9 Digital Health Trends For 2014 - InformationWeek

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Healthcare // Policy & Regulation
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9 Digital Health Trends For 2014

Step back, EHRs. These healthcare IT innovations are poised to take center stage in 2014.

Surgical Robots: Look Who's Coming To The OR
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.

[Cognitive computing will drive dramatic improvements in healthcare, says IBM. Read more: IBM Predicts Next 5 Life-Changing Tech Innovations.]

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.

3. Telehealth
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?

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User Rank: Author
12/24/2013 | 10:45:40 AM
Re: Wearables: how broad an appeal for health monitoring?
There's at least one kind of very common wearable device for managing a chronic condition: the insulin pump for Type 1 diabetics. It's not collecting and sending data that can then be acted on; it's managing the disease directly. But it's strapped on your belt -- truly wearable in that sense. 
User Rank: Apprentice
12/24/2013 | 10:42:00 AM
10. Standards
Android and iOS have become widely accepted platforms for developing smartphone & tablet add-on products, allowing designers to exploit the work of others and the immense compute power of these mobile devices, support what people already have and use, reduce costs, speed time to market, and expand market reach. Next is to select a networking standard that offers similar benefits and enables interoperability. While there are many options to chose from (including ANT+, Bluetooth LE, Wi-Fi, Zigbee and Z-Wave), and each has a set of advantages, the ones most likely to succeed in medical devices are the ones already included in smartphones: Bluetooth & Wi-Fi. 

See The Role of Standards in Telehealth
Ken Terry
Ken Terry,
User Rank: Apprentice
12/23/2013 | 4:39:05 PM
Re: Wearables: how broad an appeal for health monitoring?
Amen. There's such a thing as too much monitoring. I don't think most Americans would like the nanny state to tell them how to live their lives. But would someone who has a history of heart disease in their family want to be monitored for early signs that they might have sudden cardiac arrest? You bet.
David F. Carr
David F. Carr,
User Rank: Author
12/23/2013 | 4:35:09 PM
Wearables: how broad an appeal for health monitoring?
I can't help thinking of the astronauts in the film version of Apollo 13 ripping off their monitoring gadgets because they didn't want the flight surgeon keeping tabs on them in the midst of a crisis.

If health monitors get too good, you'll have to rip them off before going to the Christmas party if you don't want a lecture on overindulging in alcohol and dessert at your next doctor's visit.
Ken Terry
Ken Terry,
User Rank: Apprentice
12/23/2013 | 1:55:10 PM
Re: Telehealth's moment
I agree that telehealth can not only generate big savings but also increase access to care--an especailly important benefit at a time when there aren't enough primary care doctors to go around. But the business case works only for payers and for provider organizations that take financial responsibility for care delivery. Until there are more of the latter, telehealth will languish in the private sector.
User Rank: Author
12/23/2013 | 1:01:59 PM
Telehealth's moment
Teleheath is a technology where the time has come from both the tech and the business model standpoint. Big obstacle has been getting doctors paid for virtual visits, and I think we'll see those barriers blown away as the cost savings and convenience just seem too compelling.
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