are:

  • Anticoagulants: primary ADE of concern – bleeding
  • Diabetes agents: primary ADE of concern – hypoglycemia
  • Opioids: primary ADE of concern – accidental overdoses/over-sedation/respiratory depression

The World Health Organization lists has reported that as many as 4 in 10 patients globally are harmed in primary and outpatient health care. Up to 80% of harm is preventable. The most detrimental errors are related to diagnosis, prescription and the use of medicines. As such, healthcare organizations are urged to utilize the ADE Action Plan and implement strategies to prevent medication adverse effects, especially from the three priority types of ADEs identified. Healthcare data management and healthcare technology can play a major role in this regard, and those organizations that proactively use healthcare technology to detect ADEs will be a step ahead in preventing them. Some ways in which healthcare data management and healthcare technology can be used in ADE detection and prevention include:

  • Electronic exchange of health information, such as laboratory results and care (e.g., discharge) summaries. This can help to improve communication among the care team as a patient passes from one team to the next.
  • Interoperability between laboratory and pharmacy systems to help prevent medication errors and medication adverse effects.
  • Utilize electronic health records (EHRs) and patient engagement tools to provide patient-specific data that can inform appropriate clinical decisions by providers. EHRs and patient engagement tools can also provide clinical reminders and templates to prompt and facilitate recommended clinical practices. This could result in improvements in assessment, documentation, and collaborative treatment planning for patient risk factors and aberrant behaviors.
  • Leverage EHR Meaningful Use requirements by incorporating Quality Measures specific to the three types of ADEs identified in the ADE Action Plan.

ADEs can also be prevented by improving patient compliance with their medication regimen. Incorporating remote monitoring solutions such as automated medication dispensers with reminders can improve patient compliance and also prevent potential overdoses especially in seniors with memory problems.

Patient safety is a priority for all healthcare organizations and medication adverse effects are a serious threat to this. By proactively incorporating healthcare technology to detect and avoid ADEs, organizations can increasingly prevent them and improve patient safety. Acuma Health can show you how to utilize technology for proactive prevention of medication adverse effects and improved patient safety.


PGHD Patient Generated Health Data Acuma Health

Patient Generated Health Data (PGHD) Management to Improve Patient Care

February 18, 2020

Optimal Healthcare Data Management Can Achieve Benefits for Patients, Clinicians, and Payers

Patient generated health data (PGHD) is everywhere. There are many healthcare technology apps and devices that assist in patient data collection. Patients are eagerly collecting, tracking, and storing health data such as activity levels, and some are sharing that data with their healthcare providers. Some healthcare providers are utilizing patient data collection to aid in their decision-making to improve patient care. PGHD has the potential to change the healthcare landscape and healthcare stakeholders can leverage PGHD to improve outcomes and reduce costs.

In order to optimally leverage patient generated health data to produce useful insights and improve patient care however, proper patient data collection management is critical as data collected but not properly managed can become useless. Healthcare data is sensitive, personal, and protected by regulations such as the Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule and, as such, healthcare data management can be an intricate process.

When looking to capture, store, and utilize PGHD, healthcare stakeholders need to consider factors such as data privacy and security, data accuracy, data governance, interoperability, and compliance with regulations. Because of this, the process requires careful thought and planning and development of proper PGHD frameworks to ensure optimal healthcare data management and utilization.

What is Healthcare Data Management and Why is it Important?

In a broad sense, healthcare data management is the process of storing, protecting, and analyzing data pulled from diverse sources. Healthcare stakeholders are swamped with patient data collection activities from myriad sources including electronic health records (EHR), electronic medical records (EMR), and of course, PGHD. All these data sources must be effectively managed if the power in the data is to be successfully harnessed and utilized.

“Managing the wealth of available healthcare data allows health systems to create holistic views of patients, personalize treatments, improve communication, and enhance health outcomes.”

Evariant

Optimal healthcare data management,especially with the incorporation of patient generated health data, is important as it provides powerful insights into the patient life story beyond the walls of the medical establishment. This will enable the healthcare provider to better personalize the care offered to patients, improving patient outcomes and reducing costs associated with hospital admissions.

Healthcare data management through healthcare technology and data analytics is invaluable to population health management and precision medicine, driving research and improving health.

Leveraging healthcare technology for best-in-class healthcare data management is also critical if healthcare stakeholders are to remain compliant with regulations. In the era of value-based payments and meaningful use , healthcare data management must be a top priority for all healthcare stakeholders looking to remain relevant and functional in the healthcare space.

Benefits of Optimally Managing Patient Generated Health Data

There are many benefits to be gained from the optimal management of patient data collection and PGHD . There are benefits for a variety of healthcare stakeholders including patients, clinicians, payers, and researchers.

Advantages of Improved Patient Data Collection for Patients

Patients set to benefit from the optimal management of patient generated health data through ways such as:

  • More involvement in their personal healthcare as they take ownership of collecting and sharing PGHD with providers
  • Better engagement and communication with providers
  • Enhanced understanding of health conditions
  • Improved management of health conditions
  • Fewer hospitalizations and reduction in associated costs

Benefits of Optimized Healthcare Data Management for Clinicians

When PGHD is collected, shared with the provider and optimally managed through the use of healthcare technology, clinicians can realize many benefits. These include:

  • A more complete view of the patient’s quality of life over time and beyond the healthcare setting
  • Deeper insight into the patient’s adherence to treatment plans including medication adherence
  • Ability to note trends and intervene in a timely manner before acute episodes of illnesses
  • Better treatment outcomes and reduced hospitalizations
  • Increased patient engagement
  • Better patient retention

Benefits of Well-Managed Patient Data Collection and Management for Payers

Payers in the healthcare space can also benefit from optimal patient data collection and management.  Benefits to payers include:

  • Obtaining value for money by tying reimbursements to shared decision-making between providers and patients through incorporation of PGHD in care decisions
  • Offer incentives for the use of PGHD by providers

Patient Generated Health Data Management Benefits for Researchers

Patient generated health data when properly managed with healthcare technology, can provide a treasure trove of valuable information for researchers helping them to:

  • Conduct comparative effectiveness research to assess medical therapies to determine the best and most cost-effective therapeutic solutions for routine clinical use
  • Advance the field of personalized medicine
  • Develop predictive modelling and analytics
  • Make progress in the field of population health management
  • Monitor patients who are participating in clinical trials

Best Practices in Managing Healthcare Data with Healthcare Technology

Proper healthcare data management can be a daunting task. With the volumes of data that consistently flow into the healthcare system, added to the emerging field of PGHD, healthcare data management can overwhelm even the most seasoned healthcare professional if not done properly. However, the many benefits to be gained by different healthcare stakeholders from optimal healthcare data management, are enough to make the effort worthwhile.

Successfully managing healthcare data with healthcare technology to achieve the greatest benefits involves implementing measurement systems, as was executed in several healthcare case studies.  These measurement systems are designed on certain principles, such as: 

  • fitting the PGHD into the flow of care and using the data to make it easier for clinicians to do their jobs and for patients to engage in self-management and make informed decisions
  • ensuring the PGHD measurement system is co-designed with healthcare stakeholders engagement
  • engaging with patients and clinicians about how to use the PGHD
  • merging PGHD with data from other sources (clinician reports, medical records, claims) for optimal utility of the data
  • continuously improving the PGHD measurement system based on the experiences of users and new healthcare technology

Some healthcare stakeholders have begun optimizing patient generated health data, utilizing it to generate actionable insights and guide decision-making. A 2015 survey among healthcare executives found that 73% reported a positive return on investment (ROI) in healthcare technology  involving PGHD such as wearables that track fitness and vital signs.

“The use of such Digital Health apps in just five patient populations where they have proven reductions in acute care utilization (diabetes prevention, diabetes, asthma, cardiac rehabilitation and pulmonary rehabilitation) could save the U.S. healthcare system an estimated $7 billion per year.”

IQVIA

A congestive heart failure remote monitoring program initiated between Northern Arizona Healthcare and partners aimed to improve the management of patients with chronic diseases and/or high-risk conditions, by connecting patients with home-based medical devices and their care providers to ensure proper patient data collection and sharing of PGHD. An analysis of the program comparing data six months before and after implementation found an achievement of:

  • An average 44% reduction in readmission to the emergency room
  • An average 64% decrease in the number of days hospitalized
  • A reduction of $92,000 in per patient hospital charges

This program is a clear indication of the benefits to healthcare stakeholders that can be derived through successful healthcare data management.

The Dartmouth-Hitchcock Spine Center in Lebanon, NH, is a case study in the optimal use of PGHD to improve treatment outcomes. Patients complete a survey at home using a patient portal or in-office using a touchpad prior to their first visit at the center. The data are analyzed in real-time to create a summary report that is fed into the flow of care for use by the patient and the care provider. The provider also inserts some core clinical data elements into the clinical report and all information gets stored in a data warehouse for analysis and use in the care of the patient.

Overall results from a survey on the system found that over 80% of patients rated the system as“excellent to good” and one-third indicated that the system had led to positive changes in their visits. Approximately 50% of clinicians reported that the system saved time.

The Swedish Rheumatology Quality (SRQ) registry at the Karolinska University hospital, in Stockholm, Sweden, is another example where patient generated health data is incorporated into clinical care for optimal benefits.The SRQ registry is web-enabled and integrates real time, standardized data provided by patients, clinicians, and diagnostic tests. This data is used to improve the outcomes of care for individual patients, at the point of service as care is provided, and in the patient’s home to support self-management, as well as for quality improvement and research.

Efforts by patient care organizations to fit Digital Health tools into clinical practice has progressed, with 540 current clinical trials in the U.S. incorporating these tools and an estimated 20% of large health systems shifting from pilot Digital Health programs to more full-scale rollouts.
IQVIA

Researchers can benefit from well-executed healthcare data management. In one study of a framework for smartphone-enabled PGHD analysis, researchers at the Scripps Translational Science Institutelooked at blood pressure (BP) readings taken at variable times by persons in a study using a smartphone. They were able to detect an approximately 2 mmHg decrease in BP over a six-month trial, despite considerable intra- and inter-individual variation. This technique could prove useful for researchers in future study designs to analyze data as the field of digital medicine grows.

Of course, proper healthcare data management needs healthcare technology, and digital disease management solutions are available on the market to help with this. Ensure that selected solutions offer unified storage that is scalable and highly efficient to meet the requirements of multiple use cases.

Healthcare has become more patient-centric and policies such as value-based care will continue to push this movement forward. Patient generated health data has major potential for improving care, increasing patient engagement, lowering costs, and reducing wastes. However, there are many intricacies to properly leveraging PGHD to realize all these benefits. The process must include systems for proper healthcare data management which is inextricably linked to healthcare technology solutions.

Contact us at Acuma Health, where we assist healthcare stakeholders understand the digital health landscape including the benefits of PGHD, and provide you with solutions to solve your healthcare data management problems.





Data Collected from Seizure Monitors Can Improve Outcomes and Reduce Costs of Managing Chronic Conditions

Data Collected from Seizure Monitors Can Improve Outcomes and Reduce Costs of Managing Chronic Conditions

January 8, 2020

Patient Generated Health Data from Smart Watches Ensures Accurate Seizure Tracking and Reporting

Epilepsy is one of the most common neurological illnesses with estimates of approximately 3.4 million people in the US experiencing active epilepsy in 2015. Despite advancements in treatment options and optimal medication management, nearly one-third of patients with epilepsy continue to have seizures. Seizures can negatively impact the overall quality of a person’s life due to their unpredictable nature, occurring at anytime and anywhere. Healthcare technology  has come to the aid of people who have seizures with the development of seizure monitors or seizure alert devices that can detect the onset of a seizure and make an alert so that the individual suffering the seizure can be aided quickly. Good seizure monitors can also provide clinicians with detailed seizure data that can be used in the management of epilepsy.

There are many seizure alert devices on the market including seizure bed alarms or mattress sensors, seizure bracelets and smart watches, and camera/video/infrared devices. The report, “Seizure detection, seizure prediction, and closed-loop warning systems in epilepsy,” explored various seizure detection and prediction systems and noted that accelerometers such as smart watches, detect changes in velocity and direction and may serve to detect motor seizures such as tonic–clonic or myoclonic seizures. The authors found that a smart watch was able to detect 7 out of 8 tonic–clonic seizures in a pilot study. It further noted that the SmartWatch, manufactured by Smart Monitor Inc.:

·         utilized pattern recognition and feature analysis in its built-in seizure detection algorithm

·         can synchronize with a smartphone application via Bluetooth to transmit seizure data to the user’s mobile phone

·         the app can then contact caretakers to alert them of ongoing seizures

It is evident that the patient generated health data collected by smart watches can provide accurate tracking and reporting of seizures. Seizure monitor technology and seizure alert devices are very useful for patient engagement and can produce improved patient outcomes through use of the patient generated health data that they provide. The use of seizure monitors such as smart watches allows for early intervention in patients experiencing seizures, preventing injury, lessening the severity of the seizure, and potentially preventing sudden unexpected death in epilepsy (SUDEP). Seizure monitors also provide objective data that can be leveraged by healthcare providers to adjust therapy, allowing for better management of the patient with epilepsy and resulting in cost savings from reduced hospitalizations.

To find out more about how smart watches and patient generated health data can ensure better management of patient care and costs, download the Guide to Leveraging Healthcare Technology to Improve Management of High Risk Patients.


improve patient compliance acuma health

Patients as Partners: 7 Ways to Improve Patient Compliance

November 20, 2019

Improve Patient Compliance Using Patient Generated Health Data and Patient Engagement

Although most commonly used in reference to medication, patient compliance or adherence is how well a patient follows a prescribed medical regimen or treatment plan as it is intended. The duration, frequency, and complexity of the behavior(s) required of the patient,all have an impact on the level of patient compliance.  

“Patient compliance is “the extent to which a person’s behavior (in terms of taking medications, following diets, or executing lifestyle changes) coincides with medical or health advice.”

Patient Compliance and Health Behavior Models

Patient non-compliance is a huge problem for the healthcare industry with reports of non-compliance costing the US economy between $100 and $300 billion dollars annually, inclusive of costs related to avoidable hospitalizations, nursing home admissions, and premature deaths. Another report places the figure even higher, at more than $564 billion dollars annually. To prevent the burden that non-compliance places on the healthcare industry and the economy, improving patient compliance must be a priority for all healthcare stakeholders.

7 Ways to Improve Patient Compliance

Improving patient compliance requires patients to become engaged in their healthcare, taking responsibility for their well-being, and actively participating in their health decisions. Healthcare stakeholders have begun implementing different patient engagement strategies and tools to improve patient compliance and resultant health outcomes. However, for any of these strategies to be successful, healthcare stakeholders need to work with patients as partners and actively engage them in the process. Healthcare organizations can improve patient compliance by:

  1. Devising and implementing policies and procedures that support patient engagement as well as policies that help identify the non-compliant patients
  2. Leveraging patient generated health data to assist in creating treatment decisions
  3. Utilizing available healthcare technology
  4. Facilitating patient education about their illnesses/conditions and how to manage their conditions, including medication management
  5. Including the patient in the decision-making process surrounding their healthcare
  6. Engaging and empowering caregivers to provide patient-centered care
  7. Measuring progress and making changes where necessary

Simplifying the process surrounding the treatment regimen as much as possible will go a long way in improving patient compliance.

Patient Engagement to Improve Patient Compliance

An engaged patient is more likely to be a compliant patient. Healthcare organizations need to invest in patient engagement strategies to improve patient compliance and health outcomes. Policies must be developed and implemented to demonstrate the organization’s commitment to patient engagement and procedures for all staff to follow in engaging patients must also be implemented. Organizations must alsoensure that patients are treated with respect and that the organization feels welcoming to patients. The way patients are treated impacts how much they value the care they are provided by an organization which may also influence how well they comply with their treatment regimen.

“Engaged patients are better able to make informed decisions about their care options.”


WHO Report

Organizations should also (i) ensure that care providers are afforded adequate time with each patient so that they can really communicate with the patient to find out their health status and how their lives outside of the healthcare setting may be impacting their compliance (ii) make it a policy for providers to ask questions such as “What medications are you taking?” and “How often do you take a particular medication?” Providers also need adequate time to educate patients on their chronic conditions and how best to manage them.

Healthcare organizations should utilize technology for patient engagement which can improve patient compliance – employ electronic health records (EHRs) to simplify the patient registration process, facilitate online bill payments, secure messaging, etc. EHRs can also help providers to easily keep track of and update patients’ medications thus facilitating the smooth coordination of a patient’s medications across all healthcare stakeholders. Healthcare organizations should develop patient portals that provide patients with relevant information and facilitate interaction with the healthcare team, and incorporate technology that can make the medication prescription and dispensing process simpler and faster, such as Computerized Physician Order Entry (CPOE) or electronic prescribing (e-prescribing) tools.

Patient Generated Health Data (PGHD) can be Used to Improve Patient Compliance

Patients nowadays are generating a tremendous amount of their health care data on their own through use of technologies such as wearable devices and mHealth apps. Patients are also being monitored remotely through registered medical devices such as the pacemaker and blood glucose monitors that monitor data on heart rate and blood glucose levels. Healthcare organizations should encourage healthcare providers to use PGHD to assist with creating treatment regimens for their patients. Utilizing PGHD in this manner can improve patient engagement and by extension, improve compliance as well. It has been shown that patients were more engaged when PGHD were used during their office visits compared to when PGHD were not used. Patients who see and feel that their healthcare providers are invested in their health and value their contributions including their PGHD, are more likely to be engaged and compliant with treatment plans.

In order to facilitate and encourage the use of PGHD in treatment and care, healthcare organizations can also harness and implement Digital Disease Management Solutions that provides a user-friendly environment to identify changes in disease condition, manage medication adherence and enable easy communication between patients and healthcare providers. Improving patient compliance is essential to reducing disease burden, the cost of chronic care and improving patient outcomes. Healthcare organizations need to take necessary steps to improve patient compliance by treating patients as partners and utilizing available healthcare technologies and PGHD.

Learn more about Acuma Health technologies to help you incorporate patient generated health data into your healthcare organizations or begin leveraging healthcare technology today with this guide.