The Center for Connected Healthcare at Partners HealthCare in Boston has announced that it will begin integrating data from its home remote monitoring devices directly into Partner’s electronic health record system.
Patient data including blood pressure, weight and blood glucose data will be transmitted to the Center’s remote monitoring database, but, unlike previously, that data will now be displayed alongside the patient’s charts and other information in the EHR. Patients will also be able to view their own remote monitoring data through an online patient portal.
This announcement is the culmination of many years of work at the Center, according to founder and director Dr. Joseph Kvedar. He told MobiHealthNews that the process began around 2005, when the Center began running several different pilots on remote monitoring for blood pressure, blood glucose, activity and weight. At that point they made the decision to convert all the data from various devices into the same format in a data repository, which also integrated with Microsoft HealthVault.
“When you’re at the beginning of something like this, you don’t want to do that integration up front, because you’re spending a lot of money on integration, and that money might be wasted if it doesn’t improve outcomes,” Kvedar said. “As we are prone to do, we collected data on outcomes and found that heart failure monitors reduced readmission by 50 percent, diabetic monitoring reduces A1C by 1.5 percentage points on average, and 69 percent of our high blood pressure patients show a drop in blood pressure when they’re monitored. Doctors would say ‘I get it, it works, but I can’t do any more because it’s not integrated into the ER.’”
In all the Center’s previous pilots, doctors had to view the data from patient monitoring devices through a separate portal. Kvedar said the Center has been working on EHR integration for the past year. The devices involved are a range of sensors from Omron, A&D, and OneTouch among other companies, Kvedar said. The sensor data is collected through Alere Connect (formerly MedApps), and the Center is just beginning to use Qualcomm Life’s 2net hub as well. The EHR for Partners Healthcare is an in-house system, but Partners is switching to Epic shortly and Kvedar says the whole platform will port over when they do.
The advantages to the monitoring are twofold: one big part is patient empowerment, but the system also allows nurses and doctors to spot patients who aren’t taking care of themselves and intervene in what Partners calls “just in time care.”
“The care model that this supports is one where individuals are constantly monitoring their own physiology in a quantified self sort of way. If they have high blood pressure, they’re in charge of taking their blood pressure; if they have diabetes they’re obviously measuring their blood glucose, etc. So one benefit is patients began to take charge,” said Kvedar. “The second value is that it enables a clinican, typically a nurse or a pharmacist, to manage a whole slew of patients. We have software that shows them which patients are having worse readings at any point in time and they can reach into that patient’s life and help them. In aggregate, those two value propositions lead to better outcomes.”
Partners is among the first healthcare systems to connect their remote monitoring to an EHR. WellDoc integrated its diabetes manager with Allscripts in a pilot back in 2010, although it only recently published the results.
Kvedar says there’s a lot that can be done beyond just dumping the data into the EHR — future plans revolve around making that data easier for doctors to read and use, even incorporating clinical decision support tools. Kvedar said tools like these are going to be in high demand as more hospitals move from fee-for-service to outcome based reimbursements and ACOs.
“We’re quite proud of the project and it’s really emblematic of where healthcare is going,” Kvedar said. “It really puts the emphasis on the patients and on caring for more patients more efficiently.”