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Some docs skeptical of home-generated data headed their way

By Joseph Conn

An avalanche of patient-generated health data from electronic home-monitoring devices is heading toward clinicians and healthcare organizations within two to five years. Many doctors, already struggling with electronic health records, remain skeptical just how useful such home-generated data will be.

Purdue's regional extension center in West Lafayette, Ind., for example, is one of more than 60 federally funded centers across the country helping office-based physicians and small hospitals implement EHRs. Most of Purdue REC's 3,000 clients have been primary-care practices. Upward of 70% of these physicians are employed by hospitals, according to its director, Randy Hountz.

For these newbies, there remains a “healthy skepticism” that clinical decision support tools and analytics—even using data generated in-house—will improve quality of care, Hountz said, much less patient-generated data pouring in from patients at home or on the go.

In addition to the skeptics, though, Hountz said, “We've seen some of the providers who are seeing their A1Cs for the last 90 days. That gives them a better perspective. You can send out reminders and that improves quality. The optimists can see that.”

Like it or not, though, data analytics is here to stay, Hountz predicts.

“We have more data than the average healthcare organization can manage right now,” he said. “We're going to have to be very proactive this year to make sure our organizations are equipped with data governance policies that will serve all aspect of care they are providing to their patient. You're seeing a lot of care being provided in the home. You talk about consumer engagement and that becomes more important as patients are seeding information into these systems.

Experts in patient-generated data see patient demand, and lower costs, as key drivers that will force clinicians to deal with this new data stream.

Kent Dicks, CEO of Alere Connect, a developer and provider of home monitoring connectivity devices and services, said the falling cost of wireless home monitoring devices and telecommunication systems that gather data from has made these systems more affordable. Today, a package of basic physiological monitoring devices—a wireless weigh scale, pulse oximeter, BP and blood glucose—and a home transmitter costs about $1,000 with the attendant monitoring service fee running about $10 to $15 a month, Dicks said. That's quite a drop from $3,000 for devices and $75 to $150 a month for the service initially, he said.

Another driver is that, with the advent of accountable care organizations, someone other than the patient now is willing to pick up the tab.

“The payers are paying for it or the providers are paying for it to reduce readmissions,” Dicks said. “If you want to line up the ACOs, they now have to transition to using tools to keep track of the patient and monitor them on a regular basis. They would really like to know if a patient is heading toward the emergency room and intervene.”

But for now, the acceptance and use of patient-generated health data by clinicians remains, “far from mainstream,” said Dr. Steven Steinhubl, director of digital medicine at Scripps Health.

“I think that once it takes off, it's going to take off exponentially, but I think we're still on the flat spot of the exponential curve,” Steinhubl said. “I think it's going to take one or two healthcare organizations to embrace it and provide the data. The journals are full of pilot studies. You'll really need a large clinic with several hundred if not thousands of patients.”

Follow Joseph Conn on Twitter: @MHJConn


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