1) Connected health technologies like wearables, home devices, and remote patient monitoring apps have the potential to transform chronic disease management by allowing patients to manage conditions at home independently. 2) Remote patient monitoring is increasingly being used to monitor chronic conditions like congestive heart failure and is showing success in reducing hospital admissions. Technologies also support healthy aging by enabling aging in place. 3) While connectivity offers opportunities, deploying and managing these systems poses challenges for providers and patients regarding technical support, data security and privacy, and maintaining remote monitoring equipment.

1. How Interconnectivity Is Enabling
The Future Of Patient-Driven Health
John Sharp, Senior Manager
Personal Connected Health Alliance

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Connected health and
Remote patient monitoring
Connected health and remote patient monitoring, combined with
interactive patient engagement apps,
have a tremendous potential to transform chronic disease management
for patients to manage at home allowing them to live their lives with
independence.
But deploying such programs, and managing the IoT assets they often
depend on, can pose a host of challenges at both the provider and the
patient level.

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Outline for this Webinar
Growing availability of consumer wearables, home IoT smart devices and smart homes
create an opportunity for a connected life which supports health
Consumers are increasingly aware of how technology and apps can engage them in
healthier lifestyles
Remote patient monitoring is increasingly being used to monitor chronic conditions and
showing success in reducing hospital admissions for some (KLAS Report). I may add
something on new reimbursement becoming available.
For the elderly population, aging in place and more generally, healthy aging, can be
supported by this new pervasive technology
Challenges to deploying, maintaining and scaling this technology existing but can be
addressed successfully as providers and patients use them more routinely

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How close are we to
a connected life?

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Connected Devices We Use Every Day
When Mobile
• Phone
• Tablet
• Wearables
• Smart Clothing
At Home
• Voice enabled devices
• Smart TVs
• Smart thermostats
• Smart security systems
• Smart appliances

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Smart Health Devices
Wearables/mobile
• Activity monitors including heart
rate
• Continuous Glucose Monitor
• Digital asthma inhalers
Wireless devices
• Scale
• BP monitor
Apps
• Coaching for wellness, chronic
conditions
• Weight loss apps
• Monitoring conditions using
mobile phone tools –
accelerometer, camera, etc.

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How Networks Facilitate Health
Wireless networks High availability but extra cost and maintenance in
the home
Cellular Broadly available with some exceptions in remote
areas. Useful for home health nurses and
community health workers when clients don’t have
broadband
5G The future high speed network. Will likely have
many benefits for remote monitoring and
telehealth.

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Consumer
Awareness
Smartwatches
• 40 million in 2018
• 90 million in 2022
Employers and
health plans
incentivizing use

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Consumer Awareness
Through fitness devices,
are learning how to use
health dashboards

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Consumer Awareness
Voice devices – personal assistants

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Alexa Health and Fitness Skills
Over 1000 available
• Medication reminders
• Meditation apps
• 5 minute workout
• Health information (WebMD, others)
• Sleep assistance
• Diabetes support

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Monitoring Chronic
Conditions

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Monitoring Chronic Conditions
Remote Patient Monitoring
Data from Glucose monitors, Blood Pressure monitors, CPAP, scales, apps, etc.
• Sending Data to medical team
• Presenting Data to patient – health dashboard concept
Example – monitoring Congestive Heart Failure patients recently discharged with a
blood pressure monitor and scale
Rise in blood pressure and weight (due to fluid retention) key indicators of
deterioration.

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Managing Chronic Conditions
Asthma – monitoring with digital inhaler
Includes information on location, air pollution, number
of puffs at what time of day, use of rescue inhaler
One study found that use of the digital inhaler
provided better control of asthma and reduced cost by
$930 per year

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Chronic Condition Management
Putting digital tools into the hands of visiting nurses and
community health workers
BehaveCare provides services to Medicaid recipients in Rhode
Island.
As part of their home visits, the care provider can use their
device to initiate a video consult over cellular to a physician.
They can also share medical information during the visit

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Example of new CPT reimbursement codes for
Remote Patient Monitoring

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Healthy Aging
through Digital

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Healthy Aging through Digital
Aging in Place Made Easier – from AARP
Technologies allow older adults to remain active and independent
1. Ride-booking apps
2. Videoconferencing
3. Telemedicine
4. Nutrition tracking
5. Immediate delivery

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Healthy Aging through Digital
Remote Monitoring to Keep Older Adults Independent and Safe
• Safety and security-monitoring
• Assured Living program, which uses sensors to track activities such as opening a
refrigerator or medicine cabinet
• Location-tracking devices
Family caregivers can monitor from afar
However, deploying these can be daunting
• Needs to be simple to set up and have tech support available
• Need to include the elderly relative in the decision to use

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Healthy Aging through Digital
Reducing Social Isolation
• Robotic pet
• Voice-enabled smart speakers
• “tell me a story”
• Bots who answer you
• Caregiver apps and online communities

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Healthy Aging through Digital
What about smart homes?
• Include multiple sensors
• Temperature control
• Lighting control
• Cameras
• Locks control
• Fall detection/prevention
• Can be monitored/controlled remotely
• Still in early adoption
• More common in senior communities
in the future?

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Challenges to
deploying Health IoT

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Challenges to deploying Health IoT
Network reliability
 Are the tools reliant on a home wireless network
 What if the network goes down
 Is it dependent on cellular service – coverage available in most of the US except
for some remote rural areas
 Some urban areas underserved

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Challenges to deploying Health IoT
Setup of devices and apps
• Has become simpler, videos often available
• Some more reliant on training, e.g., are you attaching the blood pressure cuff
correctly?
• Use of multiple devices can add to complexity

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Challenges to deploying Health IoT
Technical support
 Need to know the technology they are supporting
 Need to understand the customer (chronically ill, elderly)
 Need to trouble shoot in basic terms for the non-tech savvy
 Need to be available 24/7
 Need to detect equipment malfunction based on data transmitted
 Need to have a delivery service for replacing equipment
 Video calls may be helpful

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Challenges to deploying Health IoT
Privacy and Security
 Is the data encrypted on the device and in transit?
 Where is the data stored?
 Does the manufacturer own the data? Is the patient aware of this?
 How is the data secured when it is received by the provider?
 Is the data securely transmitted to an app? Stored on the mobile device?

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Challenges to deploying Health IoT
Maintaining Remote Monitoring Equipment
o Cleaning instructions
o Supplies needed?
o Example – Continuous Glucose monitor
o Trouble shooting
o Replacement
o Costs

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Summary
How Interconnectivity Is
Enabling The Future Of
Patient-Driven Health

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Summary - Interconnectivity and Patient Care
1) We are approaching a pervasively connected life
2) Consumer awareness of digital health tools is growing
exponentially
3) Monitoring chronic conditions is in its initial stages but will
quickly become more common to devices, apps and
networks enable it.
Even routine prescribing of apps and devices will ramp up

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Summary - Interconnectivity and Patient Care
4) Health aging through digital – tools available for
consumers and caregivers, smart homes with IoT
devices focused on health being adopted to enhance
aging in place
5) Challenges to deploying, maintaining and scaling
exist but can be successfully addressed

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Contact me
@JohnSharp
Linkedin.com/in/johnsharp
jsharp@pchalliance.org
www.pchalliance.org

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Thank You!
www.pchalliance.org