Advancing Precision Medicine with Wearable Healthcare Technology – Now. Powered by Northrop Grumman
In the United States, the annual waste of health care – from failure to provide care to overtreatment – ranged from $ 760 to $ 935 billion, according to Journal of the American Medical Association. But wearable healthcare technology is poised to reverse these trends. New laws that allow physicians to embrace innovations in portable diagnostic and assistive devices could help usher in a new era of precision medicine that cuts medical costs and saves thousands of lives.
âStudies have shown that people using these types of devices are more involved in their own health than those who don’t,â says Michael Wittman, program manager at Northrop Grumman Information Systems in McLean, Virginia.
Fitness trackers are growing
Today’s portable healthcare technology has its origins in old fashioned pedometers who could count the number of steps a person took each day. Activity trackers began to appear in the late 2000s, like bracelets connected wirelessly to a smartphone app. In addition to tracking footsteps, most of these consumer devices were able to detect heart rate, sleep patterns, and flights of stairs. The data they collected was informative, but it was not detailed enough to fuel a medical diagnosis.
Things started to move in 2018. Apple introduced its Series 4 Watch, which had the ability to take an FDA-approved electrocardiogram (ECG) and share it with a doctor. The door to medical diagnostics was opening for wearable healthcare technology, but one detail remained. Even though a doctor could receive medical-grade data, he was unable to bill an insurance company for the related services. The situation would be similar to that of a doctor making a medical recommendation based on the result of an MRI, but not being able to charge for it.
The Centers for Medicare & Medicaid Services (CMS) saw the problem and passed changes in January 2019, said Pete Ianace, senior vice president of business development at VitalTech in Dallas, Texas. They released a handful of insurance codes that doctors could use to bill Medicare for services related to portable diagnostic and assistive devices.
For example, says Ianace, if a doctor writes a prescription for a patient with a Medicare benefit to wear a health monitoring bracelet, Medicare will pay the doctor $ 65 per month as long as the patient is wearing the device. If the doctor or nurse at that office spends 20 minutes a month reading the data, the doctor can charge $ 54. If the patient sends a photo, for example, of a rash that could be a side effect of a drug, the doctor can charge $ 13. The list is long because from January 2020 CMS is adding more codes.
âToday’s exhausted physician now has the ability to provide remote care, from telehealth to remote monitoring, and essentially add a million dollars in revenue a year to a single practice – and , by the way, to achieve better patient health outcomes, âsays Ianace.
Precision medicine in the making
Wearable medical devices in development not only track activity, including heart rate, steps, and calories burned, but also have sensors that detect vital signs, such as respiratory rate, blood oxygen levels, and irregular heartbeat. Patients at risk, such as the elderly with diabetes, asthma, chronic obstructive pulmonary disease (COPD) and heart irregularities, have a lot to gain from these portable devices. A medical grade gadget can be programmed with a patient’s basic biometric data along with their prescription regimen and automatically send regular updates to a doctor. If a patient’s usual activity or biometric indicators are outside normal ranges, the system can send an alert to a phone application owned by the patient or a family member.
Advances in health technology will improve the treatment and prevention of disease taking into account an individual’s medical history, environment and lifestyle. If a person with diabetes has too high blood sugar, for example, a medical device may issue a warning telling them to adjust their medication. If the air quality is poor on a hot summer day, the device may warn a patient with asthma to take precautions or stay indoors. Portable healthcare devices can remind people to take specific medications at specific times, detect falls, and serve as panic alerts that connect users to immediate assistance.
In response to the potential of wearable healthcare technologies, the market is exploding. According to To be tidied, Gartner market analysts have estimated that spending on wearable products, including smartwatches, will grow from $ 41 billion in 2019 to $ 52 billion in 2020. This trend is already underway. In late October 2019, Optum, a division of insurance giant United Healthcare, acquired Vivify Health, a patient tracking platform, said CNBC. And a few days later, Google announced that it had purchased Fitbit, the fitness wearable.
Use with caution
As with any emerging field, especially one that has an impact on a patient’s health and well-being, there will be challenges.
In an essay published in the Journal of the American Medical Association, doctors at Harvard Medical School, Beth Israel Deaconess Medical Center and Massachusetts General Hospital warn of technological advances in healthcare with wearable devices.
In a summary provided by the American Medical Association, the study authors write that although insurance companies have started rewarding policyholders for healthier activity, calorie intake, blood pressure, and weight tracked by wearable devices, these companies may start to penalize less healthy people with higher premiums because there are no regulations to stop them. Doctors also warn that collecting inaccurate data could unintentionally result in penalties or harmful treatment. For example, if a device registers activity levels much lower than the person produced, the numbers could reduce insurance premiums. Or, if a device gives false positive readings, doctors could potentially recommend harmful treatments.
They also point out that patients who cannot afford portable devices and are not covered by Medicare may not be able to participate in incentive programs. They would miss out on insurance premiums and, more importantly, the health benefits offered by technology.
Finally, doctors write that data from digital health devices could be intercepted by third parties and used inappropriately. Data collected by a portable device is not protected by the health insurance portability and liability law, the doctors said.
Wittman says that in order to increase adoption and be able to use the technology clinically, tech companies must manufacture devices that produce medically relevant data. Strong guidance from the FDA can help make medical devices reliable and accurate. But it may just take a while.
âI think you’re going to see more and more devices approved for home use as the technology evolves,â says Wittman.