Connected Health: Emerging Disruptive Technologies
2014; Project HOPE; Volume: 33; Issue: 2 Linguagem: Inglês
10.1377/hlthaff.2014.0042
ISSN2694-233X
Autores Tópico(s)Primary Care and Health Outcomes
ResumoFrom the Editor-In-Chief Health AffairsVol. 33, No. 2: Early Evidence, Future Promise Of Connected Health Connected Health: Emerging Disruptive TechnologiesJohn K. IglehartPUBLISHED:February 2014Free Accesshttps://doi.org/10.1377/hlthaff.2014.0042AboutSectionsView PDFPermissions ShareShare onFacebookTwitterLinked InRedditEmail ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsDownload Exhibits TOPICSTelemedicineHealth information technologyCost savingsPrescription drugsOrganization of careMobile healthPatient satisfactionTechnologyMarkets The explosion of knowledge through telecommunication is linking patients and providers separated by geography. This development, in turn, is increasing the potential of the health delivery system to achieve the "Triple Aim," the watchwords of reform driving changes in public- and private-sector actions outlined seven years ago in Health Affairs by Donald Berwick, Thomas Nolan, and John Whittington: better care, better health, and reduced per capita costs. This issue is largely devoted to papers that report early evidence and future promise of "connected health," the umbrella term arrived at to lessen the confusion over the definitions of telemedicine, telehealth, and mHealth. The importance of an array of emerging technologies and services is certain to grow as more people who reside in rural locales or areas of provider scarcity gain coverage and team-based care becomes a more prominent feature of the delivery landscape. In addition, as former Senate Majority Leader William Frist asserts in Entry Point, consumers newly empowered by actionable knowledge "will channel our chaotic, fragmented, and wasteful health care sector toward a more seamless, transparent, accountable, and efficient system." Health Affairs and the Bipartisan Policy Center (BPC) cosponsored a forum on connected health that was chaired by Senator Frist, a senior fellow at BPC. In an overview paper, Joseph Kvedar, Molly Joel Coye, and Wendy Everett underscore the breadth of uses to which connected health applies. Nationally, the Veterans Health Administration introduced a home telehealth program that demonstrated high patient satisfaction, a 25 percent reduction in bed days of care, and a 19 percent reduction in hospital admissions. Partners Healthcare in Boston documented decreased hospital readmissions and mortality among patients making use of home telemonitoring. Given that most forms of connected health are disruptive technologies, Lee Schwamm outlines seven strategies critical to successful telehealth implementation, while Keith Mueller and coauthors draw lessons from the use of tele-emergency services linking rural low-volume hospitals and an urban "hub" emergency department. However, Julia Adler-Milstein and her coauthors find that hospital telehealth adoption varies widely by state as a result of differences in state policy. In another sign of federalism American style, Tony Yang and Ross Silverman find a patchwork of policies that apply to mHealth applications related to licensure, privacy and security protection, and malpractice liability. Joseph Hall and Deven McGraw write that to realize telehealth's full potential, patients and providers must be sure that their information will be kept secure.Cost SavingsOne of the overriding questions facing connected health technologies is their potential for achieving cost savings. This uncertainty is clear in Medicare's policies, which reflect a go-slow approach to embracing telehealth services. In 2009 only 369 practitioners provided ten or more telehealth services to Medicare beneficiaries, and most were mental health services. Yet David Grabowski and James O'Malley provide the first indications in a controlled study of eleven nursing homes that switching from on-call to telemedicine physician coverage during off hours could reduce hospitalizations and therefore generate cost savings.Other SubjectsIn a close examination of hospital pricing power, Chapin White and coauthors find that high-price hospitals tend to be larger, be major teaching hospitals that provide specialized services such as Level I trauma care, and belong to systems with large market shares. In a study of the impact of opening a new supermarket in an underserved Philadelphia neighborhood, Steven Cummins and colleagues find that it led to moderate improvements in food accessibility but little change in fruit and vegetable intake or BMI.Thomas Hwang, Jerry Avorn, Daniel Carpenter, and Aaron Kesselheim examine the Food and Drug Administration's (FDA's) rulemaking process for drugs and other medical products. Although such regulations are critical to public safety, FDA rulemaking has been criticized for lack of transparency and lengthy duration. Of the rules studied by the authors, the median time to finalization was 7.3 years; they also find that longer review times are associated with reduced stringency compared to the originally proposed versions. They recommend expanding resources available to ensure greater efficiency in FDA rulemaking. Niteesh Choudhry and colleagues investigate statin use in India, which has the highest burden of cardiovascular disease among less developed countries and a unique prescription drug market. They find that while statin use increased markedly between 2006 and 2009, only a minority of patients actually received therapy.Funding SupportHealth Affairs greatly appreciates the support of the following organizations to enable publication of this issue: the California HealthCare Foundation, Kaiser Foundation Health Plan and The Permanente Medical Group, AT&T, Intel-GE Care Innovations, The Leona M. and Harry B. Helmsley Charitable Trust, Aetna Foundation, and the Carlos Slim Health Institute. Loading Comments... Please enable JavaScript to view the comments powered by Disqus. DetailsExhibitsReferencesRelated Article MetricsCitations: Crossref 10 History Published online 1 February 2014 Information Project HOPE—The People-to-People Health Foundation, Inc. PDF downloadCited byImpact of connected health interventions on psychological wellbeing and quality of life in patients with cancer: A systematic review and meta‐analysis22 September 2022 | Psycho-Oncology, Vol. 31, No. 10Supportive Care in Cancer, Vol. 30, No. 8Technology usage, eHealth literacy and attitude towards connected health in caregivers of paediatric cancerUse of patient-generated health data across healthcare settings: implications for health systems29 November 2019 | JAMIA Open, Vol. 3, No. 1Smart, Remote, and Targeted Health Care Facilitation Through Connected Health: Qualitative Study28 April 2020 | Journal of Medical Internet Research, Vol. 22, No. 4Connected Health16 October 2019 | Frontiers in Digital Health, Vol. 1The change of pediatric surgery practice due to the emergence of connected health technologiesTechnological Forecasting and Social Change, Vol. 146The Information Technology Revolution in Health Care14 December 2018The Extent and Coverage of Current Knowledge of Connected Health: Systematic Mapping Study25 September 2019 | Journal of Medical Internet Research, Vol. 21, No. 9Prevailing Opinions on Connected Health in Austria: Results from an Online Survey11 August 2016 | International Journal of Environmental Research and Public Health, Vol. 13, No. 8
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