At-home predictive care and the shifting patient experience

09 Jan 2023
www.medicaldesignandoutsourcing.com
Diagnostic Reagents
These medtech developers are advancing remote patient monitoring, virtual care, and AI predictive care. Robin Farmanfarmaian The combination of remote patient monitoring (RPM), virtual care and AI predictive care is changing the patient experience. Instead of the occasional clinic visit, people can interact with their healthcare daily and on-demand. Here are a few of the medtech startups advancing remote, continuous and predictive care. Together, these companies enable truly personalized care, tailored to someone in their daily life and environment. Remote patient monitoring (RPM) There are many technology devices that have cleared the FDA and qualify as remote physiologic monitoring under the Medicare CPT codes. Medicare also has remote therapeutic monitoring CPT codes for musculoskeletal and respiratory problems. Some devices that qualify include the Apple Watch and AliveCor, which monitor EKG. Other devices include epidermal electronics like VitalConnect and BioIntellisense that stick to the chest to track vitals continuously. BioIntellisense collects over 1,000 measurements a day. There are multiple continuous glucose monitors that track glucose levels, including Abbott’s Freestyle Libre, Dexcom’s G7 and the six-month implantable sensor from Eversense. Other devices are connected and can be used on demand wherever the patient is located, including the Oxitone pulse oximeter watch and Omron’s blood pressure monitoring watch. RELATED: The cloud is transforming medtech: Amazon, Microsoft, Google, J&J, Philips and GE Healthcare leaders explain Virtual care tools Connected RPM devices are an important addition for actionable telehealth and virtual care. Beyond those devices, other important tools enable telehealth to rival and replace an in-person clinic. TytoCare has a telemedicine exam kit that enables virtual physicals, allowing an individual to place a video call to a healthcare provider using the TytoApp. Medical device applicators including an otoscope, stethoscope and tongue depressor plug into the video camera device. The provider instructs the patient on how to use each device while watching the live video camera feed. “Please move the otoscope to the right,” the provider might say, or “Move the tongue depressor a little to the left.” It’s a step close to the provider reaching their hands through the computer screen. REGULATORY: HHS offers guidance for HIPAA-compliant audio telehealth In-home diagnostics Patients can skip the trip to a clinic or urgent care for lab tests now that so many diagnostic testing companies such as LabCorp, Quest, and eMed offer direct-to-consumer diagnostic labs. These in-home diagnostic tests can cover important labs like CBC, liver function, kidney function, A1C, thyroid, cholesterol, COVID-19, and UTIs, just to name a few. Some tests require the patient to collect a capillary blood sample from their fingertip and mail the kit to the laboratory, while others use nose swabs or urine samples to give results within 15 minutes. One main problem with integrating these diagnostics into a telehealth visit is when results come back abnormal or positive. In those cases, a telemedicine physician would likely need to repeat the test using a physical lab or at-home phlebotomist to verify that the test was taken by the correct patient, the specimen was collected and processed correctly, and that the results were interpreted correctly. eMed solves this problem with an FDA-authorized testing process that includes patient identification, medical data chain of custody, and seamless initiation of medical consultation and treatment. eMed’s telehealth proctors-on-demand verify and validate the patient’s identity, that the test was taken correctly, and the results were interpreted accurately. When there is a positive test result, eMed can initiate a telehealth session with a provider to order a prescription based on the certified test results and the patient’s health. Those certified results can be sent to their physician as well. If a medication is prescribed, the medication can be sent directly to the patient’s home, depending on the pharmacy. With the eMed platform, illnesses like UTIs and COVID-19 can be treated immediately, when the treatments are the most effective. Predictive care Many treatments for oncology are high-risk and can have expensive and deadly side effects. To monitor EKGs, EEGs, blood oxygen saturation, blood pressure and other vital signs continuously, Alacrity Care has developed a platform that uses devices like the Oxitone and Omrom. Combining these devices with in-home blood labs and patient-recorded symptoms allows the oncology team to analyze the patient’s data and catch medical problems like neutropenia, sepsis and cytokine storms early, sometimes even when they can still be avoided and long before a patient needs to be hospitalized. For example, neutropenia makes patients more susceptible to life-threatening infections. The earlier problems like neutropenia are caught, the easier they are to treat successfully, which can save the patient’s life. DEVICES: How SeaStar’s device could prevent lasting damage from COVID cytokine storms VitalConnect is another interesting company with an FDA-cleared, 24-hour disposable patch that monitors eight physiological measurements, including a single-lead EKG, heart rate, heart rate variability (HRV), temperature and even posture. They also have the ability to integrate connected devices for vitals like blood pressure and blood oxygenation. VitalConnect’s patch can be used for inpatient and outpatient monitoring, including acute care at a hospital-at-home. VitalConnect found in a study that they were able to predict a cardiac hospital readmission 6.5 days in advance with 80% accuracy. When dealing with cardiac issues, VitalConnect can be the difference between life and death. A combination of clinical-grade remote patient monitoring devices, in-home diagnostics, software platforms, and AI-based predictive algorithms are making virtual care an effective reality for people, regardless of location. By taking location out of the equation, this move to the digital point-of-care shifts healthcare from reactive to proactive and continuous, 24 hours a day. Robin Farmanfarmaian is a Silicon Valley-based speaker and entrepreneur working in cutting-edge tech poised to impact 100 million people or more. She has been involved with over 20 early-stage biotech and healthcare startups from curing cancer to medical devices and digital health, and has written four books, most recently “How AI Can Democratize Healthcare: The Rise in Digital Care” with Michael Ferro. How to join the MDO Contributors Network The opinions expressed in this blog post are the author’s only and do not necessarily reflect those of Medical Design & Outsourcing or its employees.
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