Step back, EHRs. These healthcare IT innovations are poised to take center stage in 2014.
Surgical Robots: Look Who's Coming To The OR
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Healthcare IT is surging with activity -- so much that it's hard to predict which trends are likely to have the biggest impact in 2014. That said, it looks like EHRs will take a back seat; breakthroughs in electronic documentation are not expected in the near future. Other applications and devices, particularly those related to mobile health and big data, are taking off.
With all that in mind, here are some trends worth watching in the New Year.
1. Wearable monitors
A Consumer Electronics Association survey released this month found that 13% of US adults are interested in purchasing wearable fitness devices (versus 3% in 2012), and 9% of consumers actually own such devices.
Wearable devices are not being used much to manage chronic conditions, but that could change. A number of such devices have been developed, and some are being tested. For example, as part of the University of California San Francisco's Health eHeart study, iHealth's mobile blood pressure monitor is being used to measure flow-mediated dilation, a heart health indicator traditionally gauged by ultrasound tests.
Eric Topol, MD, director of the Scripps Translational Science Institute, predicted in a HIMSS keynote speech last winter that, over time, consumers will start wearing or using sensors to measure their activity and changes in their vital signs. But Jonathan Collins, principal analyst for ABI Research, said that, before that happens, physicians will need to accept and value physiological data generated by wearables and other mobile devices.
2. Smart sensors
As the aging-in-place sector of the healthcare industry grows, smart sensors that track the locations, routines, and activity of elderly people at home and in assisted living facilities are being more widely used. This telecare branch of telehealth includes emergency response systems, geolocators, and other kinds of devices that use smart sensors.
"Sensors can alert family members, for instance, if the patient has not risen and walked around in the morning, or if the lights have not been turned on during expected hours," a recent CSC report said. "Integrated sensors built into the home and/or worn by patients can enable geo-fencing and location-based alerting."
A new AT&T emergency response system uses accelerometers, magnetometers, and gyroscopes to track users' daily activities. If an elderly person falls and can't push the emergency button on a pendant, the device can identify the fall as a break from the patient's routine and alert a monitoring center.
The Department of Veterans Affairs (VA) has blazed a trail in telehealth that the private sector may follow as it tries to contain costs and increase access. In fiscal year 2012, nearly half a million veterans received care remotely from 150 VA medical centers and 750 outpatient clinics. That included remote consultations, home monitoring, and store-and-forward services. Nearly 150,000 veterans participated in virtual visits with physicians, and remote monitoring made it possible for 42,000 patients to stay at home rather than being institutionalized.
The private sector lags far behind the VA but is starting to catch up in remote consultations. This trend has been fueled largely by health plans, which pay telehealth services to connect physicians with patients who might otherwise visit an ER or an urgent care center. American Well, one of the leaders in this field, recently started selling its service directly to consumers.
One obstacle to these initiatives is a patchwork of state laws that are inconsistent and often obstruct telehealth providers. Proposed legislation in Congress aims to reduce this confusion by giving states some guidance on telehealth regulations.
4. Google Glass v. Kinect
Google Glass's potential in the operating room is generating excitement among surgeons. Philips and Accenture recently demonstrated a prototype of a system that allows surgeons to view vital signs on a head-mounted Google Glass display while performing operations. In a Birmingham, Ala., hospital, surgeon Brent Ponce used the camera built into Google Glass to beam images of a shoulder operation to a colleague in Atlanta, who used a Glass app to share observations with Ponce virtually. Similar experiments are likely in 2014.
Microsoft Kinect, a motion-sensing technology used in video games, has shown it can help surgeons manipulate images in the OR while preserving a sterile field. Kinect allows a surgeon to rotate or enlarge images on a screen without touching a keyboard and wasting precious time by having to scrub in again. A 2012 study validated that the system can discriminate between intentional and unintentional gestures most of the time. Could Glass and Kinect be somehow paired together?