They’re the gift that keeps on giving – wearables. Healthcare CIOs have to love wearables. I know what you’re thinking. What value do consumer products have to my healthcare provider organization? They aren’t accurate, they aren’t FDA approved, and none of my caregivers use them. Why would I love wearables? How can they be a gift to the owner of a highly regulated, complex, multi-functional caregiving organization?
Let me ask you three questions:
- Are you and your organization working on Big Data initiatives?
- Has your CEO or MD Director talked to you about Population Health yet?
- Are you working on interoperability initiatives trying to get better access to more patient data?
My expectation is that if you are a healthcare CIO you answered “yes” to at least two of these questions. Then I propose that wearables are a godsend to your problems. Here are three reasons why.
1. Big Data and Analytics
I recently attended a big data and analytics conference sponsored by a local health insurance organization. The keynote talk was given jointly by the CIO’s of the major health insurance host company and a major healthcare provider. Both stressed how important big data was to the futures of their organizations. In fact both took the opportunity to announce that they were hiring 100’s of data scientists over the next 18 months and encouraged audience members to apply on the spot. Big data is going to be critical to both cost savings and new revenue sources for healthcare and as such is making healthcare CIOs more operationally critical and more strategic.
So how fast can healthcare big data actually get here?
The figure at right shows two steps in the development of big data for healthcare organizations. The first is inter-system Electronic Medical Record (EMR) interoperability. If we assume that in any given region there are five to ten healthcare organizations serving the same population then interoperability, if it can be accomplished, can give a 5x-10x increase in the amount of data that can be leveraged with analytics.
But consider the oft forgotten data sources at the base of the big data pyramid – Patient Generated Health Data (PGHD). PGHD comes from basically three sources: self-reported patient measures (weight, blood pressure, blood glucose etc.), patient self- status (“How much pain do you feel?”, “How did you sleep last night?”, “What did you eat and drink today?”, etc.), and wearable devices. If you want to create a big data asset you have to make one of these two changes or both: find a valuable data stream that produces at a high rate or find a massive array of data sources. Now that we have wearables PGHD is both.
Let’s look at why this is true. For the sake of argument let’s focus on chronically ill patients and let’s say there are 100,000 such patients in the community. Those 100,000 patients already generate data in the 5-10 healthcare organizations. Assume they generate the following data each year (rounded to the nearest half kilobyte:
Average annual data via doctors visits:
- 4 blood tests 4 x 500 bytes
- 4 blood pressure tests 4 x 500 bytes
- 4 weigh-ins 4 x 500 bytes
- Two urine tests 2 x 500 bytes
- Physicians notes 10 Kbytes
- Various Admin info 10 Kbytes
For 100,000 patients, with full interoperability, the yield is about ~2.5GB of data per year. I have not included medical images as they are a special case of big data with specific diagnostic application.
Now let’s turn on PGHD from connected scales, blood pressure cuff, and a wearable device measuring activity, sleep data, and heart rate.
Average annual data via PGHD with wearables
- Daily weigh ins 365 x 500 bytes
- Daily blood pressure tests 365 x 500 bytes
- Self-reported notes 50 Kbytes
- Wearable data every 10 sec 3.1M x 100 bytes
Total size of the PGHD annual health record is ~310 MB. The same 100,000 patients yield roughly 31 TB of data per year.
So with PGHD the big data grows over 10,000 times faster than data from patient visits and clearly the data flow is dominated by the connected devices and wearables. Combine this with the unquestioned value of data from the patient’s real life and both the volume and richness of the data grows. If your job is to help aggregate, secure, and analyze big data for a healthcare organization, nothing will create opportunity like wearables.
2. Population health
Populaiton health, accountable care, Fee-for-Value – whatever you call it is it going to transform a trillion dollars of annual healthcare payments. Every healthcare CEO today is studying population health and Fee-for-Value wondering how it will be deployed and who it will affect their healthcare organizations business. So every healthcare CIO is wondering what it will mean to both the operation of the business and how the IT systems are going to have to change to supporty the new model. Population health will change operations in several ways: billing will be come outcome based – the trending word is bundled. Care giving is going to move from hospitals to clinics and then from clinics to the home.
But there is no population heath management if the caregiving system does not survey the population for which it is accountable. Wearables are the answer to this problem and healthcare CIOs who embrace wearables become critical to the solution. Wearable devices are like BYOD on steroids but this is a challenge CIO’s have learned to overcome. CIOs will be asked to integrate patient wearable devices into operations without violating compliance, privacy, or continuity of access to the data stream. More important they will be asked to help assure the quality of the data that streams out of every patient’s everyday life. But have no doubt, wearable data is going to be a key to the new Fee-for-Value care models.
3. Wearable data is easy
This final point may be counter-intuitive and a little dramatic. But acquiring and using wearable data, from an IT perspective, is easy. The reason is that the wearable device makers make it easy to get access to the data because easy data means more device buyers. Device makers like FitBit are now also offering HIPAA compliance. The device manufacturers deliver interoperability through their APIs and thus support the advantages of federated architectures. Access to the data is granted by the patient and immediately becomes part of the big data solutions over which the healthcare system has control. No translation required, no interoperability initiative, no special EMR device integration to manage. Yes, the PGHD still has to be integrated in the operational workflow, but that is exactly the function for which the CIO is accountable and that is the opportunity to create strategic advantage working with the organization’s operational leaders.
Wearable technology is wonderful gift for the rapidly changing world of accountable care. The devices connect patients into the caregiving system in a way that has previously only been possible during in-hospital care. The streams of data wearables make possible allow the healthcare organization to leverage the emerging cognitive tools now offered by IoT technology leaders like IBM. The combination of big data and these new analytic systems will inform and assist caregivers with all aspects of the patients life in an immediate, actionable manner.
That is if the CIO does not look this gift horse in the mouth.
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